Causes, Symptoms, And Treatment Of Anorexia

Anorexia, also known as anorexia nervosa, is a serious and potentially life-threatening eating disorder characterized by an intense fear of gaining weight and a distorted perception of body image. Individuals with anorexia often go to extreme measures to avoid weight gain, such as restricting food intake, exercising excessively, and engaging in behaviors that promote weight loss. Despite its physical manifestations, anorexia is a mental health condition with deep psychological roots, and it affects people of all ages, genders, and backgrounds. 

Anorexia

Anorexia nervosa is classified as an eating disorder, but it is also a complex mental health issue. People with anorexia often have an overwhelming fear of gaining weight, even when they are underweight. This fear drives them to restrict food intake, starve themselves, or engage in other unhealthy behaviors to maintain a body weight that is significantly lower than what is considered healthy for their age, height, and physical needs.

There are 2 main subtypes of anorexia nervosa:

1) Restricting type: This is the most common form of anorexia. Individuals restrict the amount of food they eat to a dangerously low level, often avoiding entire food groups and drastically limiting caloric intake.

2) Binge-eating/purging type: In this form of anorexia, individuals engage in episodes of binge eating followed by purging behaviours, such as vomiting, using laxatives, or excessive exercise to get rid of the calories consumed.

1) Causes of anorexia

The exact cause of anorexia is not fully understood, but it is believed to result from a combination of genetic, biological, environmental, and psychological factors. Multiple influences contribute to the development of this complex disorder.

• • • Genetic and biological factors: Research suggests that genetics play a significant role in the development of anorexia. Individuals with a family history of eating disorders, depression, or anxiety are at a higher risk of developing anorexia. Some studies have identified specific genes that may increase susceptibility to anorexia by affecting brain function, particularly in areas that regulate appetite, mood, and body image.

Neurobiological factors may also contribute to anorexia. Imbalances in neurotransmitters, such as serotonin and dopamine, which regulate mood and feelings of reward, may influence the onset of anorexia. These chemical imbalances can reinforce restrictive eating behaviors and the desire to control food intake.

• • • Psychological factors: Psychological factors are deeply intertwined with the development of anorexia. Individuals with anorexia often have underlying mental health conditions such as depression, anxiety, obsessive-compulsive disorder, or perfectionism. These psychological traits can drive the compulsive need to control body weight and food intake.

Perfectionism, in particular, is a common personality trait seen in people with anorexia. They may set unrealistically high standards for themselves and experience extreme guilt or distress when they perceive themselves as failing to meet these standards, especially regarding body shape and weight.

Additionally, people with low self-esteem, a distorted body image, or a deep fear of rejection may use food and weight control as a way to gain a sense of identity or self-worth. The desire for control in other aspects of life may manifest in an obsession with food and weight management, further fuelling the disorder.

• • • Cultural and societal influences: Cultural and societal pressures play a significant role in the development of anorexia. In many societies, thinness is equated with beauty, success, and desirability, and this emphasis on being thin can create unrealistic body image expectations. The media, social media, and advertising often reinforce these ideals, making people, particularly young women, feel inadequate if they do not meet these standards.

Peer pressure, bullying, and social comparison can also contribute to body dissatisfaction and disordered eating behaviors. Adolescents, who are particularly vulnerable to societal influences, may develop anorexia as they attempt to conform to these ideals or as a coping mechanism to deal with social pressure.

• • • Family dynamics: Family dynamics can also play a role in the development of anorexia. Overprotective, controlling, or overly critical family environments may contribute to feelings of inadequacy or a lack of control, prompting some individuals to seek control over their body and food intake. Conversely, family environments that promote dieting, body image concerns, or unhealthy eating habits may also increase the risk of anorexia.
    • Stress and trauma: Stressful life events, such as the death of a loved one, divorce, abuse, or major life changes, can trigger the onset of anorexia in some individuals. Trauma, particularly childhood trauma, has been linked to an increased risk of developing eating disorders, including anorexia. For some, controlling their food intake becomes a way to cope with overwhelming emotions or regain a sense of control after experiencing trauma.

2) Symptoms of anorexia

The symptoms of anorexia can vary depending on the severity of the disorder and the individual’s specific behaviors. Anorexia affects both the body and mind, leading to a wide range of physical, emotional, and behavioural symptoms.

• • • Physical symptoms: The physical symptoms of anorexia are often the most visible and can have severe health consequences if left untreated. These symptoms may include:

– Extreme weight loss: Individuals with anorexia often have a body weight that is significantly below what is considered normal for their age, height, and activity level.

– Thin, brittle hair and nails: Malnutrition can lead to hair thinning, brittle nails, and dry skin.

– Cold sensitivity: People with anorexia often feel cold all the time, as their body lacks the necessary fat and energy to regulate temperature.

– Fatigue and weakness: Lack of nutrition and energy intake leads to constant fatigue and muscle weakness.

– Irregular menstrual periods: In females, anorexia can cause menstruation to become irregular or stop altogether (amenorrhea) due to hormonal imbalances.

– Dizziness or fainting: Low blood pressure and dehydration can cause frequent dizziness or fainting spells.

– Heart problems: Anorexia can lead to an abnormally slow heart rate, irregular heartbeat, and low blood pressure, which can result in heart failure.

– Gastrointestinal issues: Constipation, bloating, and stomach pain are common due to the reduced food intake and slowing of the digestive system.

– Osteoporosis: Prolonged malnutrition can lead to weakened bones, making individuals with anorexia more prone to fractures.

• • • Emotional and psychological symptoms: Anorexia is rooted in mental health, and the emotional and psychological symptoms are just as critical as the physical ones. These may include:

– Distorted body image: Individuals with anorexia often perceive themselves as overweight, even when they are dangerously underweight.

– Fear of gaining weight: An intense fear of gaining weight or becoming fat is a hallmark of anorexia.

– Preoccupation with food: People with anorexia may become obsessed with food, calories, and dieting. They often think about food constantly but refuse to eat or severely restrict their intake.

– Denial of the seriousness of low weight: Many individuals with anorexia do not recognise the severity of their weight loss or the health risks associated with it.

– Social withdrawal: People with anorexia may isolate themselves from friends and family, particularly in situations involving food or meals.

– Mood swings: Irritability, depression, and anxiety are common emotional symptoms associated with anorexia.

– Perfectionism: Individuals with anorexia often set unrealistically high standards for themselves and experience significant stress or disappointment when they cannot meet those standards.

• • • Behavioural symptoms: Behavioural symptoms of anorexia may include:

– Extreme dieting and calorie restriction: People with anorexia may severely limit the amount of food they eat, often counting calories obsessively.

– Excessive exercise: Many individuals with anorexia engage in compulsive exercise routines to burn calories and prevent weight gain.

– Food rituals: People with anorexia often develop rituals around food, such as cutting food into tiny pieces, eating foods in a specific order, or refusing to eat in front of others.

– Avoiding meals: Individuals may frequently skip meals, lie about eating, or make excuses to avoid eating in social situations.

3) Health consequences of anorexia

Anorexia can have severe and long-lasting health consequences if not treated. Prolonged malnutrition affects nearly every organ system in the body and can lead to irreversible damage. Some of the serious health complications associated with anorexia include:

– Heart damage: Prolonged starvation weakens the heart muscle, leading to heart disease, heart failure, and even sudden cardiac arrest.

– Kidney damage: Dehydration and malnutrition can cause kidney damage and increase the risk of kidney failure.

– Liver damage: Malnutrition can lead to fatty liver disease, which can impair liver function over time.

– Electrolyte imbalance: Low levels of essential minerals like potassium, sodium, and magnesium can lead to life-threatening conditions, such as irregular heartbeats and seizures.

– Brain damage: Starvation can lead to cognitive impairments, such as difficulty concentrating, memory loss, and poor decision-making.

– Fertility issues: In women, anorexia can lead to infertility due to hormonal imbalances and a lack of menstrual cycles.

4) Diagnosis of anorexia

Diagnosing anorexia involves a combination of physical exams, psychological evaluations, and assessments of eating behaviours. Healthcare providers typically look for the following criteria when diagnosing anorexia:

– Significantly low body weight: A body weight that is at least 15% below the normal weight for a person’s age, height, and activity level.

– Intense fear of weight gain: A persistent fear of gaining weight or becoming overweight, even when underweight.

– Distorted body image: A distorted view of one’s body weight or shape, with an excessive focus on weight and appearance.

In addition to these criteria, doctors may perform tests to assess the individual’s health and look for signs of malnutrition, such as blood tests, bone density scans, and electrocardiograms.

5) Treatment for anorexia

Anorexia treatment requires a multidisciplinary approach, including medical care, psychological therapy, and nutritional counseling. The primary goals of treatment are to restore a healthy weight, address the psychological issues underlying the disorder, and promote long-term recovery.

• • • Nutritional counselling and weight restoration: The preliminary step in treating anorexia is restoring the individual to a healthy weight. This often involves working with a nutritionist or dietitian who specializes in eating disorders. Nutritional counselling focuses on developing a balanced eating plan that gradually increases caloric intake and restores essential nutrients to the body.
    • Psychotherapy: Psychotherapy, or talk therapy, is a crucial component of anorexia treatment. Cognitive-behavioural therapy is often used to help individuals with anorexia recognise and challenge distorted thoughts about food, weight, and body image. CBT can also help patients develop healthier coping strategies and reduce the compulsive behaviors associated with anorexia.

Other forms of therapy, such as family-based therapy, interpersonal therapy, and dialectical behaviour therapy, may also be used depending on the individual’s specific needs and circumstances.

• • • Medical care and monitoring: Because anorexia can have serious physical health consequences, medical monitoring is essential throughout the treatment process. Healthcare providers will closely monitor the individual’s weight, heart health, and other vital signs to ensure that recovery is progressing safely.

In severe cases, individuals with anorexia may require hospitalization or inpatient treatment in a specialized eating disorder clinic. This is often necessary when the individual’s physical health is severely compromised, and they need round-the-clock medical care.

• • • Medications: While there are no medications specifically approved to treat anorexia, some medications may be used to address underlying mental health conditions, such as depression, anxiety, or obsessive-compulsive disorder. Antidepressants, anti-anxiety medications, and mood stabilisers may be prescribed to help manage these conditions.

6) Preventing anorexia

Preventing anorexia involves addressing the psychological and environmental factors that contribute to its development. Early intervention is crucial in preventing the disorder from becoming severe and life-threatening.

• • • Promote healthy body image: Encourage positive body image and self-esteem by focusing on health and well-being rather than appearance. Avoid reinforcing societal pressures to be thin.
    • Encourage balanced eating habits: Promote healthy eating habits and discourage extreme dieting or restrictive eating behaviours.
    • Watch for warning signs: Be aware of the warning signs of anorexia, such as extreme weight loss, preoccupation with food, and excessive exercise, especially in young people.
    • Seek professional help early: If you or someone you know is struggling with body image or disordered eating behaviours, seek help from a healthcare professional before the disorder worsens.

Anorexia is recoverable

Anorexia is a serious eating disorder with complex causes that affect both the body and mind. Understanding the causes, symptoms, and treatment options is essential for those affected by anorexia and their loved ones. With proper treatment, including nutritional counseling, therapy, and medical care, individuals with anorexia can recover and lead healthy, fulfilling lives. If you or someone you know is struggling with anorexia, seeking professional help is the first step toward recovery.