Anorexia nervosa
Definition:
Anorexia nervosa is an eating disorder that causes people to obsess about their weight and the food they eat. People with anorexia nervosa attempt to maintain a weight that's far below normal for their age and height. To prevent weight gain or to continue losing weight, people with anorexia nervosa may starve themselves or exercise excessively.
Anorexia (an-oh-REK-see-uh) nervosa isn't really about food. It's an unhealthy way to try to cope with emotional problems. When you have anorexia nervosa, you often equate thinness with self-worth.
Anorexia nervosa can be 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:
Some people with anorexia lose weight mainly through severely restricting the amount of food they eat. They may also try to lose weight by exercising excessively. Others with anorexia binge and purge, similar to bulimia. They control calorie intake by vomiting after eating or by misusing laxatives, diuretics or enemas.
No matter how weight loss is achieved, anorexia has a number of physical, emotional and behavioral signs and symptoms.
Physical anorexia symptoms
Physical signs and symptoms of anorexia include:
Emotional and behavioral characteristics associated with anorexia include:
Anorexia, like other eating disorders, can take over your life. You may think about food all the time, spend hours agonizing over options in the grocery store and exercise to exhaustion. You also may have a host of physical problems that make you feel generally miserable, such as dizziness, constipation,
fatigue and frequently feeling cold. You may feel irritable, angry, moody, sad, anxious and hopeless.
You might visit pro-anorexia websites, refer to the disease as your "friend," cover up in layers of heavy clothing, and try to get by on a menu of lettuce, carrots, popcorn and diet soda.
If you're experiencing any of these problems, or if you think you may have an eating disorder, get help. If you're hiding your anorexia from loved ones, try to find a confidant you can talk to about what's going on.
Anorexia red flags to watch for
It may be hard to notice signs and symptoms of anorexia because people with anorexia often go to great lengths to disguise their thinness, eating habits or physical problems.
If you're concerned that a loved one may have anorexia, watch for these possible red flags:
Causes:
The exact cause of anorexia nervosa is unknown. As with many diseases, it's probably a combination of biological, psychological and environmental factors.
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.
Complications of anorexia include:
In addition to the host of physical complications, people with anorexia also commonly have other mental disorders as well. They may include:
When you have anorexia, you may need several types of treatment. If your life is in immediate danger, you may need treatment in a hospital emergency room for such issues as a heart rhythm disturbance, dehydration, electrolyte imbalances or psychiatric problems.
Here's a look at what's commonly involved in treating people with anorexia:
Medical care
Because of the host of complications anorexia causes, you may need frequent monitoring of vital signs, hydration level and electrolytes, as well as related physical conditions. In severe cases, people with anorexia may initially require feeding through a tube that's placed in their nose and goes to the stomach (nasogastric tube). A primary care doctor may be the one who coordinates care with the other health care professionals involved. Sometimes, though, it's the mental health provider who coordinates care.
Restoring a healthy weight
The first goal of treatment is getting back to a healthy weight. You can't recover from an eating disorder without restoring an appropriate weight and learning proper nutrition. A psychologist can work with you to develop behavioral strategies to help you return to a healthy weight. A dietitian can offer guidance on a healthy diet, including providing specific meal plans and calorie requirements that will help you meet your weight goals. Your family will also likely be involved in helping you maintain healthy-eating habits.
Psychotherapy
Individual, family-based and group therapy may all be beneficial.
There are no medications specifically designed to treat anorexia because they haven't been found to work very well. However, antidepressants or other psychiatric medications can help treat other mental disorders you may also have, such as depression or anxiety.
Hospitalization
In cases of medical complications, psychiatric emergencies, severe malnutrition or continued refusal to eat, hospitalization may be needed. Hospitalization may be on a medical or psychiatric ward. Some clinics specialize in treating people with eating disorders. Some may offer day programs or residential programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time. Also, even after hospitalization ends, ongoing therapy and nutrition education are highly important to continued recovery.
Treatment challenges in anorexia
Some cases of anorexia are much more severe than others. Less severe cases may take less time for treatment and recovery. One of the biggest challenges in treating anorexia is that people may not want treatment, may think they don't need it or may be concerned about weight gain. And, some people with anorexia don't see it as an illness, but instead promote it as a lifestyle choice.
Even if you do want to get better, the pull of anorexia can be difficult to overcome. Anorexia is often an ongoing, lifelong battle. Although symptoms may subside, you remain vulnerable and may have a relapse during periods of high stress or during triggering situations. For example, anorexia symptoms may go away during pregnancy only to return once your baby has been delivered. Ongoing therapy or periodic appointments during times of stress may be helpful.
Definition:
Anorexia nervosa is an eating disorder that causes people to obsess about their weight and the food they eat. People with anorexia nervosa attempt to maintain a weight that's far below normal for their age and height. To prevent weight gain or to continue losing weight, people with anorexia nervosa may starve themselves or exercise excessively.
Anorexia (an-oh-REK-see-uh) nervosa isn't really about food. It's an unhealthy way to try to cope with emotional problems. When you have anorexia nervosa, you often equate thinness with self-worth.
Anorexia nervosa can be 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:
Some people with anorexia lose weight mainly through severely restricting the amount of food they eat. They may also try to lose weight by exercising excessively. Others with anorexia binge and purge, similar to bulimia. They control calorie intake by vomiting after eating or by misusing laxatives, diuretics or enemas.
No matter how weight loss is achieved, anorexia has a number of physical, emotional and behavioral signs and symptoms.
Physical anorexia symptoms
Physical signs and symptoms of anorexia include:
- Extreme weight loss
- Thin appearance
- Abnormal blood counts
- Fatigue
- Insomnia
- Dizziness or fainting
- A bluish discoloration of the fingers
- Hair that thins, breaks or falls out
- Soft, downy hair covering the body
- Absence of menstruation
- Constipation
- Dry skin
- Intolerance of cold
- Irregular heart rhythms
- Low blood pressure
- Dehydration
- Osteoporosis
- Swelling of arms or legs
Emotional and behavioral characteristics associated with anorexia include:
- Refusal to eat
- Denial of hunger
- Afraid of gaining weight
- Lying about how much food has been eaten
- Excessive exercise
- Flat mood (lack of emotion)
- Social withdrawal
- Irritability
- Preoccupation with food
- Reduced interest in sex
- Depressed mood
- Possible use of laxatives, diet aids or herbal products
Anorexia, like other eating disorders, can take over your life. You may think about food all the time, spend hours agonizing over options in the grocery store and exercise to exhaustion. You also may have a host of physical problems that make you feel generally miserable, such as dizziness, constipation,
fatigue and frequently feeling cold. You may feel irritable, angry, moody, sad, anxious and hopeless.
You might visit pro-anorexia websites, refer to the disease as your "friend," cover up in layers of heavy clothing, and try to get by on a menu of lettuce, carrots, popcorn and diet soda.
If you're experiencing any of these problems, or if you think you may have an eating disorder, get help. If you're hiding your anorexia from loved ones, try to find a confidant you can talk to about what's going on.
Anorexia red flags to watch for
It may be hard to notice signs and symptoms of anorexia because people with anorexia often go to great lengths to disguise their thinness, eating habits or physical problems.
If you're concerned that a loved one may have anorexia, watch for these possible red flags:
- Skipping meals
- 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 cutting food into tiny pieces or spitting food out after chewing
- Cooking elaborate meals for others but refusing to eat
- Repeated weighing of themselves
- Frequent checking in the mirror for perceived flaws
- Complaining about being fat
- Not wanting to eat in public
Causes:
The exact cause of anorexia nervosa is unknown. As with many diseases, it's probably a combination of biological, psychological and environmental factors.
- Biological. There may be genetic changes that make
some people more vulnerable to developing anorexia. However, it's not
clear specifically how your genes could cause anorexia. It may be that
some people have a genetic tendency toward perfectionism, sensitivity
and perseverance, all traits associated with anorexia. There's also some
evidence that serotonin — one of the brain chemicals involved in
depression — may play a role in anorexia.
- Psychological. Some emotional characteristics may
contribute to anorexia. Young women may have obsessive-compulsive
personality traits that make it easier to stick to strict diets and
forgo food despite being hungry. They may have an extreme drive for
perfectionism, which means they may never think they're thin enough.
- Environmental. Modern Western culture emphasizes thinness. The media are splashed with images of thin models and actors. Success and worth are often equated with being thin. Peer pressure may help fuel the desire to be thin, particularly among young girls.
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.
Complications of anorexia include:
- Death
- Anemia
- Heart problems, such as mitral valve prolapse, abnormal heart rhythms and heart failure
- Bone loss, increasing risk of fractures later in life
- 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
In addition to the host of physical complications, people with anorexia also commonly have other mental disorders as well. They may include:
- Depression
- Anxiety disorders
- Personality disorders
- Obsessive-compulsive disorders
- Drug abuse
When you have anorexia, you may need several types of treatment. If your life is in immediate danger, you may need treatment in a hospital emergency room for such issues as a heart rhythm disturbance, dehydration, electrolyte imbalances or psychiatric problems.
Here's a look at what's commonly involved in treating people with anorexia:
Medical care
Because of the host of complications anorexia causes, you may need frequent monitoring of vital signs, hydration level and electrolytes, as well as related physical conditions. In severe cases, people with anorexia may initially require feeding through a tube that's placed in their nose and goes to the stomach (nasogastric tube). A primary care doctor may be the one who coordinates care with the other health care professionals involved. Sometimes, though, it's the mental health provider who coordinates care.
Restoring a healthy weight
The first goal of treatment is getting back to a healthy weight. You can't recover from an eating disorder without restoring an appropriate weight and learning proper nutrition. A psychologist can work with you to develop behavioral strategies to help you return to a healthy weight. A dietitian can offer guidance on a healthy diet, including providing specific meal plans and calorie requirements that will help you meet your weight goals. Your family will also likely be involved in helping you maintain healthy-eating habits.
Psychotherapy
Individual, family-based and group therapy may all be beneficial.
- Individual therapy. This type of therapy can help
you deal with the behavior and thoughts that contribute to anorexia. You
can gain a healthier self-esteem and learn positive ways to cope with
distress and other strong feelings. A type of talk therapy called
cognitive behavioral therapy (CBT) is commonly used. Therapy may be done
in day treatment programs, but in some cases, may be part of treatment
in a psychiatric hospital.
- Family-based therapy. This therapy begins with the
assumption that the person with the eating disorder is no longer capable
of making sound decisions regarding his or her health and needs help
from the family. An important part of family-based therapy is that the
family is involved in making sure that healthy-eating patterns are
followed. This type of therapy can help resolve family conflicts and
muster support from concerned family members. Family-based therapy can
be especially important for children with anorexia who still live at
home.
- Group therapy. This type of therapy gives you a way to connect to others facing eating disorders. And informal support groups may sometimes be helpful. However, be careful with informal groups that aren't led by a mental health professional. For some people with anorexia, support groups might result in competitions to be the thinnest person there.
There are no medications specifically designed to treat anorexia because they haven't been found to work very well. However, antidepressants or other psychiatric medications can help treat other mental disorders you may also have, such as depression or anxiety.
Hospitalization
In cases of medical complications, psychiatric emergencies, severe malnutrition or continued refusal to eat, hospitalization may be needed. Hospitalization may be on a medical or psychiatric ward. Some clinics specialize in treating people with eating disorders. Some may offer day programs or residential programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time. Also, even after hospitalization ends, ongoing therapy and nutrition education are highly important to continued recovery.
Treatment challenges in anorexia
Some cases of anorexia are much more severe than others. Less severe cases may take less time for treatment and recovery. One of the biggest challenges in treating anorexia is that people may not want treatment, may think they don't need it or may be concerned about weight gain. And, some people with anorexia don't see it as an illness, but instead promote it as a lifestyle choice.
Even if you do want to get better, the pull of anorexia can be difficult to overcome. Anorexia is often an ongoing, lifelong battle. Although symptoms may subside, you remain vulnerable and may have a relapse during periods of high stress or during triggering situations. For example, anorexia symptoms may go away during pregnancy only to return once your baby has been delivered. Ongoing therapy or periodic appointments during times of stress may be helpful.
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This blog was extremely useful. I really appreciate your kindness in sharing this with me and everyone else! Anorexia.
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