What is Anorexia Nervosa?
Anorexia Nervosa (often simply called anorexia) is a mental illness and eating disorder in which the sufferer has an extreme preoccupation with food and body image. Despite being underweight, a person with anorexia nervosa continues to try to lose more weight. A person at or above a healthy weight for their height who exhibits these symptoms would be considered to have an eating disorder not otherwise specified (eating disorder NOS).
Anorexia Nervosa is an eating disorder that surpasses concerns about obesity or dieting, although a person with anorexia may initially begin to diet to lose weight. Over time, however, weight loss becomes a sign of control and mastery over one's body. The drive to be thinner is secondary to the idea of control and fears related to the body.
An individual with anorexia has an ongoing cycle of restrictive eating, typically accompanied by extreme exercising, abuse of diet pills, diuretics, laxatives, or enemas to reduce weight and achieve an ideal body weight. This ideal body weight is close to starvation, and may be an exercise in control over his or her body. The cycle of anorexia becomes an obsession for the anorexic and is often described as similar to an addiction.
The medical complications of this disorder are, however, extremely severe, often involving death.
Who Becomes Anorexic?
About 95% of those who have anorexia are women - often teenage girls - but males may develop anorexia nervosa as well.
Anorexia nervosa generally begins to appear during early adolescence, however it is increasingly seen in younger children and adults. It is estimated that one of every 100 teen girls has anorexia nervosa. The National Institute of Mental Health reports that 0.5-3.7% of women will suffer from anorexia at some point during their lifetime. Approximately 0.3% of men are estimated to develop anorexia at some point in their lives.
Anorexia is more common in Caucasians in the middle and upper socioeconomic groups.
It is speculated that people who have a professional requirement to be thin (actors, models, dancers) are at a greater risk for eating disorders.
Causes of Anorexia Nervosa:
While there doesn't appear to be a single defined cause for anorexia nervosa, there appear to be a variety of genetic, biological, development and/or psychological factors that contribute to the development of anorexia nervosa.
Recent studies suggest that there may be more of a genetic component to the propensity toward developing anorexia and researchers are working to determine the gene or combination of genes that may predispose certain people to developing the disorder.
Other research has showed that a brain dysfunction in the hypothalamus may also contribute to the development of anorexia nervosa. Additional research suggests that neurotransmitter imbalances may occur in those who suffer anorexia.
Signs and Symptoms of Anorexia Nervosa:
There are a number of physical, behavioral and psychological signs of anorexia nervosa:
Physical Signs of Anorexia Nervosa:
Most of the physical signs of anorexia nervosa are related to starvation. Most organ systems are affected by the progressive deterioration in physical health:
- Abnormally slow heart rate
- Unusually low blood pressure
- Abnormal heart rhythms
- Abdominal pain
- Absence of menstrual periods
- Decreased urination
- Potassium deficiency
- Bone density loss
- Increased risks of bone fractures
- Electrolyte imbalances
- High cholesterol levels
- Dry, flaky, yellowish skin
- Fine downy hair on the face, back, arms and legs
- Loss of hair on the head
- Brittle nails
- Trouble maintaining core body temperature
Behavioral Signs of Anorexia Nervosa:
- Social Isolation
- Difficulty with social interactions
- Decreased attention span
- Decreased concentration
- Compulsive eating rituals
- Obsessive about food
- Mood disorders
- Anxiety disorders
- Personality disorders
- Addictions to gambling, alcohol, or drugs
- Compulsions relating to sex, housework, exercising, and/or shopping
Treatment for Anorexia Nervosa:
If a person with anorexia is severely malnourished and is experiencing organ malfunction, hospitalization may be the first step. In a hospital, an anorexic can be treated for malnutrition through IV's or tube feedings. A weight gain of up to three pounds a week is a safe goal. Weight gain may also be treated through eating schedules, decreased exercising, and increased social activity.
For those who have suffered anorexia for years, treatment goals may need to be slowed down to prevent relapse and protect the person from being overwhelmed by treatment.
The treatment of anorexia is focused upon more than weight gain. Depending upon the person, there are a variety of treatment approaches, including a short hospital stay followed by a day treatment program. It's common for a person with anorexia to have a team of specialists to aid in treatment.
Many times, therapies - including individual, cognitive behavioral therapy, group and family therapy - are used to treat a patient with anorexia. Treatment is focused upon identifying and addressing the underlying issues of control, perfectionism, and self-perception as family relationships are explored. The ultimate goal for treatment of anorexia nervosa should be to help the individual accept him/herself and lead an emotionally and physically healthy life.
Occasionally medications such as antidepressants are prescribed.
Outcome of Anorexia Nervosa:
Among mental illnesses, anorexia has one of the highest mortality rates, with 6% of patients with anorexia dying due to complications. These medical complications include cardiac arrest and electrolyte imbalances. Suicide is another common cause of death for those with anorexia.
Early diagnosis and treatment can improve outcomes for those with anorexia. With appropriate treatment, approximately half of those with anorexia nervosa make a full recovery. Others relapse or progressively deteriorate, while others will simply never recover. It's estimated that 20% of individuals with anorexia will remain chronically ill with the disease.
What is "Pro-Ana?"
Pro-ana (also known as "ana" or "a girl named ana") is the promotion of anorexia nervosa by people who suffer from anorexia nervosa. Most pro-ana organizations claim to exist as a non-judgmental environment for people with anorexia, a place to discuss their eating disorder, and to support those who choose to enter recovery. Others deny that anorexia is an illness, rather, it is a lifestyle choice.
Collectively, these pro-ana communities may:
- Endorse eating disorders as good, desirable things
- Share crash dieting advice
- Coach members on socially acceptable ways to refuse food.
- Fast in solidarity
- Compete in weight loss
- Advise on how best to vomit, purge, and use other weight loss tactics
- Provide tips for how best to hide weight loss from parents and doctors
- Post body pictures, measurements, details of dietary restrictions to receive affirmation
- Suggest ways to ignore or suppress hunger
Pro-ana websites are generally seen (by doctors and medical professionals) to be a glamorization of a very serious illness. These sites are considered harmful and dangerous to those who suffer from anorexia nervosa.
Additional Anorexia Nervosa Resources:
Academy for Eating Disorders - a global professional association committed to leadership in eating disorders research, education, treatment, and prevention.
National Association of Anorexia Nervosa and Associated Disorders - nonprofit devoted to prevention and treatment of eating disorders. Links to support group, treatment centers, and information about anorexia nervosa and other eating disorders.
The Center for Disordered Eating - helping individuals and families in recovery from eating disorders and disordered eating since 2004. They are committed to providing a safe place for those who are suffering and understand the importance of healing the body, mind and spirit.
The National Eating Disorders Associations offers support to both sufferers and family members alike. They also have an event and programs calendar with events planned around the USA.