Overview

Anorexia nervosa, commonly known as anorexia, is an eating disorder characterized by abnormally low body weight, an intense fear of gaining weight, and a distorted perception of weight. Individuals with anorexia engage in extreme efforts to control their weight and shape, often significantly disrupting their lives.

People with anorexia resort to various methods to prevent weight gain, such as severe food restriction, vomiting after eating, misusing laxatives, diuretics, or enemas, and excessive exercising. Despite significant weight loss, individuals with anorexia continue to fear gaining weight, equating thinness with self-worth.

Underlying anorexia is an attempt to cope with emotional problems, making it an extremely unhealthy and potentially life-threatening condition. Treatment can help individuals regain a healthier sense of self, adopt healthier eating habits, and address the serious complications associated with anorexia.

Symptoms

The physical signs and symptoms of anorexia are related to malnutrition. Besides physical issues, anorexia involves emotional and behavioral problems, including an unrealistic perception of body weight and an intense fear of gaining weight.

Physical symptoms of anorexia may include extreme weight loss, fatigue, dizziness, thinning hair, absence of menstruation, irregular heart rhythms, and others. Emotional and behavioral signs include restricting food intake, excessive exercise, denial of hunger, obsession with food, and preoccupation with body image.

Causes

The exact cause of anorexia is not fully understood. It is likely a combination of biological, psychological, and environmental factors. Genetic changes may increase the risk of anorexia, along with obsessive-compulsive personality traits, extreme perfectionism, and high levels of anxiety. Environmental factors, such as societal emphasis on thinness and peer pressure, may contribute to the development of anorexia.

It is more common in girls and women, but boys and men are increasingly affected, possibly due to societal pressures. Certain factors, such as genetics, dieting, and transitions in life, increase the risk of anorexia.

Complications

Anorexia can lead to severe complications and, in extreme cases, even death. Physical complications include anemia, heart problems, bone loss, loss of muscle, gastrointestinal issues, electrolyte abnormalities, and kidney problems. Moreover, individuals with anorexia often experience other mental health disorders, such as depression, anxiety, personality disorders, and substance misuse. Self-injury and suicidal thoughts may also be present.

Prevention

Preventing anorexia is challenging, but early identification and intervention can be beneficial. Healthcare providers can inquire about eating habits and body image during routine medical appointments to identify potential indicators of anorexia. Family members and friends can be observant of low self-esteem, extreme dieting, and dissatisfaction with appearance, and offer support and intervention when needed.

While preventing an eating disorder entirely may not be possible, discussing healthier behaviors and treatment options can be helpful for those at risk of developing anorexia.

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Diagnosis

If your doctor suspects that you have anorexia nervosa, a series of tests and exams will be conducted to diagnose the condition, rule out medical causes for weight loss, and check for related complications.

  • Physical exam: Includes measurements of height and weight, vital signs, skin, nails, and examination of the abdomen.
  • Lab tests: May include complete blood count (CBC), blood tests for electrolytes, protein, liver, kidney, and thyroid function, and a urinalysis.
  • Psychological evaluation: Involves discussing thoughts, feelings, and eating habits, and may include psychological self-assessment questionnaires.
  • Other studies: X-rays and electrocardiograms may be taken to check bone density, detect fractures, and assess heart irregularities.

Treatment

Treatment for anorexia typically involves a multidisciplinary approach, including doctors, mental health professionals, and dietitians experienced in eating disorders.

  • Hospitalization and other programs: Emergency hospitalization may be necessary for severe complications or medical emergencies. Specialized eating disorder programs offer intensive treatment.
  • Medical care: Frequent monitoring of vital signs, hydration, electrolytes, and related physical conditions is essential. Nasogastric tubes may be used for feeding in severe cases.
  • Restoring a healthy weight: Returning to a healthy weight and proper nutrition is a primary treatment goal. This may involve collaboration with a primary care doctor, psychologist, mental health professional, and dietitian.
  • Psychotherapy: Family-based therapy for teenagers and cognitive-behavioral therapy for adults are effective approaches to support weight gain and change distorted beliefs.
  • Medications: While no medications directly treat anorexia, antidepressants or psychiatric medications may help with co-existing mental health disorders.

Treatment Challenges in Anorexia

One of the major challenges in treating anorexia is the resistance to treatment. Some barriers include denial of the need for treatment, fear of weight gain, and considering anorexia as a lifestyle choice rather than an illness. Ongoing therapy during stressful periods may aid in maintaining recovery.

Lifestyle and Home Remedies

Self-care in anorexia includes sticking to the treatment plan, discussing appropriate supplements with a doctor, avoiding isolation, and resisting urges to weigh frequently or engage in unhealthy habits.

Coping and Support

Coping with anorexia can be challenging due to mixed messages from media and society. Seeking advice on coping strategies and emotional support from a healthcare professional is vital for successful treatment.

Preparing for Your Appointment

Before your appointment, make a list of symptoms, personal information, medications, and questions to ask your doctor. Be ready to answer questions about your eating habits, exercise, physical symptoms, and family history of eating disorders.

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