Anorexia nervosa is defined as an eating disorder which causes individuals to become obsessed with the food they eat and their weight. Those suffering from anorexia want to maintain a weight well below what is considered normal for their height and age. They may exercise excessively or starve themselves in order to lose weight or to prevent weight gain.
Symptoms of anorexia are divided into two categories; emotional and physical. One of the difficulty in diagnosing and treating patients with anorexia is symptoms can vary greatly between patients.
- Denying one is hungry
- Exercising excessively
- Fear of gaining weight
- Lying about food intake
- Preoccupied with food
- Reduced libido
- Refusing to eat
- Socially withdrawn
- Cessation of menstruation
- Cold intolerance
- Dry skin
- Excessive weight loss
- Heart arrhythmia
- Low blood pressure
- Swelling of extremities
- Thinning and brittle hair
It can be very difficult to identify the symptoms of anorexia because individuals with this condition become quite good at hiding it from others. There are, however, several red flags others can look for in people they think may be suffering from anorexia nervosa.
- Avoids eating in public
- Excuses for not eating
- Frequently checks appearance in mirrors for imagined flaws
- Only eating specific foods, usually those that are low in calories and fat
- Preparing elaborate meals for others but refusing to join
- Rigid eating rituals
- Skipping meals
- Weighing in repeatedly
- Worrying about being overweight
The cause of anorexia nervosa is not known. As with a number of diseases it is likely a combination of biological, environmental, and psychological factors.
• Biological – It is possible that certain genetic changes may cause some individuals to become more likely to develop anorexia nervosa. Unfortunately, scientists have not been able to pinpoint exactly how these changes occur or contribute to the development of the disease. It is possible that those who are genetically predisposed to perseverance and perfectionism may have an increased risk. Additionally, there is some scientific evidence that the levels of serotonin may contribute to anorexic tendencies.
• Environmental – Modern culture idealizes thinness. All forms of media are filled with images of actors and models that are often unnaturally thin. The social pressure to be thin may heavily contribute to the development of anorexia nervosa, especially in young girls.
• Psychological – There are some emotional and psychological characteristics which are often found in people who develop anorexia. Individuals with obsessive-compulsive disorders or personalities may find it easier to maintain stringent eating habits and to abstain from eating even when they are hungry. Those with a heightened drive for perfectionism may always feel they need to eat less because they are unable to achieve a state they perceive as being thin enough.
There are several tests that can help physicians identify anorexia nervosa. It is necessary to eliminate possible medical causes for the extreme weight loss and to look for any medical complications that may have occurred due to malnutrition or starvation.
• Laboratory Tests – Blood or urine tests may be conducted to evaluate the overall health of the individual and to determine if electrolyte and protein levels are within normal ranges. Other tests may be run to ensure the kidney, liver, and thyroid are functioning properly.
• Psychological Evaluation – A mental health professional may be asked to evaluate a patient to determine their psychological and emotional state.
• Physical Exam – A typical medical exam will record height, weight, and vital signs such as temperature, heart rate, and blood pressure. The physician may also look for abnormalities in skin and nails and listen to the heart and lungs. An abdominal exam may also be performed.
• Other Tests – Anorexia can lead to numerous other health problems which should be identified as soon as possible to limit ongoing damage. Tests may be done to identify previously broken bones and bone density. X-rays and electrocardiograms may be ordered to check the health of the heart and lungs.
Initially, many people with anorexia do not want to be treated. They want to remain thin which will often override any health concerns. Most patients suffering from anorexia will require extensive medical and psychological treatments to restore their physical health and to prevent future relapses.
Medical – Many patients with anorexia need to be hospitalized to treat the problems caused by severe malnutrition, especially for patients who refuse to eat. Others will require outpatient care.
Psychological – Individual, family, and group therapy can all be beneficial for patients suffering from anorexia. Individual therapy helps the person identify and deal with detrimental behaviors and patterns. Family therapy can help family members provide a healthy environment, understand triggers, and learn how to identify problems in the future. Group therapy provides the patient with a way to connect with other people suffering from the same disorder.
Ultimately, anorexia nervosa is not about food or weight. It is the result of severe emotional problems. Most people suffering from anorexia equate their weight with their self-worth. It is a difficult disorder to overcome but with treatment it is possible for patients to return to healthier habits.