Anorexia Nervosa: Symptoms, Causes, and Treatment
What is Anorexia Nervosa?
Anorexia Nervosa or simply anorexia is an eating disorder where people starve themselves. Anorexia involves an inability to stay at the minimum body weight considered healthy for the person's age and height. Persons with this disorder may have an intense fear of weight gain, even when they are underweight. They may use extreme dieting, excessive exercise, or other methods to lose weight.
Anorexia usually begins in young people around the onset of puberty. Individuals suffering from anorexia have extreme weight loss. Weight loss is usually 15% below the person's normal body weight. Anorexia mainly affects adolescent girls.
People suffering from anorexia are very skinny but are convinced that they are overweight. They continue to think they are overweight even after they become extremely thin, are very ill or near death. Weight loss is obtained by many ways. Some of the common techniques used are excessive exercise, intake of laxatives and not eating.
The disorder is thought to be most common among people of higher socioeconomic classes and people involved in activities where thinness is especially looked upon, such as dancing, theater, and distance running.
Are you Anorexic?
Anorexia is a complex eating disorder with three key features:
- Refusal to maintain a healthy body weight
- An intense fear of gaining weight
- A distorted body image
Because of your dread of becoming fat or disgust with how your body looks, eating and mealtimes may be very stressful. And yet, what you can and can’t eat is practically all you can think about.
In order to know if you’re anorexic, ask yourself the following questions:
- Do you feel fat even though people tell you you’re not?
- Are you terrified of gaining weight?
- Do you lie about how much you eat or hide your eating habits from others?
- Are your friends or family concerned about your weight loss, eating habits, or appearance?
- Do you diet, compulsively exercise, or purge when you’re feeling overwhelmed or bad about yourself?
- Do you feel powerful or in control when you go without food, over-exercise, or purge?
- Do you base your self-worth on your weight or body size?
If your answers are in affirmative to most of the questions, then it’s highly likely that you may be anorexic.
Causes of Anorexia:
The exact causes of anorexia nervosa are unknown. Many factors probably are involved. Genetics and hormones may play a role. Social attitudes that promote unrealistically thin body types may also contribute.
More and more evidence points away from the idea that conflicts within a family may contribute to this or other eating disorders. Most mental health organizations no longer support this theory.
Risk factors include:
- Being a perfectionist
- Feeling increasing concern about, or attention to, weight and shape
- Having eating and digestive problems during early childhood
- Having a mother or father with anorexia or addictions
- Having parents who are concerned about weight and weight loss
- Having a negative self-image and a high level of negative feelings in general
- Undergoing a stressful life change, such as a new job or move, or events such as molestation or abuse
Media's Portrayal of the Female Body
It is not uncommon for people to believe that the media and advertisements have no effect on their beliefs or values they hold. However, this is simply untrue. Although some people believe advertisements are trivial, actually they have significant cumulative, unconscious effects. A clear-cut example of how our cultural standards are influenced by these advertisements can be is seen in the current emphasis placed on the ultra-thin female body. Advertising creates an ultimate standard of worth, so that women are judged against this standard all the time, whether we choose to be or not. Therefore, advertisements are aimed at doing more than just selling their products, they supply us with ideas of normalcy and tell us what we should and should not be. Most advertisements show excessively thin, beautiful, young and flawless models displaying their products and women are repeatedly being exposed to these types of images both in printed ads, television, and movies. Being constantly shown these types of images, it becomes difficult for women to tell what is 'normal.' It is even harder for women to not compare themselves to this 'ideal'.
Symptoms of Anorexia:
There are many symptoms for anorexia; some individuals may not experience all of the symptoms. The symptoms include: inconsistent body weight with age, build and height (usually 15% below normal weight).
Some other symptoms of anorexia are:
- Loss of at least 3 consecutive menstrual periods (in women)
- Not wanting or refusing to eat in public
- Brittle skin
- Shortness of breath
- Obsessive-ness about calorie intake
The difference between Healthy Dieting and Anorexia
Believe it or not, anorexia isn’t really about food and weight -- at least not at its core. The food and weight-related issues are symptoms of something deeper: things like depression, loneliness, insecurity, pressure to be perfect, or feeling out of control. These conditions can’t be cured by any amount of dieting or weight loss programs.
Healthy Dieting is an attempt to control weight.
Anorexia is an attempt to control your life and emotions.
Your self-esteem is based on more than just weight and body image.
Your self-esteem is based entirely on how much you weigh and how thin you are.
You view weight loss as a way to improve your health and appearance.
You view weight loss as a way to achieve happiness.
Your goal is to lose weight in a healthy way.
Becoming thin is all that matters; health is not a concern.
Consequences of Anorexia:
There are many medical risks associated with anorexia. They include: shrunken bones, mineral loss, low body temperature, irregular heartbeat, permanent failure of normal growth, and development of osteoporosis.
Anorexia may lead to Bulimia Nervosa, another equally alarming eating disorder.
Bulimia Nervosa or simply bulimia is another eating disorder that primarily affects women. However, bulimia is categorized by a binging and purging cycle. Women affected by this eating disorder eat large amounts of food in one sitting (binge eating) which is followed by a purging from the body through vomiting, misusing laxatives, diuretics, or enemas. In addition, bulimics often use alternate methods such as intense exercise or fasting to balance the effects of excess calories.
Difference between Anorexia and Bulimia
The biggest difference between anorexia and bulimia is that people suffering from bulimia eat large amounts of food and then throw up. This is called binge and purge. Anorexics do not eat large amounts and throw up. Bulimics do.
Anorexia: Exams and Tests
Other causes of weight loss or muscle wasting must be ruled out with medical testing. Examples of other conditions that can cause similar symptoms include:
- Addison's disease
- Celiac disease
- Inflammatory bowel disease
These tests may include:
- Bone density tests to check for thin bones (osteoporosis)
- Kidney function tests
- Liver function tests
- Total protein
- Thyroid function tests
Anorexia: Treatment and Therapy
The biggest challenge in treating anorexia nervosa is having the person recognize that they have an illness. Most persons with anorexia nervosa deny that they have an eating disorder. Individuals often enter treatment only once their condition is fairly advanced.
The goals of treatment are to first restore normal body weight and eating habits. A weight gain of 1 - 3 pounds per week is considered a safe goal.
Since anorexia involves both mind and body, a team approach to treatment is often best. Those who may be involved in anorexia treatment include medical doctors, psychologists, counselors, and dieticians. The participation and support of family members also makes a big difference in treatment success. Having a team around you that you can trust and rely on will make recovery easier.
Treating anorexia involves three steps:
- Getting back to a healthy weight
- Starting to eat more food
- Changing how the patient thinks about herself and food
Although a short hospital stay is a common way to start treatment, a longer hospital stay may be needed if:
- The person has lost a lot of weight, such as being below 70% of their ideal body weight for their age and height. Severe and life-threatening malnutrition may require feedings through a vein or stomach tube.
- Weight loss continues despite treatment.
- Medical complications, such as heart problems, confusion, or low potassium levels develop.
- The person has severe depression or thinks about committing suicide.
Psychological Counseling as a Treatment for Anorexia: Counseling is crucial to anorexia treatment. Its goal is to identify the negative thoughts and feelings that fuel the eating disorder and then replace them with healthier, less distorted beliefs. Another important goal of counseling is to teach the patient how to deal with difficult emotions, relationship problems, and stress in a productive, rather than a self-destructive way.