Anorexia Nervosa is an eating disorder which involves the partial or total abstinence from food (solids or liquids) because one believes any amount of food will cause weight gain. An anorexic often perceives herself/himself as ‘fat’ and has an intense fear of gaining 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 isn't really about food. It's an extremely unhealthy and sometimes life-threatening way to try to cope with emotional problems. When you have anorexia, you often equate thinness with self-worth.
The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioral 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 signs and symptoms of anorexia may include:
- Extreme weight loss
- Thin appearance
- Dizziness or fainting
- Bluish discoloration of the fingers
- Hair that thins, breaks or falls out
- Absence of menstruation
- Constipation and abdominal pain
- Dry or yellowish skin
- Irregular heart rhythms
- Swelling of arms or legs
Behavioral symptoms of anorexia may include attempts to lose weight by:
- Exercising excessively
- 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
- Not wanting to eat in public
- Lying about how much food has been eaten
- 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
The exact cause of anorexia is unknown. As with many diseases, it's probably a combination of biological, psychological and environmental factors.
Although it's not yet clear which genes are involved, there may be genetic changes that make some people at higher risk of developing anorexia. Some people may have a genetic tendency toward perfectionism, sensitivity and perseverance — all traits associated with anorexia.
Some people with anorexia 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 causes them to think they're never thin enough. And they may have high levels of anxiety and engage in restrictive eating to reduce it.
Modern Western culture emphasizes thinness. Success and worth are often equated with being thin. Peer pressure may help fuel the desire to be thin, particularly among young girls.
Anorexia is more common in girls and women. However, boys and men have increasingly developed eating disorders, possibly related to growing social pressures.
Anorexia is also more common among teenagers. Still, people of any age can develop this eating disorder, though it's rare in those over 40. Teens may be more at risk because of all the changes their bodies go through during puberty. They may also face increased peer pressure and be more sensitive to criticism or even casual comments about weight or body shape.
Changes in specific genes may put certain people at higher risk of anorexia. Those with a first-degree relative — a parent, sibling or child — who had the disorder have a much higher risk of anorexia.
Dieting is a risk factor for developing an eating disorder. There is strong evidence that many of the symptoms of anorexia are actually symptoms of starvation. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. Starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.
Whether it's a new school, home or job; a relationship breakup; or the death or illness of a loved one, change can bring emotional stress and increase the risk of anorexia.
A healthcare professional will make a comprehensive plan to address the individual’s specific needs. It will involve a team of specialists who can help the person overcome the physical, emotional, social, and psychological challenges that they face.
- Cognitive-behavioral therapy (CBT), which can help the person find new ways of thinking, behaving, and managing stress
- Family and individual counseling
- Nutritional therapy, which provides information on how to use food to build and maintain health
- Supplements to resolve nutritional deficiencies
It can be challenging for a person with anorexia nervosa to engage in treatment. As a result, the person’s participation in therapy may fluctuate. Relapses can occur, especially during the first 2 years. Family and friends can provide crucial support. If they can understand the condition and identify its signs and symptoms, they can support the individual during recovery and help prevent a relapse.
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