Many people with anorexia nervosa see themselves as overweight, even when they are starved or are clearly malnourished. Eating, food and weight control become obsessions. A person with anorexia nervosa typically weighs herself or himself repeatedly, portions food carefully, and eats only very small quantities of only certain foods.
According to some studies, people with anorexia nervosa are up to ten times more likely to die as a result of their illness compared to those without the disorder. The most common complications that lead to death are cardiac arrest, and electrolyte and fluid imbalances and suicide.
Many people with anorexia nervosa also have coexisting psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse, cardiovascular and neurological complications, and impaired physical development.
Causes of Anorexia Nervosa:
It is not known specifically what causes some people to develop Anorexia Nervosa. As with other mental illnesses, there are many possible factors that could play a role in the development of eating disorders, such as genes, certain behaviors, psychological disorders, and family and societal influences:
- Biological: Some people may be genetically vulnerable to developing anorexia nervosa. A person with a biological sibling or parent with an eating disorder has a higher risk of developing the disease. Researchers have discovered an area on chromosome 1 that appears to be associated with an increased susceptibility to anorexia nervosa but are still trying to determine exactly how genetics play a role.
- Emotional Health: People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may have low self-esteem, perfectionism, impulsive behavior, anger management difficulties, past trauma, family conflicts and/or troubled relationships. They may have low self-worth or may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry. Individuals may have an extreme drive for perfectionism, which means they may never think they're thin enough.
- Society: The modern cultural environment often cultivates and reinforces a desire for thinness. Success and worth are often equated with being thin in popular culture. Peer pressure and what people see in the media may fuel this desire to be thin, particularly among young women.
Risk Factors for Anorexia Nervosa
- Sex: Anorexia is more common in girls and women. However, boys and men have been increasingly developing eating disorder.
- Age: Although people of any age can develop an eating disorder, Anorexia is more common among teenagers. Teenagers may be more susceptible because of all of the changes their bodies go through during puberty. They also may face increased peer pressure and may be more sensitive to criticism or even casual comments about weight or body shape.
- Family History: A person with a biological sibling or parent with an eating disorder has a higher risk of developing the disease.
- Weight Changes: When people lose or gain weight — on purpose or unintentionally — those changes may be reinforced by positive comments from others if weight was lost, or by negative comments if there was a weight gain. Such changes and comments may trigger someone to start dieting to an extreme.
- Life Changes: Whether it's a new school, home or job, a relationship breakup, or the death or illness of a loved one, change can bring emotional distress and increase the risk of anorexia nervosa.
- Occupation: Athletes, actors and television personalities, dancers, and models are at higher risk of anorexia. For some professions, thinness may even be a professional requirement. Sports associated with anorexia include running, wrestling, skiing, figure skating and gymnastics. Professional men and women may believe they will improve their performance by losing weight, and then take it to an extreme. Coaches and parents may inadvertently raise the risk by suggesting that young athletes lose weight.
- Media and society: The media, such as television and fashion magazines, frequently feature a parade of skinny models and actors. But whether the media merely reflect social values or actually drive them isn't clear-cut. In any case, these images may seem to equate thinness with success and popularity.
Anorexia Nervosa Symptoms:
Some people with anorexia lose weight mainly through severely restricting the amount of food they eat. They may also try to lose weight by exercising excessively. Others with anorexia engage in binging and purging, similar to bulimia. They control calorie intake by vomiting after eating or by misusing laxatives, diuretics or enemas.
No matter how weight loss is achieved, anorexia has a number of physical, emotional and behavioral signs and symptoms.
Physical Symptoms of Anorexia Nervosa include:
- Extreme weight loss
- Refusal to maintain body weight of at least 85% of normal expected weight
- Thin appearance
- Abnormal blood counts
- Dizziness or fainting
- Brittle nails
- Hair that thins, breaks or falls out
- Growth of fine hair covering the body
- Absence of menstruation in women
- Dry skin
- Intolerance of cold
- Irregular and slow heart rhythms
- Low blood pressure
- Swelling of arms or legs
Emotional and Behavioral Anorexia symptoms:
- Refusal to eat
- Denial of hunger
- Excessive exercise
- Flat mood, or lack of emotion
- Social withdrawal
- Preoccupation with food
- Reduced interest in sex
- Depressed mood
- Possible use of herbal products or diet aids
Complications of Anorexia Nervosa:
Complications of anorexia include:
- Heart problems, such as mitral valve prolapse, abnormal heart rhythms and heart failure
- Bone loss, increasing risk of fractures later in life
- In females, absence of a period
- In males, decreased testosterone
- Gastrointestinal problems, such as constipation, bloating or nausea
- Electrolyte abnormalities, such as low blood potassium, sodium and chloride
- Kidney problems
If a person with anorexia becomes severely malnourished, every organ in the body can sustain damage, including the brain, heart and kidneys. This damage may not be fully reversible, even when the anorexia is under control.
In addition to the host of physical complications, people with anorexia also commonly have other mental disorders as well. They may include:
- Anxiety disorders
- Personality disorders
- Obsessive-compulsive disorders
- Drug abuse
Treating Anorexia Nervosa
The treatment of anorexia nervosa involves four components:
1. Restoring the person to a healthy weight
2. Treating the psychological issues related to the eating disorder
3. Reducing or eliminating behaviors or thoughts that lead to disordered eating
4. Preventing relapse.
Different forms of psychotherapy, including individual, group and family-based, can help address the psychological reasons for the illness. Some studies suggest that family-based therapies in which parents assume responsibility for feeding their afflicted adolescent are the most effective in helping a person with anorexia gain weight and improve eating habits and moods.
The combined approach of medical attention and supportive psychotherapy designed specifically for anorexia patients is the most effective care for their recovery
What to look for - Anorexia Nervosa Red Flags:
It may be hard to notice signs and symptoms of anorexia nervosa because people with anorexia nervosa often go to great lengths to disguise their thinness, eating habits or physical problems. If you're concerned that a loved one may have anorexia, watch for these possible red flags:
- Skipping meals
- Making excuses for not eating
- Eating only a few certain "safe" foods, usually those low in fat and calories
- Adopting rigid meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing
- Cooking elaborate meals for others but refusing to eat
- Repeated weighing of themselves
- Frequent checking in the mirror for perceived flaws
- Complaining about being fat
- Not wanting to eat in public
Many anorexics deny having a problem; however, some do recognize their eating disordered behavior, but do not know what to do to fix it. Anorexia is a debilitating illness that for some is hard to understand, but for those who suffer from it, find it hard to over come.
With treatment, you can gain a better sense of who you are, return to healthier eating habits and reverse some of anorexia's serious complications. Often those who have anorexia nervosa suffer with the disorder for years, feel ashamed, depressed may feel very alone. It is important to recognize that you are not alone, there are millions like you and there are successful treatment options available for you.