Anorexia nervosa is an eating disorder that causes people to obsess about their weight and the food they eat. People with anorexia nervosa attempt to maintain a weight that’s far below normal for their age and height. To prevent weight gain or to continue losing weight, people with anorexia nervosa may starve themselves or exercise excessively.
Anorexia (an-oh-REK-see-uh) nervosa isn’t really about food. It’s an unhealthy way to try to cope with emotional problems. When you have anorexia nervosa, you often equate thinness with self-worth.
Anorexia nervosa can be difficult to overcome. But with treatment, you can gain a better sense of who you are, return to healthier eating habits and reverse some of anorexia’s serious complications.
Symptoms
1. Physical anorexia symptoms
Physical signs and symptoms of anorexia include:
Extreme weight loss
Thin appearance
Abnormal blood counts
Fatigue
Insomnia
Dizziness or fainting
A bluish discoloration of the fingers
Hair that thins, breaks or falls out
Soft, downy hair covering the body
Absence of menstruation
Constipation
Dry skin
Intolerance of cold
Irregular heart rhythms
Low blood pressure
Dehydration
Osteoporosis
Swelling of arms or legs
2. Emotional and behavioral anorexia symptoms
Emotional and behavioral characteristics associated with anorexia include:
Refusal to eat
Denial of hunger
Afraid of gaining weight
Lying about how much food has been eaten
Excessive exercise
Flat mood (lack of emotion)
Social withdrawal
Irritability
Preoccupation with food
Reduced interest in sex
Depressed mood
Possible use of laxatives, diet aids or herbal products
When to see doctor
Anorexia, like other eating disorders, can take over your life. You may think about food all the time, spend hours agonizing over options in the grocery store and exercise to exhaustion. You also may have a host of physical problems that make you feel generally miserable, such as dizziness, constipation, fatigue and frequently feeling cold. You may feel irritable, angry, moody, sad, anxious and hopeless. You might visit pro-anorexia websites, refer to the disease as your “friend,” cover up in layers of heavy clothing, and try to get by on a menu of lettuce, carrots, popcorn and diet soda.
If you’re experiencing any of these problems, or if you think you may have an eating disorder, get help. If you’re hiding your anorexia from loved ones, try to find a confidant you can talk to about what’s going on.
Anorexia red flags to watch for
It may be hard to notice signs and symptoms of anorexia because people with anorexia often go to great lengths to disguise their thinness, eating habits or physical problems.
If you’re concerned that a loved one may have anorexia, watch for these possible red flags:
Skipping meals
Making excuses for not eating
Eating only a few certain “safe” foods, usually those low in fat and calories
Adopting rigid meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing
Cooking elaborate meals for others but refusing to eat
Repeated weighing of themselves
Frequent checking in the mirror for perceived flaws
Complaining about being fat
Not wanting to eat in public
Unfortunately, many people with anorexia don’t want treatment, at least initially. Their desire to remain thin overrides concerns about their health. If you have a loved one you’re worried about, urge her or him to talk to a doctor.
Causes
The exact cause of anorexia nervosa is unknown. As with many diseases, it’s probably a combination of biological, psychological and environmental factors.
1. Biological. There may be genetic changes that make some people more vulnerable to developing anorexia. However, it’s not clear specifically how your genes could cause anorexia. It may be that some people have a genetic tendency toward perfectionism, sensitivity and perseverance, all traits associated with anorexia. There’s also some evidence that serotonin — one of the brain chemicals involved in depression — may play a role in anorexia.
2. Psychological. Some emotional characteristics may contribute to anorexia. Young women may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry. They may have an extreme drive for perfectionism, which means they may never think they’re thin enough.
3. Environmental. Modern Western culture emphasizes thinness. The media are splashed with images of thin models and actors. Success and worth are often equated with being thin. Peer pressure may help fuel the desire to be thin, particularly among young girls
Treatments And Drugs
Here’s a look at what’s commonly involved in treating people with anorexia:
1. Medical care
Because of the host of complications anorexia causes, you may need frequent monitoring of vital signs, hydration level and electrolytes, as well as related physical conditions. In severe cases, people with anorexia may initially require feeding through a tube that’s placed in their nose and goes to the stomach (nasogastric tube). A primary care doctor may be the one who coordinates care with the other health care professionals involved. Sometimes, though, it’s the mental health provider who coordinates care.
2. Restoring a healthy weight
The first goal of treatment is getting back to a healthy weight. You can’t recover from an eating disorder without restoring an appropriate weight and learning proper nutrition. A psychologist can work with you to develop behavioral strategies to help you return to a healthy weight. A dietitian can offer guidance on a healthy diet, including providing specific meal plans and calorie requirements that will help you meet your weight goals. Your family will also likely be involved in helping you maintain healthy-eating habits.
3. Psychotherapy
Individual, family-based and group therapy may all be beneficial.
4. Individual therapy. This type of therapy can help you deal with the behavior and thoughts that contribute to anorexia. You can gain a healthier self-esteem and learn positive ways to cope with distress and other strong feelings. A type of talk therapy called cognitive behavioral therapy (CBT) is commonly used. Therapy may be done in day treatment programs, but in some cases, may be part of treatment in a psychiatric hospital.
5. Family-based therapy. This therapy begins with the assumption that the person with the eating disorder is no longer capable of making sound decisions regarding his or her health and needs help from the family. An important part of family-based therapy is that the family is involved in making sure that healthy-eating patterns are followed. This type of therapy can help resolve family conflicts and muster support from concerned family members. Family-based therapy can be especially important for children with anorexia who still live at home.
6. Group therapy. This type of therapy gives you a way to connect to others facing eating disorders. And informal support groups may sometimes be helpful. However, be careful with informal groups that aren’t led by a mental health professional. For some people with anorexia, support groups might result in competitions to be the thinnest person there.
7. Medications
There are no medications specifically designed to treat anorexia because they haven’t been found to work very well. However, antidepressants or other psychiatric medications can help treat other mental disorders you may also have, such as depression or anxiety.
8. Hospitalization
In cases of medical complications, psychiatric emergencies, severe malnutrition or continued refusal to eat, hospitalization may be needed. Hospitalization may be on a medical or psychiatric ward. Some clinics specialize in treating people with eating disorders. Some may offer day programs or residential programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time. Also, even after hospitalization ends, ongoing therapy and nutrition education are highly important to continued recovery.
Lifestyle And Home Remedies
When you have anorexia, it can be difficult to take care of yourself properly. In addition to professional treatment, follow these steps:
1. Stick to your treatment plan. Don’t skip therapy sessions and try not to stray from meal plans, even if they make you uncomfortable.
2. Talk to your doctor about appropriate vitamin and mineral supplements. If you’re not eating well, chances are your body isn’t getting all of the nutrients it needs.
3. Don’t isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart.
4. Resist urges to weigh yourself or check yourself in the mirror frequently. These may do nothing but fuel your drive to maintain unhealthy habits.