Anorexia Nervosa

What is Anorexia?

Anorexia nervosa is an eating disorder characterized by abnormally low body weight, an intense fear of gaining weight, and a distorted perception of body weight. It is also known as anorexia or loss of appetite. Individuals suffering from anorexia nervosa often severely restrict their food intake to prevent weight gain or continue losing weight.

Causes of Anorexia

There are genetic predispositions that may increase the risk of developing anorexia nervosa in some individuals. Some people may have a genetic inclination towards perfectionism, sensitivity, and persistence, traits associated with anorexia. Studies have shown that individuals with first-degree relatives (parents, siblings, or children) who have anorexia nervosa are at a much higher risk of developing the disorder.

Uncontrolled and unscientific dieting is a risk factor for developing an eating disorder. Researchers have found strong evidence that many symptoms of anorexia are actually symptoms of starvation. Prolonged starvation can biologically affect the brain, leading to mood changes, increased anxiety, and reduced appetite. The combination of starvation and weight loss may alter brain function in some individuals, making it difficult to return to normal eating habits and perpetuating restrictive eating behaviors.

Emotional stress from changes such as starting a new school, moving to a new home, a relationship breakup, or the illness or death of a loved one can increase the risk of anorexia.

Complications Associated with Anorexia

Complications of anorexia include anemia, abnormal heart rhythms or heart failure, kidney problems, electrolyte imbalances (such as low potassium, sodium, and chloride levels), decreased testosterone levels in men, gastrointestinal issues like constipation, bloating, or nausea, absence of menstruation in women, muscle loss, bone loss (osteoporosis), increasing the risk of fractures, and heart problems like mitral valve prolapse.

Preventing Anorexia

If a family member or friend is noticed to have low self-esteem, unexpected eating habits, or dissatisfaction with their appearance, talking with them about these issues may be effective. Although it may not be possible to prevent the development of an eating disorder, guiding them toward healthier behaviors or treatment options might be possible.

Symptoms and Types of Anorexia

Anorexic individuals may severely restrict food intake through starvation, dieting, or constant fasting. They may also engage in excessive exercise, self-induced vomiting, or use diet pills, herbal products, laxatives, or enemas to lose weight.

In addition to physical symptoms, emotional and behavioral signs of anorexia nervosa include:

  • Refusal to eat or making excuses to avoid eating
  • Avoiding eating in the presence of others
  • Reduced interest in sex
  • Appearing emotionless
  • Wearing layers of clothing to hide their body
  • Frequent weighing or measuring due to fear of gaining weight
  • Lying about how much they have eaten
  • Irritability
  • Complaints about being fat despite being underweight
  • Frequently checking themselves in the mirror for perceived flaws
  • Skipping meals or refusing to eat
  • Social withdrawal
  • Insomnia
  • Defining certain low-fat or low-calorie foods as "safe" and avoiding others
  • Developing food rituals, such as chewing food and then spitting it out without swallowing
  • Obsessing over food but refusing to eat, even after preparing complex meals

Many individuals with anorexia nervosa do not seek treatment, especially at the onset of the disorder. The desire to remain thin often outweighs concerns about their health. Therefore, those who suspect a loved one is affected should encourage them to consult a doctor.

Individuals exhibiting the symptoms of anorexia nervosa or who believe they have an eating disorder should seek help. Even those who try to hide their condition should consider confiding in someone they trust.

Diagnosing Anorexia

Various laboratory tests may be performed to check electrolyte and protein levels in the body, as well as to assess liver, kidney, and thyroid function.

A psychological self-assessment questionnaire may also be requested.

An electrocardiogram (ECG) may be conducted to check for potential heart irregularities.

Treatment of Anorexia

Anorexia nervosa is not a disorder that can be overcome without treatment. The treatment process involves a team approach, including medical care to help the individual reach a healthy weight, monitoring calorie intake and weight gain, and developing behavioral strategies. A psychiatrist, dietitian, and psychologist work together to provide specific meal plans and monitor progress closely.

The primary goal of anorexia nervosa treatment is to return to a healthy weight. The continuity of treatment and consistent nutritional education are crucial for sustained recovery. This process may involve hospitalization, medical care, psychotherapy, and medication.

One of the greatest challenges in treating anorexia is that individuals may not want treatment. They may believe they do not need help, fear gaining weight, or view anorexia nervosa as a lifestyle choice rather than a disease, all of which can hinder treatment.

If a person's life is in immediate danger due to issues like abnormal heart rhythms, dehydration, electrolyte imbalances, or psychiatric threats, they may require emergency intervention at a hospital. Severe medical complications, serious psychiatric issues, or extreme malnutrition may necessitate long-term hospitalization.

There are specialized clinics for treating eating disorders. These clinics offer day or residential programs instead of full hospitalization. Special eating disorder programs may provide more intensive treatment options for those in need over longer periods.

Due to the complications associated with anorexia, frequent monitoring of electrolyte levels, hydration, and vital signs may be necessary. In more severe cases, individuals with anorexia nervosa may need to be fed through a nasogastric tube (a tube that runs from the nose to the stomach) at the start of treatment.

Psychotherapy includes various treatment methods beneficial for anorexia. Family-based therapy has been proven effective for treating young people with anorexia nervosa. In this approach, parents are involved in helping with nutrition and weight gain until the individual can make healthy decisions independently.

For adults, cognitive behavioral therapy (CBT), particularly enhanced cognitive behavioral therapy (CBT-E), has been observed to help treat the condition. The primary goal during this process is to normalize eating habits and behaviors to support weight gain. The secondary aim is to help change distorted beliefs and thoughts that lead to restrictive eating.

Lifestyle Changes and Home Care for Anorexia

It can be challenging for individuals with anorexia nervosa to care for themselves. In addition to ongoing professional treatment, there are several steps they can take. They should adhere to their treatment plan, attend therapy sessions, and follow meal plans even if they feel uncomfortable.

Consulting a doctor about appropriate vitamin and mineral supplements may be beneficial. Individuals with poor nutrition may lack essential nutrients like vitamin D or iron. However, getting vitamins and minerals primarily from food is healthier.

Individuals should not isolate themselves from family, friends, or loved ones. Support from close ones is one of the most critical factors for a successful treatment. Throughout the process, individuals should express any concerns to their loved ones and healthcare professionals.

Individuals should resist the urge to weigh, measure, or evaluate themselves in front of a mirror frequently. These routines may reinforce unhealthy habits.

Under normal circumstances, diet supplements and herbal products designed to suppress appetite or aid weight loss can be misused by individuals with anorexia nervosa. Weight loss supplements or herbal remedies can have serious side effects and may dangerously interact with other medications. These products often do not undergo rigorous scientific review, and their contents may not always match what is listed on the packaging.

Anxiety-reducing approaches like massage, Pilates, meditation, and yoga can enhance a sense of well-being and promote relaxation.