One important hypothesis describe that anorexia nervosa happen because of dopamine overactivity on hypothalamus triggered by psychological stress or severe diet effort. Self induced vomit represent one way of anorexia patient to get or maintain decrease body weight that desired.

One third of patient feel gastrointestinal disorders and blame this condition as cause of decrease of their appetite. Another symptoms are headache, dry skin, hair fall, nocturia, and dyspnea d’ effort. Most of subcutis fat  is lose and the body is very thin. The back and extremity often covered with smooth hair, and acrosianosis often happen. About 30% case show hypotension and bradycardia. Hypothermia usually happen on severe emaciation. It is often found atrophy of mammae, little pubic hair and axillary hair.

Patients are seldom the man. Self induced vomit often happen in adult women than girls, especially at patient with this history since 2 years ago. They are people with overweight conditon before they start to emaciate body, with severe activity than pure dietarian, having tendency related with drugs abuse and alcohol, and they also tend to have histerionic and compulsive personality.

Vomit and using laxative drugs usually happen together and both of it can lead to dehydration condition and lose of electrolyte. Lose of K⁺ for a long time through feces and vomit accompanied with low K⁺ intake related to severe muscle weakness on the patient even they deny it.

Vomit repeatedly for twice or three times a day for months can cause perioral dermatitis. Vomit contain stomach acid can damage teeth so that induce large caries dentis. Increase of blood ureum and hypokalemia with or without alkalosis can representing biochemistry indicator that show there are recurrent vomit and using laxative drugs.

The prognosis is worse at patient vomit and using laxative drugs than at patient decrease body weight only with hard diet. (doc b3ty)