What is anorexia nervosa? The eating disorder anorexia nervosa is about more than food. It’s a disorder that affects the body and the mind. People who have anorexia nervosa may obsess about their weight and the food they eat as a way to cope with emotional problems. People with anorexia tend to feel better about themselves when they are thin, very thin. They may eat very little, starve themselves, or exercise excessively in order to keep their weight way below what is normal for their height, gender, and age.
Anorexia is a very serious disorder. It is life threatening and can be difficult to treat. Anorexia can result in anemia, heart problems, and kidney problems. The malnutrition that accompanies anorexia can damage every organ in the body, and the damage is not always reversible, even with treatment. Treatment focuses on restoring a healthy weight, enhancing feelings of self worth, and improving self-knowledge and understanding.
Males and females get anorexia nervosa, but the disorder is much more common in females. While there are ten times as many females with anorexia than males, the incidence of the disorder in males is on the rise. Anorexia can develop at any time, but it typically begins around the time of puberty.
The precise causes of anorexia are not fully understood. Genetics, lifestyle, profession, environment, biology, psychology, personality traits, and cultural factors may contribute to the disorder. Like all eating disorders, anorexia requires medical treatment.
Signs and Symptoms of Anorexia
Physical signs and symptoms of anorexia include:
• Radical loss of weight
• Appearing physically very thin
• Abnormal blood count
• Fatigue
• Insomnia
• Dizziness, fainting
• Electrolyte imbalance
• Bluish discoloration of fingers
• Brittle hair and nails
• Soft hair covering the body to keep the body warm
• Constipation, bloating, nausea
• Dry, yellow skin
• Cold intolerance
• Irregular heart beats (arrhythmias)
• Low blood pressure
• Swelling of arms or legs
• Dehydration
• Osteoporosis
• Lack of menstrual periods in women
Emotional and behavioral signs and symptoms include:
• Refusal to eat
• Denial of hunger
• Exercising excessively
• Lack of emotion
• Irritability, anger, anxiety, hopelessness, depression
• Social withdrawal
• Preoccupation with food
• Intense fear of gaining weight
• Distorted body image
• Disinterest in sex
People who are suffering from anorexia nervosa may:
• Skip meals
• Make excuses for not eating
• Cook for others but not eat
• Cover themselves with heavy or loose clothing
• Not eat in public
• Have rigid eating rituals, like cutting their food into tiny pieces
• Spit food out after chewing
• Eat only a few foods, usually ones that are very low in calories and fat.
• Weigh themselves frequently
• Look in the mirror frequently, almost constantly, to look for flaws
• Complain about being fat
• Use diet aids, laxatives, or diuretics to lose weight
Treatment for Anorexia Eating Disorder
Research shows that half of the people who have anorexia nervosa fully recover. Treatment often involves a team of health providers, including family physicians, internal medicine specialists, pediatricians, registered dieticians, psychiatrists, psychologists, nutritionists, and social workers.
Recovery requires medical treatment as well as significant lifestyle changes. Lifestyle changes typically involve:
• Following a healthy diet and healthy eating habits;
• Developing a support system;
• Maintaining a healthy weight; and
• Cutting back on exercise if over-exercising has been used as a way to lose weight.
Because anorexia can have such serious health effects, people with the disorder may need emergency treatment for physical or psychiatric problems. Initially they may need feeding through a tube that goes through the nose into the stomach.
Other treatments, which may be provided at an eating disorders center, in a hospital, or on an outpatient basis, include:
• Education and weight restoration. Learning about good nutrition and healthy eating habits is the first step toward regaining a healthy weight. Nutritionists may provide nutrition counselling.
• Psychotherapy. Individual, group, and/or family therapy can help treat anorexia by dealing with underlying emotional issues, providing support, and changing unhealthy thoughts and behaviors.
• Medications. No medications have been found to be helpful in treating anorexia. However, doctors may prescribe medications for mental health disorders and other health problems that result from or accompany anorexia. Doctors may prescribe vitamins and supplements to provide needed nutrition.
• Medical treatment. Depending on the medical condition of the individual, various medical treatments and monitoring may be needed. Doctors may order tests to determine levels of electrolytes, iron, sugar, protein, fat, hormones, and vitamins and minerals. Other tests look at the functioning of the kidneys, liver, and thyroid gland.
Prevention
Parents and teachers can play important roles in the prevention of the eating disorder anorexia by helping children develop healthy eating habits, a positive body image, and a strong sense of self worth.
Early intervention can help people with anorexia nervosa get treatment. Anorexia tends to get worse the longer it goes untreated. The sooner an individual receives professional help for an eating disorder, the more likely serious medical consequences can be avoided or treated successfully. Friends and family can help by encouraging their loved ones to get help if they exhibit the signs and symptoms and behaviors noted in this article.
Admiring movie stars and models for being very thin, glamorizing extreme dieting, and denying the seriousness of eating disorders all contribute to the incidence of anorexia nervosa. It is important to challenge social and cultural norms that equate being thin with being beautiful and worthwhile.