Anorexia nervosa is characterized by an irrational dread of becoming fat coupled with a relentless pursuit of thinness. People with anorexia go to extremes­ to reach and maintain a dangerously low body weight. But no matter how much weight is lost, no matter how emaciated they become, it’s never enough. The more the scale dips, the more obsessed they become with food, dieting, and weight loss. The key features of anorexia nervosa are refuse to sustain a minimally normal body weight, intense fear of gaining weight, despite being underweight and distorted view of one’s body or weight, or denial of the dangers of one’s low weight.
There are two types of anorexia. First, restricting type where weight loss is achieved by restricting calories. Restricting anorexics follow drastic diets, go on fasts, and exercise to excess. Second, purging type where people get rid of calories they’ve consumed by vomiting or using laxatives and diuretics. Anorexia is most common in adolescent girls and young women, with a typical age of onset between the ages of 13 and 20. But people of all ages­ including men and children also can suffer from anorexia.
People with anorexia often hide their condition, so the warning signs are not always easy to spot. Furthermore, anorexics will typically try to explain away their disordered eating behaviors when confronted. But as anorexia progresses, the signs and symptoms become increasingly obvious and difficult to deny. The eating and food behavior sings and symptoms are dieting despite being thin, obsess with calories, fat grams and nutrition, pretending to eat or lying about eating, preoccupation with food and strange or secretive food rituals. Someone with anorexia will have dramatic weight loss, feeling fat, harshly critical of appearance, denies being too thin.
Research suggests that a genetic predisposition to anorexia may run in families. If a girl has a sibling with anorexia, she is 10 to 20 times more likely than the general population to develop anorexia herself. Brain chemistry also appears to play a significant role. People with anorexia tend to have high levels of cortisol, the brain hormone most related to stress, and decreased levels of serotonin and norepinephrine, which are associated with feelings of well-being. In addition to the cultural pressure to be thin, there are other family and social pressures that can contribute to anorexia. This includes participation in an activity that demands slenderness, such as ballet, gymnastics, or modeling. It also includes having parents who are overly controlling, put a lot of emphasis on looks, diet themselves, or criticize their children’s bodies and appearance. Stressful life events—such as the onset of puberty, a breakup, or going away to school—can also trigger anorexia.
The severe calorie restriction of anorexia has dire physical effects. When the body doesn’t get the fuel it needs to function normally, it goes into starvation mode. It slows down to conserve energy and turns in on itself for essential nutrients. In essence, the body begins to consume itself. As the self-starvation continues and more body fat is lost, the medical complications pile up. The physical signs and effects of anorexia are loss of mestrual periods, constipation and abdominal pain, lack of energy and weakness, feeling cold all the time, dry and yellowish skin, dizziness, fainting and headaches. Other effects of anorexia include tooth decay and gum damage from malnutrition and vomiting, and damage to the esophagus and larynx from acid reflux. Anorexia can also lead to depression, severe mood swings, and thoughts of suicide.
Treating anorexia involves three components including restoring the person to a healthy weight; treating the psychological issues related to the eating disorder; and reducing or eliminating behaviors or thoughts that lead to disordered eating, and preventing relapse. While the physical and emotional consequences of anorexia can be devastating, the good news is that it’s a treatable condition. With the right treatment team, people with anorexia can and do get better. They can regain their health, learn to eat normally again, and develop healthier attitudes about food and their bodies. Since anorexia involves both mind and body, both attitudes and behaviors, a team approach is often best. Those who may be involved in anorexia treatment include medical doctors, mental health professionals, and dieticians. The participation and support of family members also makes a big difference in anorexia treatment success.