Anorexia Nervosa – Causes, Symptoms, and Treatment

Anorexia Nervosa – Causes, Symptoms, and Treatment

It’s nice to be skinny, but where’s the limit? Is anorexia what you should strive for? What is anorexia nervosa, what are its causes and how to avoid this beauty trap?

Anorexia means losing weight beyond all limits of health and beauty standards. From ancient times the people wanted to look thin and took care of their appearance. The ideals of beauty have changed, but not the desire and aspiration. Therefore, it is no wonder that anorexia nervosa is one of the most widespread diseases of the modern age.

The rules have remained the same today. It is normal that we all want to look beautiful, however, the standard by which we are “bombarded” from all sides, is that we cannot be that if we are not thin. From the front pages, catwalks and important events of the jet-set, famous beauties are smiling at us, all of them skinny.

Since anorexia nervosa is the disorder with the highest mortality rate among mental disorders, it is necessary to take this disease very seriously from the beginning.

What is anorexia nervosa and what types are there?

Anorexia is not just a dietary disorder, it is much more than that. It is not reserved only for teenage girls, as is usually thought. As many as 46% of girls and women get anorexia [1] after the age of 30. Although the emphasis in this disease is on diet, this is actually a disease of the mind, ie. mental disorder. It is defined as extremely low body weight in relation to height, extreme and unnecessary weight loss, unfounded fear of gaining weight, and a distorted image of yourself and your body.

Anorexia is a condition that goes beyond the concern of obesity or the desire to control diet. A person with anorexia often starts a diet first to lose weight. Over time, weight loss becomes an obsession, and control of the body becomes imperative over weight loss. The person continues with a restrictive diet, sometimes as drastic as the Danish diet, and often accompanied by other behaviors such as excessive exercise and physical activity, excessive use of diet pills that cause loss of appetite, use of diuretics, laxatives or even vomiting in order to lose weight. Even starvation becomes a kind of challenge, due to the feeling of control over your body. This cycle becomes an obsession and is similar to addiction.

There are two basic types of anorexia nervosa :

  1. restrictive type of anorexia – weight loss is achieved by a huge calorie restriction, a person consumes only certain foods, mostly has obsessive-compulsive actions related to food intake and gradually gets used to starvation.
  2. exhausting type of anorexia – sudden weight loss is achieved by vomiting or using laxatives and diuretics. This type is characterized by overeating and consuming high-calorie food, due to which there is a huge feeling of guilt. After eating, in order to remove those calories, you resort to vomiting, abusing laxatives, or excessive exercise. This type is also called bulimic, due to the similarity in behavior with people suffering from bulimia.

Although there are two types of anorexia nervosa, both show similar symptoms, such as irrational fear of gaining weight, abnormal eating patterns, excessive sudden weight loss.

Between 10 and 20 percent of women with anorexia nervosa die from heart attacks, other complications, or commit suicide [2]. This disease has the highest mortality rate of all mental illnesses. Only half of those with anorexia eventually recover.

What causes anorexia nervosa and who is at risk?

Anorexia nervosa is not a simple disorder. It has many symptoms and effects, and the causes are also very complex. Medical and psychological research points to possible causes, although the cause of anorexia has not been definitively determined.

Anorexia is thought to develop as a result of several factors, biological, psychological, and social, among which genetics, self-esteem, and social pressure probably play the most important role.

Genetic predisposition

Research shows [3, 4, 5] that genetic predisposition has a more significant effect on the development of anorexia than previously thought, and even mentions the possibility that this disease is hereditary, similar to depression. Risks of the disease can also be problems in nutrition in the earliest period of growing up, ie. in the baby, as well as depression in the mother. A young woman whose sister or mother has an eating disorder is at higher risk, which indicates possible genetic links.

Psychological pressures

The most common causes, however, are psychological pressures in the age of growing up, in which the formation of personality ends, and which can occur in the family. Anorexics usually come from families that have high demands on their success in school and other activities and often seek perfection. Among the factors, there are also bad relationships in the family, violence, bad relationship between mother and daughter, lack of attachment and emotions, feelings of abandonment and parental alienation, which leads to a low level of self-esteem.

Cultural influences

Cultural influences can also contribute to the development of anorexia nervosa – a society that promotes good looks as a means to success, talks about diet, calorie loss, and weight loss at every turn and shows slim, attractive bodies and where these become major topics especially among females. Pressure can stimulate the desire to starve and lose weight suddenly, which over time becomes normal.

Most of those affected by anorexia nervosa are women, most often young women, but men can too develop this disorder.

Many experts believe that people whose profession requires a certain appearance or body constitution, ie. thinness (such as athletes – gymnasts, as well as models, dancers, and actors…), have a higher risk of eating disorders, such as anorexia.

Anorexia Nervosa - models on the catwalk

Symptoms of anorexia and the most common signs

A person living with anorexia nervosa constantly hides his habits. This makes it difficult for friends and family to notice the warning signs at first. When confronted, this person tries to explain their irregular diet and rejects the reasons for concern. But the more anorexia progresses, close people will be able to deny their instincts that something is wrong.

The most common signs of behavior in anorexic people and symptoms of anorexia are:

  • keeping a diet despite a lean appearance – a person adheres to strict and restrictive diets, eats only certain low-calorie foods, while “bad” foods, such as carbohydrates and fats, are prohibited; she is obsessed with calories, fats, and pounds, reading food labels, measuring and weighing portions, keeping food diaries, reading nutrition books…
  • she pretends to eat or does not tell the truth – she hides food, plays with it or throws it away in order to avoid eating it. Invents excuses to stop a meal (“I had a lot of lunch” or “My stomach hurts”)
  • food preoccupation – constantly thinking about food, cooking for others, collecting recipes, reading about food in magazines, making meal plans while eating very little. – strange rituals during meals – refuses to eat with others or in public places, behaves strangely during meals (eg chops food for no reason, chews and spits, uses a special plate and utensils)
  • use of diet pills, laxatives or diuretics – consumes plenty of water, various tablets and herbal preparations to reduce appetite and lose weight
  • postprandial vomiting – often disappears during and after a meal or goes to the toilet, lets water cover up the sound of vomiting, brushes teeth immediately after a meal
  • excessive exercise – strenuous exercise due to burning calories, engages in physical activities and in addition to injuries, during illness or when the weather is bad.

Signs of anorexic appearance and symptoms of physical appearance are:

  • sudden weight loss, dramatic weight loss – a person loses weight quickly, drastically without a medical cause, feels fat despite malnutrition, even feels overweight in some places, such as the abdomen, hips, thighs
  • she has a very distorted body image – she is focused on body weight and body shape, as well as the size of her clothes. She is often weighed on the scales and is also worried about a small oscillation in weight; sharply criticizes her appearance, spends a lot of time in front of the mirror where she checks her shortcomings, criticizes herself because she is never skinny enough
  • denial of thinness – while pointing out that there is no problem with low weight, she tries to hide it (drinks a lot of water, wears baggy pants or huge clothes).
A girl with anorexia nervosa in front of a mirror

Anorexia can have serious psychological and behavioral effects on all aspects of an individual’s life, but also on his family members. Malnutrition can lead to depression and social withdrawal, a person can become irritable, easily upset, and have difficulty interacting with others. Excessive weight loss can lead to sleep disorders, frequent insomnia, and fatigue during the day, decreased attention and concentration. Other psychiatric problems common to people with anorexia nervosa include affective disorders, anxiety disorders, and personality disorders.

Most people with anorexia nervosa in every other aspect of life live harmoniously except for their relationship with food. They often strive for control, perfection, exaggerate in various activities and often have high achievements in many areas.

Starvation also leads to severe physical consequences. When the body does not receive the necessary nutrients for normal functioning, all functions slow down because the organism is forced to save energy. The heartbeat becomes very slow and low blood pressure. The risk of heart failure increases when the heart rate (bradycardia) [6] and blood pressure [7] are lower. Bone density decreases (osteoporosis), which results in dry, brittle bones, muscle loss, and weakness. There are also disorders in the endocrine system, disorders in the menstrual cycle, and even the absence of menstruation and hormonal imbalance.

Anemia decreases immunity, and in addition to reducing the number of red blood cells, people with anorexia nervosa may have a small number of white blood cells, which play an important role in protecting the body from infections. Dehydration can lead to kidney failure. Unconsciousness, fatigue, and general weakness are becoming commonplace, and dry hair, yellow skin, brittle nails, hair loss are common to all anorexics. Constipation, bloating, dizziness, and headaches also occur. Frequent vomiting can lead to dental problems, caries, and damage to the gums and eventually to tooth loss. It is also characterized by extreme sensitivity to cold (wearing several layers of clothing, even when it is not cold outside).

Anorexia nervosa treatments

The biggest challenge in treating anorexia nervosa is to admit that the person has the disease. Most people with anorexia nervosa deny having an eating disorder or cleverly hiding it. People often agree to treatment only when their condition becomes serious.

Since anorexia nervosa affects both the mind and the body, the team approach to treatment is the most effective, and it is best that the professional team consists of a doctor, psychologist, counselor, and nutritionist. The participation and support of family members also play a major role in the success of treatment.

The priority in the treatment of anorexia is to solve and stabilize possible serious health problems. Hospitalization is necessary for a patient who has lost too much weight, with heart or other serious problems, and for a person with severe depression or suicidal thoughts.

Another component of treating anorexia nervosa is nutritional counseling and trying to gain weight. The patient’s nutritionist or dietitian teaches about a healthy and proper diet and helps to create and follow a diet plan that includes enough calories to reach and maintain a normal, healthy weight.

Counseling is crucial for the treatment of anorexia nervosa. Its goal is to identify negative thoughts and feelings and to encourage the replacement of disturbed eating habits with healthy ones. Another important goal of counseling is for the patient to learn how to deal with difficult emotions, relationship problems, and stress in a productive rather than self-destructive way. Support groups can also be part of the treatment. Talking to people who have shared experiences and problems can help keep the patient from feeling lonely.

Anorexia nervosa is a serious condition that can be life-threatening. Treatment can help an anorexic person regain the normal weight. But it is not uncommon for the disease to return. Most people with anorexia will continue to prefer a lower body weight and will be very focused on food and calories. Establishing and maintaining a healthy weight can be difficult and sometimes requires long-term treatment.

Healthcare professionals often talk about the dangers of anorexia, and through educating their patients and the public, influence the prevention of anorexia and other eating disorders.

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