What is Anorexia Nervosa?
Anorexia nervosa is a type of eating disorder which results in unhealthy and potentially dangerous eating habits.
Eating disorders fall under the category of mental illnesses. They consist of conditions which cause abnormal, usually harmful eating behaviors.
Anorexia nervosa can affect anyone, although it is more common in women than men. (1)
There is no single cause of anorexia. The illness can develop due to physical, psychological and social influences.
If you have a family member with an eating disorder, you have a higher risk of anorexia nervosa. Lack of self esteem and depression can also provoke the illness.
Individuals who develop the disorder may have a tendency towards obsessive behaviors. Furthermore, people with anorexia often have poor coping strategies (i.e. dealing with stress).
Socially, peer pressure and perception of the “ideal” body image can result in anorexic behaviors to lose weight.
Abuse, bullying and traumatic life changes are also associated with increased chances of developing eating disorders. (2)
The symptoms of anorexia can be both behavioral and physical. Not every individual will experience the same symptoms. These can include: (3)
An individual with anorexia nervosa may develop specific eating rituals. These can include excessively chewing or carefully arranging food before eating.
A classic sign of anorexia is food restriction. Individuals exhibit a preoccupation with food and calories. The person may eventually cut out entire food groups (i.e. carbohydrates, protein etc).
Avoids Eating Publicly
Someone with this eating disorder may be uncomfortable eating around others. The person can make frequent excuses to avoid situations that involve food, such as mealtimes.
Distorted Body Image
Many individuals with anorexia nervosa have a distorted body image. They perceive themselves as being overweight, even if they are not.
Anorexia is almost always accompanied by an intense, almost phobic fear of gaining weight.
A rigid, obsessive exercise routine is a warning sign of anorexia. An individual might push themselves to exercise even if they are ill or suffering from an injury.
Extreme Weight Loss
As the illness progresses, the individual can go through dramatic weight loss. Certain people with the condition will attempt to hide this weight loss by wearing loose clothing.
Weight Loss Complications
Dramatic weight loss can have serious health consequences. Heart rate can slow and deficiencies in vital vitamins and minerals are highly likely because of the lack of nutrition.
Fainting from hunger can also occur and over time, immune system function can become impaired.
Anorexia nervosa can present in various ways depending on the individual. It has a wide range of symptoms which can vary in severity and manifestation.
For this reason, there is no universally recognized staging system for the condition.
However, there is a system to stage a person’s progress from illness to recovery. It is referred to as the “stages of change” and is applicable to any eating disorder, not just anorexia. (4)
Relapse is a normal part of recovery throughout all stages. It occurs when the affected person reverts to harmful behaviors, such as limiting food.
Although unpleasant, relapsing into the disorder can be helpful long term. Doctors and patient alike can identify triggers (such as stress) that provoke anorexia. (5)
The stages progress as follows: (6)
The anorexic individual cannot or will not acknowledge their symptoms are problematic.
Friends and family member may notice telltale warning symptoms of anorexia at this stage. These can include obsessive eating rituals, avoiding food or over-exercising.
Concerns or questions about the person’s welfare tend to be met with anger or hostility.
By now, the affected individual is aware that anorexia is a problem. They might even begin to consider reaching out for support.
However, the idea of stopping anorexic behaviors entirely is daunting. The person may fear gaining weight if they get help.
At the contemplation stage, very little or no concrete changes occur. Anorexic behavior can serve as a comforting coping mechanism for some during times of stress. (7)
The anorexic person is planning how to reduce or stop harmful habits. They actively acknowledge it’s important to implement change.
The individual may open up to friends or family members about their desire to seek help.
A medical practitioner specialized in eating disorders is usually necessary to move forward. (8)
At this stage, the individual directly confronts anorexia. Destructive thoughts and behaviors begin to change.
The person must commit to practicing healthy efforts. An example can include meal planning or gradually reducing exercise.
Development towards recovery is not always steady. The individual may make significant progress and then relapse. (9,10)
The individual is now learning how to maintain a healthy lifestyle without anorexia.
It is important to identify basic strategies to avoid relapse. For example, the person can learn to avoid stressful triggers that provoke anorexic behavior.
The maintenance stage takes commitment and time. In order to recover, the individual will continue to require a sound support network long term. (11)
Anorexia is usually diagnosed according to the American Psychiatric Association’s (APA) criteria for diagnosis.
The APA criteria for anorexia nervosa describes several key factors:
Firstly, a person is consistently limiting caloric intake leading to low weight. Behaviors that prevent weight gain, such as excessive exercise, are also noticeable. A powerful fear of gaining too much weight is another criterion.
Finally, the person must display excessive focus on body weight and size. Even if weight is dangerously low, an anorexic individual can still perceive themselves as overweight. (12)
Treatment for anorexia aims to help the affected person identify the underlying reasons of the disorder. In turn, anorexic behaviors can be confronted and reduced.
There are no specific medications for treating anorexia. Treatments usually involve talk-based therapies. (13)
Treatments can include one or more of the following: (14)
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) aims to change negative thoughts and behavior over time.
A therapist will work with you to develop an individualized treatment plan. This can involve learning about nutrition and healthy meal planning. CBT can also help you understand your feelings about the disorder.
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
MANTRA is a type of therapy to identify the personal underlying causes of anorexia.
This therapy is not only about overcoming the disorder. Rather, the therapist will work with you to understand why you developed anorexia.
A MANTRA therapist allows you to focus on whatever issues you choose to prioritize.
When and if you are ready, the therapist can begin helping you to actively change anorexic behaviors.
Focal Psychodynamic Therapy
Focal psychodynamic therapy is usually implemented if other therapies are unsuccessful. This type of therapy aims to help you understand the relationship between your thoughts and eating habits.
You will also explore personal feelings about yourself and other individuals who are a part of your life. In turn, this can help you and your therapist understand potential triggers of anorexic behaviors.
If you are extremely underweight, you may be hospitalized for your own safety. You can suffer from life threatening complications if your body weight is too low.
Hospitalization may also be an option if you continue to lose weight and refuse treatment.
What is anorexia nervosa? Anorexia nervosa is a type of eating disorder that results in restrictive eating habits in an attempt to achieve a very low weight.
What are the signs of anorexia nervosa? Signs of the disorder can include eating rituals, restricting food and avoiding eating in public. Other symptoms include a distorted body image, excessive exercise and extreme weight loss. Physical complications from weight loss can occur, such as a slowed heart rate.
How do you develop anorexia nervosa? The condition can develop as a result of one or more factors. These include: genetics, dissatisfaction with appearance and perfectionism. Individuals with a history of abuse are more likely to develop eating disorders such as anorexia. (15)
What is the best treatment for anorexia nervosa? Treatments for anorexia consist of different therapies, such as cognitive behavioral therapy. Other therapies include: maudsley anorexia nervosa treatment for adults and focal psychodynamic therapy. Hospitalization can be an option in severe cases.
What are the long term complications of anorexia nervosa? An extremely low calorie diet can cause serious physical problems long term. Heart failure, kidney failure, and weakened bones are examples of potential complications. (16)
Is anorexia nervosa considered a disability? If anorexia has resulted in severe health issues, you may be eligible for disability. Your doctor will have to verify your condition causes serious mental or physical health impairments. For example, heart failure or disorders such as depression making it difficult or impossible for you to work. (17)
Is there any cure for anorexia nervosa? Yes, treatments for anorexia can help individuals recover and learn to live without the disorder. However, not all individuals will successfully recover. (18)
Is anorexia nervosa life threatening? Yes, anorexia can be life threatening. The illness has the highest mortality rate of any eating disorder. Individuals have a higher risk of suicide as well as potentially fatal physical complications. (19, 20)
The earlier an eating disorder is diagnosed, the better the chances of successful recovery are. If you suspect you may be developing anorexia nervosa, seek support from your doctor.
If you notice the symptoms of this illness in someone else, attempt to approach the person in a supportive manner.
Anorexia can be deadly in the long term even if medical exams do not detect any serious issues. Cardiac arrest can happen suddenly without warning if the body is in a weakened, starved state. (21)