Anorexia nervosa is an eating disorder that is characterized by either an extreme lack of appetite or a serious aversion to eating. It’s a potentially life-threatening condition in which an individual has a distorted body image and often loses an abnormal amount of weight. HelpGuide.org defines Anorexia Nervosa as having three distinct features. First, the individual refuses to maintain a healthy body weight. Second, the person has an intense fear of gaining weight. Finally, the person has a distorted body image. Thinking about eating, planning meals, and worrying about what his or her body looks like is an all-consuming process.
At its core, this disease is not about the food or dieting, but involves much deeper issues for the individual suffering from the disorder. These issues could include depression, insecurity, loneliness, or a type of perfectionism. Bullying is increasingly being recognized as a reason many individuals, especially young people, are developing eating disorders. Being teased about weight or appearance can significantly impact a young person’s self-esteem and confidence and lead to dramatic changes in eating.
Medically, there is a difference between anorexia and anorexia nervosa. Anorexia is simply a loss of appetite that may come about for various reasons. It can be caused by depression or result from medication side-effects. Anorexia nervosa is more complex and involves not just medical but psychological issues as well.
People who suffer from this disease usually lose an abnormal amount of weight by either severely restricting their caloric intake or by restricting intake as well as vomiting, taking laxatives, or exercising excessively. There are generally two types of anorexia. The restricting type includes drastically limiting calories to lose weight. This type often includes excessive amounts of exercise as well. The purging type involves restricting weight and losing weight by vomiting or using laxatives.
No matter what combination of methods the individual uses to achieve extreme weight loss, there are several symptoms that most anorexics have in common. Experiencing extreme weight loss and having an overall thin and gaunt appearance is the most obvious symptom. According to the Mayo Clinic, these individuals often suffer from fatigue and may experience dizziness or fainting. They may also suffer from insomnia, lack of menstruation, and thinning, breaking hair. Dry skin, constipation, and an inability to tolerate cold are other symptoms they may have. Some anorexics may even experience dehydration and swelling in their arms and legs.
Someone who is concerned that a loved one may be suffering from the disease should watch for certain kinds of behavior. Frequently skipping meals or making excuses for not eating may be signs of a problem. Frequently weighing themselves or looking in the mirror are also red flags. Sometimes these individuals will prepare elaborate meals for other people but eat little or none of the food themselves. They may also stick to a very limited or regimented meal plan.
It may sometimes be difficult, at least initially, to see the difference between dieting and a serious problem. Someone who is anorexic may attempt to lose extreme amounts of weight as a way to control their emotions while normal dieting is simply a way to control weight. An anorexic puts being thin before health concerns instead of losing weight to become healthy. Anorexics may see losing weight as a way to achieve happiness and not just about attempting to get healthy or alter their appearance. Finally, self esteem for an anorexic may be based entirely on how thin he or she is.
According to the National Association of Anorexia Nervosa and Associated Disorders, 95 percent of people struggling with eating disorders are between the ages of 12 and 25.8. Of all mental illnesses, eating disorders have the highest mortality rate.
While Anorexia can affect male and females in any age category, it is most prevalent in teenagers and young adults. It does primarily affect females, as males account for only between 10 and 15 percent of all cases. According to ANRED, Anorexia Nervosa and Related Eating Disorders, approximately 1 percent of adolescents suffer from the disease. They also state that without treatment up to 20 percent of individuals with eating disorders eventually die.
Even with treatment, only about 60 percent make a full recovery. About 20 percent make what would be termed a partial recovery. In spite of receiving treatment these individuals still struggle with the disorder to the point that it dramatically affects their lives. They may only marginally make and maintain friendships and romantic relationships. They often struggle with jobs and building lasting careers. Much of their time, money, and energy is spent on diet books, exercise classes, and a preoccupation with food. The final 20 percent do not get better, even with treatment.
Statistic Brain reports that 42 percent of first to third grade girls want to be thinner. Considering that the pressure and desire to be thin starts at such a young age it shouldn’t be a surprise that culture and social pressure plays a large role in the causes behind anorexia. By the time children are only 10 years-old, the percentage of those who fear being fat jumps to 80 percent.
It should be noted that there appears to be a link between depression and all eating disorders. According to the National Association of Anorexia Nervosa and Associated Disorders, approximately 50 percent of individuals with eating disorders meet the criteria for depression.
The Mayo Clinic states that the causes of the disease are probably a combination of biological, psychological, and environmental factors. Biological factors may include genetics as well as chemical components in the brain. It is sometimes difficult to assess if biological factors occur as symptoms of anorexia or if they are a cause that lead to the disorder. There could be biological factors that increase the likelihood. If someone has a sibling that has the disease that person is 10 to 20 times more likely to develop the disorder themselves than the average person. It’s even suggested that anorexics may have certain chemicals in the brain at a higher level that may lead to an eating disorder. High levels of cortisol, the stress hormone, may be higher in those who develop anorexia. These individuals may also have lower levels of serotonin, which is associated with positive feelings.
Psychological factors include tendencies toward perfection or even types of obsessive compulsive behaviors. Individuals who struggle with depression or anxiety may be more likely to develop the disorder. A person who is emotionally restrained or has difficulty handling stress may also be susceptible.
Environmental factors include the overwhelming idea in our modern culture that being thin is associated with beauty. Peer pressure is a part of this, especially among girls. Some anorexics are the type of individual who makes good grades and are involved in a variety of activities. Cultural, social, and family pressure can contribute to the intense desire to be thin. Certain activities such as participating in ballet or becoming a model can create an intense desire in certain individuals to lose extreme amounts of weight. Stressful events in life can also be a trigger.
Bullying may play a large role in leading people to succumb to eating disorders. Research conducted by the UK Charity Beat discovered after surveying 600 individuals that 75 percent of those suffering from an eating disorder admitted to being bullied at some point. In fact, they even said that the bullying was a major factor relating to their disorder. Parents or loved ones of individuals need to learn to recognize the symptoms of bullying. Recognizing these signs as early as possibly may help stop eating disorders from starting. Some signs of bullying include loss of interest in school or other usual activities, unexplained injuries or bruises, and difficulty sleeping at night. Increased feelings of low self-worth and a change in eating habits could be signs of bullying as well as the beginning of an eating disorder.
According to the University of Maryland Medical Center there are several possible complications from Anorexia Nervosa. Some of these complications may include bone density loss, electrolyte imbalance, anemia, and fertility problems. There could also be hormonal problems that affect both male and females. Females may eventually stop having their periods while males may experience a decrease in testosterone. There is also the chance of developing an abnormal heart rhythm. Other heart problems that can occur include mitral valve prolapse. Anorexics may have abnormal blood counts and low blood pressure. Some may even suffer from osteoporosis.
The disease affects people throughout their entire bodies. An anorexic’s hair may become thin and brittle. Their skin bruises easily and they may develop the growth of fine hair all over their body. This may be in an attempt to keep the body warm since they have a tendency to be cold much of the time. The intestines may not function properly, leading to constipation and bloating. Kidney stones can happen in an anorexic due to low potassium levels. Even kidney failure is a possibility. Muscles tend to be weak, joints are sore, and early osteoporosis may develop. Those who induce vomiting will eventually damage the stomach, the esophagus, and their teeth. Those who rely more on laxatives can see intestinal damage. There may even be dramatic changes in brain chemistry no matter how the anorexic chooses to lose weight.
There are several types of mental disorders associated with the disease. These can include depression, anxiety, obsessive compulsive disorder, and types of personality disorders. Sometimes the psychological disorders are secondary to the eating disorder, but other times the eating disorder is secondary. It’s crucial to get a proper diagnosis when attempting to successfully treat an individual.
Several celebrities have battled the disease through the years. Growing Pains actress Tracey Gold fought this disorder for several years. She recovered, relapsed, and has since recovered. She reportedly developed the disorder at the age of 12. Ironically, Tracey played the role of a young woman suffering from the disease in the film “For the Love of Nancy.” This movie was based on a true story.
Tara Reid, Jessica Alba, and Calista Flockheart, are but a few other famous individuals who have battled anorexia. The pressure to stay thin in Hollywood can be overwhelming. This condition doesn’t only affect female celebrities. Ashley Hamilton, son of celebrity George Hamilton, has also suffered from eating disorders. After overcoming drug and alcohol abuse, Ashley fought both bulimia and anorexia. Ashley even admitted that in high school “Fatley” was his nickname.
The first celebrity that publicly battled the disease was music legend Karen Carpenter. Her ordeal with the disorder is one of the most compelling anorexia stories. It’s reported that her struggle with her weight began shortly after high school when she embarked on the Stillman water diet. Initially, everything seemed to be going well. Karen dropped down to 110 pounds and received compliments on her trim figure. But somewhere along the way she crossed a line and became obsessed with losing weight. It reached the point that audiences would even gasp when she came on stage. Since this eating disorder was a relatively unknown disease at the time, some fans thought she had cancer. Band mates and others working around her realized she was becoming increasingly unhealthy when she would lay down between shows during their concerts.
Eventually, Karen was encouraged to seek professional help. Karen received more attention from her mother when she would go to extremes regarding dieting. But this may have triggered her to diet even more, as she seemed to crave the extra attention. In late 1975 Karen checked into Cedars-Sinai Medical Centre in Los Angeles. There were several personal struggles during these few years that included unsuccessfully trying to launch a solo career and a difficult marriage. In November 1981, Karen divorced and decided to seek treatment for her eating disorder. But Karen didn’t seem completely committed to recovery and continued to indulge in frequent exercise and taking certain types of diet pills. In September of 1982 Karen’s disease began to take an extreme physical toll. She complained of a “funny” heartbeat and extreme dizziness. A tube was inserted in the right atrium of her heart. During the procedure one of her lungs was punctured. During this recovery she was being fed intravenously. She continued to gain weight after leaving the hospital.
In February 1983, Karen collapsed at her parents’ home. She was pronounced dead at the hospital with the cause of death listed as “cardiac irregularities” by chemical imbalances that were brought about by anorexia nervosa. It was also stated that she had inadvertently poisoned herself with ipecac syrup. This is often used to induce vomiting. The family, however, disputes this, claiming Karen wouldn’t use ipecac because it would damage her vocal chords and that she had relied on laxatives to stay thin.
Parents off children and young adults can encourage and help develop their self esteem to help prevent eating disorders from starting. Helping a child understand that there is a broad definition of beauty is a good place to start. It’s also important for the adults in a child’s life to have a healthy body image themselves. Parents can also watch for signs of children being bullied because of their weight. These can include a child suddenly talking about his or her weight or not wanting to wear certain clothing any longer. A dramatic change in eating habits are another sign of weight bullying.
Once an eating disorder may have taken root there are specific criteria for a diagnosis of anorexia nervosa set forth by the American Psychiatric Association. The criteria include refusing to stay at a body weight that is considered normal for that particular individual, exhibiting an intense fear of being fat even though the person is underweight, having a distorted body image, and in women, lacking menstruation for at least three consecutive cycles. There are some people, however, who may not meet all of these criteria but still have an eating disorder.
Getting individuals who are suffering to admit they have a problem is often the most difficult step of the recovery process. Some people, unfortunately, may not want help even if they eventually realize they have a problem. Considering how the media and our culture glamorizes people who are thin and that there are even websites promoting anorexia and how to achieve it, convincing some individuals that it’s not worth it to continue their behavior may be difficult.
According to the National Eating Disorders Association (NEDA) there are five stages that occur in the recovery process. The Pre-contemplation Stage is when an individual doesn’t believe he or she has a problem, though others around the person has probably already noticed several symptoms. The Contemplation Stage begins when the person admits having a problem. The person may be receiving counseling at this point but has not yet committed to actual treatment. The Preparation Stage begins when the individual is ready to change but isn’t sure how to go about doing it. A plan of treatment may be in the process of being developed by a team of nutritionists, physicians, and therapists. The Action Stage happens with the individual is ready to actually go through treatment. The person must be willing to trust the treatment team for this stage to be successful. The Maintenance Stage begins when the individual has successfully sustained the Action Stage for six months. New behaviors and new ways of thinking are part of this stage as well.
For a parent or any loved one who is trying to help the individual through these various stages there are signs to be aware of and ways to best help the person make a full recovery. Don’t be in denial about the person’s eating disorder or make excuses for them. Be aware of the signs and symptoms and be willing in a loving, non-judgmental way to discuss the situation with the person. During the Contemplation Stage become educated about the disorder, but don’t try to fix the problem yourself. During the Preparation Stage you need to make clear the role you’re playing in the process. The role a parent would play to an underage child would be different than the role of a friend. During the Action Stage loved ones should listen and follow the advice given by the treatment team. They should also remove triggers from the environment such as scales or certain types of diet food. During the Maintenance Stage they should encourage and applaud success. Sometimes new boundaries and guidelines in the relationship need to be established.
Even though the reason for developing the condition in the first place may be complex, it may be unnecessary to pick apart all the the separate biological, psychological, cultural, and social issues in order for recovery to occur. The first goal of treatment is getting the person back to a normal, healthy weight. There are a variety of treatment options available for those suffering from this disease. Cognitive-behavioral therapy is the type of treatment most often used. This type of therapy addresses negative behaviors and the thoughts behind the destructive behavior. Patients are encouraged to become aware of how they use food to deal with their emotions. During this process it’s important to realize emotional triggers and how to overcome them. Nutritional counseling is usually a part of establishing healthy eating patterns. Joining a support group can also be an important step to making a full recovery. It can be important to connect to others who are going through the same struggles. Currently there are no medications that are consistently used to treat the disease. Anxiety or depression that often go along with a diagnosis can, however, be treated with medication.