Anorexia nervosa
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Contents |
General Overview
Anorexia nervosa is an eating disorder characterized by emaciation—extreme, dangerous thinness—that results from abnormal eating habits. Individuals suffering from anorexia have a distorted body image and incorrectly view themselves as overweight. They often restrict their eating, exercise compulsively, and are obsessed with calories and weight control.
While anorexia affects both genders, women and girls account for approximately 90% of eating disorder cases. Anorexia can develop at any time, but most frequently surfaces during adolescence or young adulthood. Anorexia is a treatable medical condition whose causes are complex, appearing to include both psychological and biological factors.
Causes
Anorexia stems from a distorted body image, which causes individuals with anorexia to perceive themselves as overweight even when they are actually unhealthily thin. There is no one precise cause for anorexia, but some people may be more susceptible to developing it than others. Certain personality traits are common among people with anorexia, and certain types of life situations are known to sometimes precipitate anorexia.
Psychological factors related to anorexia:
◦ Perfectionism
◦ Low self-esteem
◦ Feelings of helplessness
◦ Extreme dissatisfaction with appearance
• Situational factors related to anorexia:
◦ Constant teasing about weight or appearance
◦ Participation in sports that emphasize a certain body image, such as gymnastics or ballet
◦ Trauma, such as abuse, rape, or the death of a loved one
◦ Stressful events that impact a person's role or body image, even happy ones like giving birth
Symptoms
The most noticeable physical symptom of anorexia nervosa is an extremely low body weight. People with anorexia are dangerously thin, yet they believe that they are overweight. Being severely underweight can result in a number of other physical symptoms, including severe constipation, lack of menstruation, brittle hair and nails, anemia, muscle loss, dry and yellowish skin, osteoporosis, lanugo (growing of a fine hair all over the body), low blood pressure, slowed heart rate, lethargy, and feeling cold all the time because of a drop in body temperature.
In addition to physical symptoms, individuals with anorexia may also display a number of behavioral symptoms. Because of a distorted body image, a person with anorexia often insists he or she is overweight, and expresses an intense fear of gaining weight. In order to lose weight, people with anorexia may engage in behaviors like obsessively counting calories, excessive dieting and exercising, and purging through vomiting or misusing laxatives, enemas or diuretics. Eating only very small quantities of certain foods, refusing to eat in front of other people, and repeatedly weighing oneself are other common behaviors.
Other psychiatric illnesses are also common in people with anorexia, especially depression, anxiety disorders, and substance abuse. It is unclear whether anorexia leads to these other mental disorders or is itself a symptom.
Risks
Anorexia nervosa has severe physical consequences that increases a person's risk for a variety of health problems, and is associated with one of the highest mortality rates of any psychiatric disorder. Some studies have found that people suffering from anorexia are up to 10 times more likely to die than those in the general population, and the National Institute of Mental Health estimates that one out of every ten people with anorexia die of starvation, suicide or medical complications. The most common medical complications resulting in death are cardiac arrest and electrolyte and fluid imbalances associated with kidney failure.
Treatment Options
Treatment for anorexia has both psychological and medical aspects and commonly involves multiple professionals. While there are a variety of approaches, they all involve three main components: achieving a healthy weight, addressing underlying psychological issues, and reducing/eliminating destructive thoughts and behaviors. Physicians and nutritionists play an important role in the first component and are often called upon to assess the patient's health, rule out and treat medical illnesses, and design a nutrition plan. A psychologist or other therapist works with the patient to address the psychological components of anorexia treatment.
Psychotherapy is used to address underlying psychological issues relating to anorexia and often involves working to improve personal relationships or move beyond a traumatic experience. In addition, a psychologist will help the patient replace the destructive thoughts and behaviors that led to anorexia with positive ones. There are different forms of psychotherapy, including individual, group, marital and family therapy, and the type of psychotherapy or combination of psychotherapies often depends on the patient. Working on interpersonal relationships through marital and family therapy may help prevent future relapses by helping loved ones understand anorexia and learn appropriate coping techniques. Some studies have found that adolescent patients with non-chronic anorexia seem to benefit most from family-based therapies. Many patients require long-term treatment in order to achieve successful recovery from anorexia.
There is some indication that medications such as antidepressants, which address co-existing conditions like depression and anxiety, may aid in the treatment of anorexia. However, there is no medication that specifically addresses anorexia nervosa itself or assists in maintaining a healthy weight.
While some people recover after only one episode of anorexia, others will face relapses in the future. Those with a more chronic form of anorexia may struggle with the illness for years as their health deteriorates. However, anorexia nervosa can be successfully treated, and those who seek professional help have a good chance of long-term recovery.
