Anorexia Nervosa is a type of eating disorder in which people suffer from a constant fear of gaining weight, which makes them reduce the amount of food they consume and become frighteningly thin.
Anorexia Nervosa affects the body and the psyche of the affected person, as it starts as a simple diet, but it soon turns into an uncontrollable condition, making the patient think about eating, dieting and weight all the time, and he will have a distorted image of his body even though the people around him tell him that he has thinned sharply, but he sees in the mirror that he is a fat person.
If a person suffers from anorexia, they should go to counseling and seek help immediately, and the longer the treatment is delayed, the more difficult it will be to overcome the issue, but if proper treatment is provided and received, the patient’s situation will improve significantly and he will regain his healthy and normal weight as before.
Table of Contents
Understanding anorexia nervosa
Anorexia nervosa is an eating disorder that most often occurs during puberty. It manifests as a categorical refusal to eat normally for a long period of time, in order to lose weight or keep it off.
Anorexia nervosa is most often triggered between the ages of 14 and 17, with peak prevalence at 16. However, the age of onset appears to be getting earlier and earlier. The disorder can occur as early as 8, or as late as 18. Contrary to popular belief, anorexia affects all social classes, not just the more affluent.
Around 20% of young girls adopt restrictive and fasting behaviors at some point in their lives, but only a minority become anorexic, presenting all the diagnostic criteria associated with this disorder. An epidemiological study carried out among adolescents in their 18th year of life, in France in 2008, showed that anorexia nervosa affected 0.5% of girls and 0.03% of boys between the ages of 12 and 17. Foreign data point in the same direction, with equivalent figures.
According to a review of epidemiological studies carried out between 2000 and 2018, the lifetime prevalence of anorexia is 1.4% in women and 0.2% in men. These figures have remained stable over the last few decades.
Anorexia nervosa in adolescence
Anorexia nervosa often appears during adolescence, a period of intense physical and psychological change. Adolescents, particularly girls, are often exposed to social pressures regarding physical appearance, which can contribute to the development of anorexia nervosa. Studies show that the age of onset tends to be increasingly early, sometimes as early as 8, and that the disorder can also occur after the age of 18.
Anorexia nervosa in adulthood
Anorexia nervosa in adult men
Although rare, anorexia nervosa in adult men often manifests as an excessive preoccupation with a lean, muscular body. Men may be less diagnosed due to stereotypes that eating disorders are female problems. The pressure to maintain a certain appearance, particularly in sports or professions focused on physical appearance, can exacerbate this disorder.
Anorexia nervosa in adult women
In adult women, anorexia nervosa may be exacerbated by professional or personal factors, such as high standards of beauty in certain professional sectors. It can also be triggered by life events such as bereavement or divorce. In addition, a history of eating disorders in adolescence may persist or reappear in adulthood.
Symptoms of Anorexia Nervosa
Most people who suffer from anorexia nervosa deny that they have an issue, as they do not notice its existence, so relatives should take the initiative to consult a doctor about the patient’s condition, and some symptoms may appear that may help diagnose the issue, as follows:
Physical symptoms
Physical symptoms include severe weight loss, extremely low body mass index (BMI), hormonal disorders such as amenorrhea, and complications such as osteoporosis and anemia. Other manifestations include dry skin, brittle hair and sensitivity to cold. Anorexia nervosa can lead to serious complications. These can be somatic, linked to undernutrition and, in particular, an increased risk of heart disease with heart rhythm disorders, but also psychiatric, with risks of depression, addiction and suicide.
Undernutrition and lack of appetite
Undernutrition is a major consequence of anorexia nervosa, resulting from prolonged nutritional insufficiency. It affects overall health, leading to extreme fatigue, reduced muscle mass, and vitamin and mineral deficiencies. Lack of appetite, while often intentional in the context of anorexia nervosa, can be exacerbated by biological alterations, such as a decrease in the secretion of hunger-regulating hormones like ghrelin. This condition may require medical intervention to avoid serious consequences for physical and mental health.
Psychological symptoms
Psychological symptoms include obsessive eating, an intense fear of gaining weight, and compulsive behaviours, often accompanied by depression and anxiety. Patients may develop complex eating rituals and over-investment in work or studies to compensate for low self-esteem. These psychological symptoms can also lead to social isolation and relationship difficulties.
Patients often exaggerate their food intake and hide behaviours such as induced vomiting. Binge eating or compensatory behaviours are present in 30-50% of patients. The remainder simply restrict their food intake.
Many patients with anorexia nervosa also engage in excessive physical activity to control their weight. Even patients with a cachectic appearance may remain very active (e.g., by continuing vigorous exercise programs).
Complaints of meteorism, abdominal pain and constipation are common. Most women suffering from anorexia nervosa experience a cessation of menstruation. The patient usually loses interest in sexuality. Depression is common.
Common clinical signs include bradycardia, low blood pressure, hypothermia, lanugo (soft, fine hair usually found only on newborns) or mild hirsutism and edema. Body fat is very low. Patients who vomit frequently may have tooth enamel erosion, painless salivary gland enlargement and/or esophageal inflammation.
Causes of anorexia nervosa
Genetic and biological factors
Studies suggest that there is a genetic predisposition in some people to anorexia nervosa. Biological abnormalities, such as neurotransmitter dysfunction, are also implicated. For example, hyperfunction of the serotonergic system and abnormalities in the dopaminergic circuit have been observed in anorexics. These biological factors can influence eating behavior and emotional responses.
Psychological and environmental factors
Psychological factors include perfectionism, low self-esteem and anxiety disorders. The social and cultural environment, with its ideals of thinness, plays a crucial role, as do traumatic life events. Periods of early intense stress, such as sexual abuse, violence or maltreatment, can also be triggering factors. These factors contribute to the complexity of the disorder and the difficulty of managing it.
Complications of anorexia nervosa
In most cases, anorexia begins in adolescence. Diagnosing anorexia in its early stages allows for more successful treatment, and if not treated quickly, it can progress to a lifelong condition, leading to nutritional deficiencies and severe medical issues, such as osteoporosis, kidney damage, and heart conditions that can sometimes cause death: Osteoporosis, kidney damage, and cardiopathy, which can sometimes lead to death.
Diagnosing Anorexia Nervosa
If the doctor suspects that someone is suffering from anorexia nervosa, he or she will compare the person’s weight to a normal weight, and will examine the lungs, heart, blood pressure, skin and hair to find any signs and symptoms that could prove that the patient is deliberately starving himself or herself, and the doctor may also recommend blood tests or radiographs.
In addition, the doctor will ask about the patient’s general well-being, since the relationship between psychological issues, such as depression, anxiety, and some eating disorders: Depression, anxiety, and some eating disorders are highly correlated.
Anorexia Nervosa Treatment
People suffering from anorexia nervosa need medical treatment, even in cases where the patient shows some signs and symptoms of anorexia nervosa, you should seek immediate counseling and help to maximize the effectiveness of the treatment.
The treatment is supposed to help you maintain a healthy weight:
- Adopting a healthy diet.
- Obtaining a sense of self-satisfaction, as this disease arises from both physical and psychological factors, and treatment is likely to be done in collaboration between the doctor, dietitian, and psychological counselor.
- There is no drug treatment for anorexia nervosa, but if the patient suffers from depression or anxiety, the doctor will prescribe some medications to treat the depression or anxiety.
- If the patient’s weight is too low, he or she may need to be treated in a hospital, or in clinics specializing in eating disorders, and treatment in such clinics may be very expensive, but it is one of the best means of treatment.
The patient needs a long period of time to overcome anorexia nervosa, and during this period, he goes through many difficulties that may return him to improper eating habits, which requires support and assistance from specialists.
Consequences of anorexia nervosa and associated illnesses
Because of its effects on the body and mind, anorexia nervosa can lead to a number of serious consequences and secondary illnesses. Undernutrition caused by severe and prolonged food restriction affects almost every bodily system.
Physical consequences
- Cardiovascular disease: Malnutrition can lead to heart rhythm disorders and heart weakness.
- Osteoporosis: Calcium and vitamin D deficiency, common in people with anorexia, can lead to reduced bone density and increased risk of fractures.
- Infertility: Hormonal imbalances can disrupt the menstrual cycle, leading to amenorrhea and difficulty conceiving.
- Muscle weakness and fatigue: The loss of muscle mass and chronic fatigue resulting from undernutrition affect the ability to carry out normal daily activities.
Psychological consequences
Depression and anxiety: Mood disorders are common in people suffering from anorexia nervosa, exacerbating feelings of hopelessness and anxiety.
Social isolation: Obsession with weight and diet can lead to social withdrawal, increasing feelings of loneliness and isolation.
Suicidal risk: Because of the severity of depressive symptoms, people with anorexia are at increased risk of suicidal thoughts and self-harm.
Associated illnesses
- Obsessive-compulsive disorder (OCD): Anorexia nervosa is often associated with obsessive-compulsive behaviors, which may require psychiatric treatment.
- Digestive disorders: Dietary restriction and the use of laxatives can lead to gastrointestinal problems, such as chronic constipation or irritable bowel syndrome.
- Endocrine dysfunction: Undernutrition affects hormone production, disrupting the body’s metabolic and thermoregulatory functions.
- It is essential to address these consequences through appropriate medical and psychological treatment to minimize the risks associated with anorexia nervosa. Early intervention and regular follow-up with healthcare professionals can help prevent these serious complications.
Prevention of anorexia nervosa
Prevention strategies
Prevention involves education about the risks of restrictive dieting and the promotion of a positive body image. Awareness-raising programs in schools can be beneficial in informing young people about the dangers of anorexia nervosa and eating disorders in general. Encouraging balanced eating habits from an early age can also help prevent the development of these disorders.
The role of family and friends
Family support is crucial to prevention and recovery. Families can help by encouraging healthy eating habits and avoiding negative comments about weight. Family therapy can also be a valuable tool for reinforcing positive family dynamics and supporting the patient on his or her healing journey. An understanding and supportive family environment can greatly facilitate the healing process.
Frequently asked questions
What is the definition of anorexia?
Anorexia refers to loss of appetite, but anorexia nervosa is a complex psychological disorder involving intentional weight loss without somatic cause.
How much does an anorexic weigh?
Weight varies, but is often significantly below what is considered healthy for a person of the same age and height. A BMI of less than 17.5 kg/m² is often a diagnostic criterion.
What are the two types of anorexia?
There is restrictive anorexia nervosa, without purging behaviors, and binge anorexia nervosa, where episodes of binge eating are followed by purging.
What causes anorexia nervosa?
Causes include genetic, biological, psychological and environmental factors, each of which plays a role in the development of the disorder.
Conclusion
There’s no foolproof way to prevent anorexia nervosa. Primary care professionals, including pediatricians, family medicine specialists and internal medicine specialists, may be qualified enough to notice early signs of illness that can lead to anorexia. For example, they can ask questions about eating habits and satisfaction with appearance during routine medical appointments. This may open up a discussion about how this relates to health and where to get help if needed.
If you notice that people around you have eating habits that seem too rigid, or are unhappy with their appearance, consider talking to them about these issues. Although you may not be able to prevent the onset of an eating disorder, you can talk about your concerns and offer your help if needed.
