Have you ever seen someone obsessively think about food, obsessively trying to lose weight? Maybe it's you. It's normal to worry about your body shape and weight. But if this worry and control over what you eat goes beyond the point of normal, it can lead to a mental and health condition called Anorexia Nervosa . Today, we'll talk about what anorexia nervosa is, how it affects us, and how to get help.
What is Anorexia Nervosa? Let's understand it simply!
Simply put, Anorexia Nervosa is a mental illness related to eating. A person with this condition severely restricts their calorie intake. That is, they eat very little, sometimes even without eating. The main goal of these people is to keep their body weight as low as possible. As a result, they suffer from severe malnutrition . Although not always, their BMI (Body Mass Index) , which is a value that indicates weight for height, is often very low.
In medical terms, the word "anorexia" means a loss of appetite or aversion to food. However, when you add the word "nervosa" to it, it becomes a mental condition. That is, it is related to your nervous system - your brain, your nerves, your thoughts. It is caused by negative thoughts and feelings about food, body weight, and your body image.
It's normal to think about these things and try to control them. But for someone with anorexia nervosa, there's no escape from these thoughts. They control them and drive them to extreme behaviors. This can seriously affect both mental and physical health. If not recognized and treated properly, it can even be life-threatening.
What are the main types of Anorexia Nervosa?
Anorexia nervosa can be divided into two main types, depending on how it is treated around food:
- Restrictive Anorexia: This type involves severely restricting calorie intake, meaning eating very little.
- Binge-purge anorexia: This involves restricting calories, but at the same time, similar to bulimia nervosa , eating a large amount of food at once (binge eating) and then purging it. This purging may be done by vomiting, using laxatives, or excessive exercise.
Another special type is atypical anorexia . In this, the person has symptoms of anorexia but is not (yet) underweight. This makes it a little harder to diagnose.
What are the symptoms of Anorexia Nervosa? How do you recognize it?
Symptoms of anorexia nervosa can be physical, behavioral, or psychological. Some of these include:
- Significant weight loss within a few weeks or months.
- Being underweight for height (usually a BMI of less than 18.5 ).
- As a child grows, unexplained changes in height/weight balance occur.
- Excessive focus on food types, quantities, and/or calorie counts.
- Frequent critical thoughts and opinions about body weight and image.
- Misuse of appetite suppressants, laxatives, or diuretics.
- Exercising for a long time, especially after eating, as if by force .
- Always going to the bathroom after eating.
Imagine, you have a friend who used to eat well. But now, for the past few months, she has become very thin. She gets very upset when talking about food, saying things like, "This has a lot of calories, that has a lot of fat." She quickly runs to the bathroom after eating. If you see something like this, you should suspect that it could be anorexia.
As the disease progresses, symptoms of malnutrition may also appear. For example:
- Heartbeat abnormalities (`Arrhythmias`).
- Dizziness, feeling dizzy, or fainting.
- Extreme fatigue and physical weakness.
- Always feeling cold.
- Quick to anger.
- Hair loss.
- For women, menstrual periods become irregular or disappear completely.
- Swelling of the limbs.
What are the causes of Anorexia Nervosa?
There is no single cause for anorexia nervosa. It can be caused by a number of biological, psychological, and social factors.
- Brain changes: Scientists have found that people with anorexia have changes in the structure and function of their brains. For example, they have changes in their levels of neurotransmitters like serotonin and dopamine . These neurotransmitters are chemicals that affect things like our appetite, mood, impulse control, and the brain's "reward system."
- Genes and family: If a close family member (mother, father, siblings) has an eating disorder, you are significantly more likely to develop one. This can be influenced by the genes you inherit from your parents, as well as the values and habits you learn as you grow up in your family.
- Peer pressure: Social and professional pressures are very strong, especially if your social or professional status depends on your physical appearance. The careers of athletes, dancers, models, and actors are all tied to this. Young people can also be very critical of themselves and others. The unrealistic pressure to be "beautiful" through social media may be one reason for this.
- Psychological causes: Having low self-esteem, or believing that one's worth is determined by one's ability to control one's weight, can pave the way for an eating disorder. Sometimes, these feelings are triggered by past traumatic events or psychological conditions such as anxiety and depression.
What are the possible complications of Anorexia Nervosa?
Malnutrition and fasting can affect almost every organ and tissue in your body. Some severe organ damage may not be reversible, even after you recover from anorexia. Anorexia can also have a devastating impact on your relationships and your mental and emotional health. Even with treatment, these effects can take time to heal.
If left untreated, anorexia can lead to conditions such as:
- Decreased bone mass ( osteoporosis ) and erosion of tooth enamel.
- Rapid breakdown of skeletal muscle ( rhabdomyolysis ).
- Kidney and liver damage.
- Heart failure or cardiac arrest.
- Delayed puberty and growth in children.
- Infertility in adults.
- Mental health decline, self-harm and suicidal thoughts.
Important: If you are having suicidal thoughts, please seek help immediately. You can call organizations like Sri Lanka Friends (0112692909). You are not alone.
How is Anorexia Nervosa diagnosed?
Doctors diagnose anorexia nervosa according to criteria in the official guide to diagnosing mental illnesses , the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) . These three criteria are:
1. Self-restricted calories, resulting in significant weight loss or failure to gain weight in growing children. Typically, having a low body weight for age, gender, height, and stage of development.
2. Unusual obsession with body weight and intense fear of gaining weight or becoming "big".
3. Having a distorted view of one's own appearance or an inability to accept the severity of one's condition.
If you have symptoms of anorexia, a doctor will perform a physical exam and take your complete medical history, including your mental health history. Then, they will ask you detailed questions about your eating habits, exercise patterns, weight loss medications, and related feelings and beliefs.
Your doctor may also order certain tests to assess the effects of anorexia on your body. These may include:
- Bone density test
- Complete blood count
- Electrocardiogram ( EKG )
- Electrolyte panel test
- Kidney function tests
- Liver function tests
- Thyroid blood tests
- Urinalysis
How is Anorexia Nervosa treated?
Treatment for anorexia nervosa is individualized. That is, treatment is tailored to each individual. The main goals of treatment are to:
- Restoring good nutritional status.
- Stabilizing weight loss.
- Eliminating disordered eating behaviors.
- Treating underlying psychological problems.
The biggest challenge in treating someone with anorexia is helping them recognize and accept that they have a serious illness. Many people with anorexia deny that they have an eating disorder. They only seek help when their condition is severe enough to be life-threatening. That is why it is so important to diagnose the disease and start treatment early.
Your doctor will create a treatment plan that is right for you. It may include:
- Nutrition therapy
- Psychotherapy
- Medication
- Hospitalization
Hospitalization may be necessary to treat severe malnutrition or other serious health complications. Severe mental health problems may also require hospitalization. Medications sometimes play an important role in treating these complications. However, the long-term treatment for anorexia nervosa is psychotherapy.
What is psychotherapy?
Psychotherapy, or talk therapy, can help you change the thoughts and behaviors associated with eating disorders. It can help you develop healthier attitudes about food, weight, and body image. It can also help you learn better ways and techniques to deal with stress and negative thoughts.
Some people with anorexia may have other mental health conditions that contribute to their eating disorder (`coexisting mental health conditions`). It is important to treat these conditions along with anorexia. But even if you don't have another disorder, anorexia is still a mental health problem. Treatment should address the underlying cause in your mind.
There are many psychotherapy methods, for example:
- Acceptance and commitment therapy (ACT): This method focuses on developing motivation to change your behaviors, regardless of your thoughts and feelings.
- Cognitive behavioral therapy (CBT): This method helps to address distorted thoughts and attitudes about weight, shape, and appearance, and to create behavioral changes.
- Cognitive remediation therapy (CRT): This involves exercises and activities that help improve your cognitive and executive functioning and your ability to take control of your life.
- Dialectical behavior therapy (DBT): Specific skills you will learn from DBT include developing mindfulness, improving relationships, managing emotions, and coping with stress.
- Family therapy: Family support is essential for successful treatment of anorexia. Family-based therapy for anorexia ( the Maudsley Method ) places responsibility for your nutrition with your family.
- Interpersonal psychotherapy (IPT): IPT improves your relationships and communication, which may reduce your eating disorder symptoms.
- Psychodynamic psychotherapy: This therapy looks at the underlying causes of anorexia, considering it as a key to your recovery.
What are the possible complications of anorexia treatment?
The most serious complication of anorexia treatment is refeeding syndrome . This can happen when someone who is severely malnourished starts eating again. Your body needs certain nutrients to digest food and produce energy. When your body's stores of these nutrients are depleted, your body pulls those nutrients from your bloodstream.
This transfer of nutrients from the blood to the cells can cause various complications, sometimes even fatal. That is why it is very important to start refeeding under medical supervision. Doctors will make sure to restore the minimum amount of nutrients in your body first and monitor you carefully during the refeeding process.
How long does it take to recover from anorexia?
Recovery from anorexia is a different journey for each person. Some parts of your treatment plan may take longer than others. The most important thing is to remember that recovery is possible. No matter where you or your loved one is on this journey, it is essential to keep working towards recovery.
When should you see a doctor about anorexia?
If you or someone you care about is showing signs of an eating disorder, talk to a doctor right away . It's always better to seek help sooner rather than later. Even if you or your loved one doesn't (yet) meet the criteria for anorexia nervosa, early intervention can stop the seeds of the disease from growing.
What is the prognosis for someone with anorexia?
The outlook for someone with anorexia nervosa depends on a variety of factors, including:
- How long have they lived with this situation?
- How dire their situation is.
- What kind of treatment do they receive?
- How well they follow their treatment plan.
The longer anorexia is left untreated, the worse the condition gets, and the physical and mental health effects that come with it get worse. It is difficult to change long-standing habits. Also, people with anorexia tend to deny that they have a problem. They may resist treatment or fail to work through their treatment plan in the long run.
Without treatment, anorexia nervosa can be a life-threatening condition. Eating disorders like anorexia are among the deadliest mental health conditions, both for physical and mental health reasons. People with anorexia are five times more likely to die prematurely and 18 times more likely to die by suicide.
With the right support and treatment, recovery is possible. But it often takes time – and there is a risk of relapse. Long-term care and the support of loved ones can make a big difference.
Can anorexia be prevented?
We don't know all the causes of anorexia, and we can't control all the factors that may contribute to it. But we can make a difference by the way we raise our children and the role models we set.
we can:
- Teach healthy eating habits and attitudes.
- Help children develop a ``healthy body image``.
- Identify and address bullying, and prevent our children from bullying others.
It's normal to feel ashamed, embarrassed, or afraid about having an eating disorder. But please know that there's nothing wrong with asking for help. Seeking treatment for anorexia, or any mental health condition, is just as important as seeking treatment for a physical condition. And, even if it doesn't feel like it right now, things can change.
If you suspect that someone you know has anorexia, you may not know how to help. Seek guidance from medical professionals. They can listen to your loved one, provide them with resources and strategies to talk to. The sooner they can get a diagnosis and treatment, the better.
Summary: The most important things to remember
Although anorexia nervosa is a serious condition, don't forget that it is possible to recover from it.
The main thing is to understand that you are not alone and that seeking help is not a weakness.
- If you or someone you know has unusual eating behaviors or excessive concerns about body weight, seek medical advice.
- Early detection and treatment increase the chances of recovery.
- Treatment is a journey, it takes time and patience. The support of family and friends is invaluable.
- Try to maintain a healthy lifestyle, a balanced diet, and a positive attitude towards your body.
I hope this information is helpful to you. If you have any further questions regarding this, please do not hesitate to speak to a trusted doctor.
` Anorexia nervosa, anorexia, mental health, body weight, eating disorders, nutrition, treatment
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