Understanding Eating Disorders: Anorexia Nervosa

Understanding Anorexia nervosa

Anorexia nervosa is an eating disorder characterized by abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight. People with anorexia generally restrict the number of calories and the types of food they eat. Some people with this disorder also exercise compulsively, control calorie intake by vomiting after eating or by misusing laxatives, diet aids, or enemas. 

Symptoms

The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioural issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.

Other physical symptoms include:

  • Extreme weight loss or not making expected developmental weight gains

  • Stomach cramps, other non-specific gastrointestinal complaints like 

  • Fainting/syncope

  • Insomnia

  • Infertility and menstrual irregularities

  • Dental problems, such as enamel erosion, cavities, discolouration of teeth and tooth sensitivity

Other behavioural symptoms include:

  • Dramatic weight loss

  • Maintains an excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury 

  • showing excessive concern with weight, body size, dieting, calories, and food

  • exercising a lot, taking laxatives, or inducing vomiting

  • Post-puberty female loses menstrual period

  • Showing signs of depression and has a strong need for control

Causes

Concerns about body weight and shape are often features of anorexia nervosa, but they may not be the main cause.

Some factors that may increase an individual's risk include:

  • past criticism about their eating habits, weight, or body shape

  • a history of teasing or bullying, especially about weight or body shape

  • a sense of pressure from society or their profession to be slim

  • low self-esteem

  • anxiety

  • having a personality that tends toward obsession or perfectionism

  • sexual abuse

  • pressure to fit in with cultural norms that are not their own

Diagnostic Criteria

The following criteria must be met if a person has to be diagnosed with Anorexia nervosa:

  1. Intense fear of gaining weight or becoming fat, even though underweight.

  2. Restriction of energy intake relative to requirements leading to significantly low body weight in the context of age, sex, developmental trajectory, and physical health.

  3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

Risk Factors

Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities. Statistics show that males represent about 25% of people with anorexia and that the effects are more likely to be life-threatening among males than females. The reason for this is that males often receive a later diagnosis due to the mistaken belief that it does not affect them.

Some of the complications of anorexia nervosa include:

  • Heart problems, such as mitral valve prolapse or heart failure

  • Bone loss (osteoporosis) and muscle loss

  • In females, the absence of a period. In males, decreased testosterone

  • Gastrointestinal problems, such as constipation, bloating or nausea

  • Kidney problems

Treatments and Therapies

It can be challenging for a person with anorexia nervosa to engage in treatment. Family and friends can provide crucial support in understanding the condition and identify its signs and symptoms and encourage the person to seek help.

Some other strategies include 

  • cognitive-behavioural therapy (CBT), which can help the person find new ways of thinking, behaving, and managing stress

  • The Maudsley approach and individual counselling, as appropriate

  • nutritional therapy, which provides information on how to use food to build and maintain health

  • medication to treat depression and anxiety

Beyond Treatment

Here are other tips that may help if you or your loved one may have Anorexia nervosa:

  • Try thinking of food as something your body needs, instead of something that controls your weight.

  • Set realistic goals for yourself.

  • Be kind and respectful rather than judgmental.

  • Try not to isolate yourself, and let others help you.

  • Make sure to get all the education and support possible.

  • Consider a treatment team — including a dietitian, a therapist, and a psychiatrist — all of whom should specialize in eating disorders.

Sources

https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591

https://www.medicalnewstoday.com/articles/267432#treatment-and-recovery

https://www.nimh.nih.gov/health/topics/eating-disorders/?ftag=YHF4eb9d17


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