Anorexia Nervosa
Overview
Anorexia (an-o-REK-see-uh)
nervosa — often simply called anorexia — is an eating disorder characterized by
an abnormally low body weight, an intense fear of gaining weight and a
distorted perception of weight. People with anorexia place a high value on
controlling their weight and shape, using extreme efforts that tend to
significantly interfere with their lives.
To prevent weight gain or to
continue losing weight, people with anorexia usually severely restrict the
amount of food they eat. They may control calorie intake by vomiting after
eating or by misusing laxatives, diet aids, diuretics, or enemas. They may also
try to lose weight by exercising excessively. No matter how much weight is
lost, the person continues to fear weight gain.
Anorexia is not really about
food. It is an extremely unhealthy and sometimes life-threatening way to try to
cope with emotional problems. When you have anorexia, you often equate thinness
with self-worth.
Anorexia, like other eating
disorders, can take over your life and can be exceedingly difficult to
overcome. But with treatment, you can gain a better sense of who you are,
return to healthier eating habits and reverse some of anorexia's serious
complications.
Symptoms
The physical signs and
symptoms of anorexia nervosa are related to starvation. Anorexia also includes
emotional and behavioral issues involving an unrealistic perception of body
weight and an extremely strong fear of gaining weight or becoming fat.
It may be difficult to
notice signs and symptoms because what is considered a low body weight is
different for each person, and some individuals may not appear extremely thin.
Also, people with anorexia often disguise their thinness, eating habits or
physical problems.
Physical symptoms
Physical signs and symptoms
of anorexia may include:
Extreme weight loss or not
making expected developmental weight gains
Thin appearance
Abnormal blood counts
Fatigue
Insomnia
Dizziness or fainting
Bluish discoloration of the
fingers
Hair that thins, breaks, or
falls out
Soft, downy hair covering
the body
Absence of menstruation
Constipation and abdominal
pain
Dry or yellowish skin
Intolerance of cold
Irregular heart rhythms
Low blood pressure
Dehydration
Swelling of arms or legs
Eroded teeth and calluses on
the knuckles from induced vomiting
Some people who have
anorexia binge and purge, similar to individuals who have bulimia. But people
with anorexia generally struggle with an abnormally low body weight, while
individuals with bulimia typically are normal to above normal weight.
Emotional and
behavioral symptoms
Behavioral symptoms of
anorexia may include attempts to lose weight by:
Severely restricting food
intake through dieting or fasting
Exercising excessively
Binging and self-induced
vomiting to get rid of food, which may include the use of laxatives, enemas,
diet aids or herbal products
Emotional and behavioral
signs and symptoms may include:
Preoccupation with food,
which sometimes includes cooking elaborate meals for others but not eating them
Frequently skipping meals or
refusing to eat
Denial of hunger or making
excuses for not eating
Eating only a few certain
"safe" foods, usually those low in fat and calories
Adopting rigid meal or
eating rituals, such as spitting food out after chewing
Not wanting to eat in public
Lying about how much food
has been eaten
Fear of gaining weight that
may include repeated weighing or measuring the body
Frequent checking in the
mirror for perceived flaws
Complaining about being fat
or having parts of the body that are fat
Covering up in layers of
clothing
Flat mood (lack of emotion)
Social withdrawal
Irritability
Insomnia
Reduced interest in sex
When to see a doctor
Unfortunately, many people
with anorexia do not want treatment, at least initially. Their desire to remain
thin overrides concerns about their health. If you have a loved one, you are
worried about, urge her or him to talk to a doctor.
If you are experiencing any
of the problems listed above, or if you think you may have an eating disorder,
get help. If you are hiding your anorexia from loved ones, try to find a person
you trust to talk to about what is going on.
Causes
The exact cause of anorexia
is unknown. As with many diseases, it is a combination of biological, psychological,
and environmental factors.
Biological.
Although it is not yet clear which genes are involved, there may be genetic
changes that make some people at higher risk of developing anorexia. Genetics. Changes in specific genes may put
certain people at higher risk of anorexia. Those with a first-degree relative —
a parent, sibling, or child — who had the disorder have a much higher risk of
anorexia.
Psychological.
Some people with anorexia may have obsessive-compulsive personality traits that
help them to stick to strict diets and forgo food despite being hungry. They
may have an extreme drive for perfectionism, which causes them to think they
are never thin enough. And they may have elevated levels of anxiety and engage
in restrictive eating to reduce it. Some
people may have a genetic tendency toward perfectionism, sensitivity, and
perseverance — all traits associated with anorexia.
Environmental. Modern
Western culture emphasizes thinness. Success and worth are often equated with
being thin. Peer pressure may help fuel the desire to be thin, particularly
among young girls.
Risk factors
Anorexia is more common in
girls and women. However, boys and men have increasingly developed eating
disorders, related to growing social pressures.
Anorexia is also more common
among teenagers. Still, people of any age can develop this eating disorder, though
it is rare in those over forty. Teens may be more at risk because of all the
changes their bodies go through during puberty. They may also face increased
peer pressure and be more sensitive to criticism or even casual comments about
weight or body shape.
Certain factors increase the
risk of anorexia, including:
Dieting and
starvation. Dieting is a risk factor for developing an
eating disorder. There is convincing evidence that many of the symptoms of
anorexia are symptoms of starvation. Starvation affects the brain and
influences mood changes, rigidity in thinking, anxiety, and reduction in
appetite. Starvation and weight loss may change the way the brain works in
vulnerable individuals, which may perpetuate restrictive eating behaviors and
make it difficult to return to normal eating habits.
Transitions. Whether it is a
new school, home, or job; a relationship breakup; or the death or illness of a
loved one, change can bring emotional stress and increase the risk of anorexia.
Complications
Anorexia can have numerous
complications. At its most severe, it can be fatal. Death may occur suddenly —
even when someone is not severely underweight. This may result from abnormal
heart rhythms (arrhythmias) or an imbalance of electrolytes — minerals such as
sodium, potassium and calcium that maintain the balance of fluids in your body.
Other complications of
anorexia include:
Anemia
Heart problems, such as
mitral valve prolapse, abnormal heart rhythms or heart failure
Bone loss (osteoporosis),
increasing the risk of fractures
Loss of muscle
In females, absence of a
period
In males, decreased
testosterone
Gastrointestinal problems,
such as constipation, bloating or nausea
Electrolyte abnormalities,
such as low blood potassium, sodium, and chloride
Kidney problems
If a person with anorexia
becomes severely malnourished, every organ in the body can be damaged,
including the brain, heart, and kidneys. This damage may not be fully
reversible, even when the anorexia is under control.
In addition to the host of
physical complications, people with anorexia also commonly have other mental
health disorders as well. They may include:
Depression and other mood
disorders
Anxiety disorders
Obsessive-compulsive
disorders
Alcohol and substance misuse
Self-injury, suicidal thoughts,
or suicide attempts
Prevention
There is no guaranteed way
to prevent anorexia nervosa. Primary care physicians (pediatricians, family
physicians and internists) may be in a good position to identify early indicators
of anorexia and prevent the development of full-blown illness. For instance,
they can ask questions about eating habits and satisfaction with appearance
during routine medical appointments.
If you notice that a family
member or friend has low self-esteem, severe dieting habits and dissatisfaction
with appearance, consider talking to him or her about these issues. Although
you may not be able to prevent an eating disorder from developing, you can talk
about healthier behavior or treatment options.
Jan Ricks Jennings, MHA,
LFACHE
Senior Consultant
Senior Management
Resources, LLC
JanJenningsBlog.Blogspot.com
412.913.0636 Cell
724.733.0509 Office
January 16, 2022
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