Anorexia (an-o-REK-see-uh) nervosa — often simply called anorexia — is an eating disorder and serious mental health condition. It can be potentially life-threatening. The good news is that once diagnosed it can be successfully treated.
What is Anorexia nervosa?
This is an eating disorder characterised by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight.
To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat. They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics, or enemas. They may also try to lose weight by exercising excessively. No matter how much weight is lost, the person continues to fear weight gain.
Anorexia is more than a food problem. It is an extremely unhealthy and sometimes life-threatening way to try to cope with emotional problems. When someone has anorexia, he/she often equates thinness with self-worth.
What causes anorexia nervosa?
The exact cause of anorexia is unknown. As with many diseases, it is probably a combination of biological, psychological and environmental factors.
Who gets anorexia nervosa?
Anorexia affects 1% to 2% of the population. Anorexia can occur in people of any age, sex, gender, race, gender, ethnicity, sexual orientation and economic status – and individuals of all body weights, shapes, and sizes. Anorexia most commonly affects adolescents and young adult women, although it also occurs in men and is increasing in numbers in children and older adults.
What are some symptoms and signs of anorexia?
The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioural issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.
It may be difficult to notice signs and symptoms because what is considered a low body weight is different for each person, and some individuals may not appear extremely thin. Also, people with anorexia often disguise their thinness, eating habits or physical problems.
Physical symptoms
Physical signs and symptoms of anorexia may include:
• Extreme weight loss or not making expected developmental weight gains
• Thin appearance
• Abnormal blood counts
• Fatigue
• Insomnia
• Dizziness or fainting
• Bluish discolouration of the fingers
• Hair that thins, breaks, or falls out
• Soft, downy hair covering the body
• Absence of menstruation
• Constipation and abdominal pain
• Dry or yellowish skin
• Intolerance of cold
• Irregular heart rhythms
• Low blood pressure
• Dehydration
• Swelling of arms or legs
• Eroded teeth and calluses on the knuckles from induced vomiting
Some people who have anorexia binge and purge, similar to individuals who have bulimia. Individuals with anorexia generally struggle with an abnormally low body weight, while individuals with bulimia typically are normal to above normal weight.
Emotional and behavioural symptoms
Behavioural symptoms of anorexia may include attempts to lose weight by:
• Severely restricting food intake through dieting or fasting
• Exercising excessively
• Bingeing and self-induced vomiting to get rid of food, which may include the use of laxatives, enemas, diet aids or herbal products
Emotional and behavioural signs and symptoms may include:
• Preoccupation with food, which sometimes includes cooking elaborate meals for others but not eating them
• Frequently skipping meals or refusing to eat
• Denial of hunger or 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 spitting food out after chewing
• Not wanting to eat in public
• Lying about how much food has been eaten
• Fear of gaining weight that may include repeated weighing or measuring the body
• Frequent checking in the mirror for perceived flaws
• Complaining about being fat or having parts of the body that are fat
• Covering up in layers of clothing
• Flat mood (lack of emotion)
• Social withdrawal
• Irritability
• Insomnia
• Reduced interest in sex
Getting help
If you think that you have anorexia you should get help and support as soon as possible as this gives you the best chance of recovering from anorexia.
If you think you may have anorexia, even if you are not sure, see your family doctor as soon as you can.
Your doctor will carry out a detailed clinical history, ask you questions about your eating habits and how you are feeling, and will check your overall health and weight. He/she may also arrange for you to have some blood tests to make sure your weight loss is not caused by something else.
If he/she think you may have anorexia, or another eating disorder, he/she should refer you to an eating disorder specialist or team of specialists.
It can be extremely hard to admit you have a problem and to ask for help. It may make things easier if you bring a friend or loved one with you to your appointment.
Getting help for someone else
If you are concerned that a family member or friend may have anorexia, let him/her know you are worried about him/her and encourage him/her to see a doctor. You could offer to go along with him/her.
Diagnosis
If your doctor suspects that you have anorexia nervosa, he or she will typically do several tests and exams to help pinpoint a diagnosis, rule out medical causes for the weight loss, and check for any related complications.
Treatment
The biggest challenge in treating anorexia is helping the person recognise and accept that they have an illness. Many people with anorexia deny that he/she has an eating disorder. They often seek medical treatment only when their condition is serious or life-threatening. This is why it is important to diagnose and treat anorexia in its beginning stages.
Treatment for anorexia is generally done using a team approach, which includes doctors, mental health professionals and dietitians, all with experience in eating disorders. Ongoing therapy and nutrition education are incredibly important to continued recovery.
You can recover from anorexia, but it may take time – and recovery will be different for everyone.
Your treatment plan will be tailored to you and should consider any other support you might need, such as for depression or anxiety.
Dietary supplements and herbal products, designed to suppress the appetite or aid in weight loss, may be abused by people with anorexia. Weight-loss supplements or herbs can have serious side effects – and dangerously interact with other medications. If you use dietary supplements or herbs, discuss the potential risks with your doctor.
People with anorexia can recover. However, they are at increased risk of relapse during periods of high stress or during triggering situations. Ongoing therapy or periodic appointments during times of stress may help you stay healthy.
What are the complications of anorexia?
The medical complications and health risks of malnutrition and starvation, which are common in people who have anorexia, can affect nearly every organ in the body. In severe cases, vital organs such as your brain, heart and kidneys can sustain damage. This damage may be irreversible even after a person has recovered from anorexia.
Severe medical complications that can happen from untreated anorexia include irregular heartbeats, osteoporosis, kidney and liver damage, seizures, rapid breakdown of skeletal muscle, delayed puberty and physical growth, infertility, insomnia, anaemia cardiac arrest and death.
In addition to physical complications, people with anorexia also commonly have other mental health conditions, including depression, anxiety, personality disorders, obsessive-compulsive disorders, alcohol abuse and substance misuse.
If these mental health conditions are left untreated, they could lead to self-injury, suicidal thoughts, or suicide attempts.
Conclusion
Anorexia nervosa is an eating and mental health disorder. It is a serious and potentially life-threatening disorder. The good news is that recovery is possible. If you or someone you know is experiencing signs and symptoms of anorexia, it is important to seek help and care as soon as possible. It is never too late to seek treatment but getting help early improves the chance of a lasting recovery.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented. Always talk to your doctor for professional medical advice.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
