A serious and life-threatening form of disordered eating that involves the rigid restriction of food in order to achieve the lowest weight possible is known as anorexia nervosa. Sufferers of this condition possess an intense fear of gaining weight or becoming overweight and, as a result, go to great lengths to abstain from the consumption of food. Additionally, those battling this mental illness are known to abuse substances, such as stimulants, diet pills, laxatives, and diuretics, to prevent the body from absorbing nutrients as another method to avoid weight gain.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are two types of anorexia nervosa:
Restricting type: The most widely known form of this disorder, the restricting type involves rigid dieting, fasting, and excessive exercising to prevent weight gain.
Binge eating/purging type: Those with the binge eating/purging type of anorexia nervosa may have episodes in which they overeat and induce vomiting afterwards as a means of ridding the body of the food that was consumed.
The monumental mental and physical health risks associated with this illness are quite costly and can lead to death if treatment is not sought and implemented as soon as symptoms become apparent. Many sufferers of anorexia nervosa require both therapeutic and medical interventions in order to overcome this potentially fatal mental illness. A key thing to understand, however, is that there are viable options for care in existence that can save the lives of those battling anorexia nervosa.
Anorexia nervosa is believed to affect more women than men. And while prevalence rates of this condition are higher among females, research has found that 10-15 percent of all adults diagnosed with this illness are male, though experts believe that many men do not seek treatment for this condition as often as women. Anorexia nervosa has the highest mortality rate when compared to other eating disorders and sufferers of this condition are often at greater risk for developing self-injurious behaviors, ideations of suicide, and attempting suicide when compared to individuals with other forms of disordered eating. In fact, it is estimated that for every 100,000 suicides that occur yearly, 12 of those individuals battle anorexia nervosa.
Causes and Risk Factors for Anorexia Nervosa
There are several causes and risk factors that can make a person more vulnerable to the development of anorexia nervosa. The following elaborations on these causes and the listed risk factors briefly explain how someone can come to develop this life-threatening mental health condition.
Genetic: Similar to other mental illnesses, anorexia nervosa is known to possess a genetic component. This conclusion was made after it was realized by researchers that the disorder is known to occur more frequently among those with a family history of eating disorders, depressive disorders, and bipolar disorder. In lieu of this finding, it can be said that genetics are partially at work in the development of this mental illness.
Environmental: Experts in the field of mental health believe that a person’s environment can greatly impact whether or not an individual will develop symptoms synonymous with anorexia nervosa. For example, people who are part of cultures that value thinness and place a great deal of importance on maintaining certain weight expectations have a greater risk for developing this form of disordered eating. Furthermore, individuals of certain professions or those engaged in certain athletics in which physical appearance is prized also have an increased likelihood for developing anorexia nervosa. Lastly, men and women with a history of being victimized or enduring trauma are also more likely to battle this dangerous eating disorder.
- Being female
- Being in an environment or part of a culture that values thinness
- Exposure to chronic stress
- Personal history of being a victim of trauma, abuse, and/or neglect
- Family history of disordered eating or other mental health conditions
- Pre-existing mental health condition or conditions
Signs and Symptoms of Anorexia Nervosa
There are a number of signs and symptoms that suggest an individual is suffering from anorexia nervosa. Many of the telltale signs are observable by others and some may not be as apparent unless the individual battling this disorder conveys certain thoughts or feelings. The listed behavioral, physical, cognitive, and psychosocial symptoms are those that infer anorexia nervosa is present in a person’s life—symptoms that need to be reported to a mental health professional in the event that treatment is sought.
- Refusing to eat
- Making excuses for not eating
- Self-induced vomiting
- Skipping meals
- Wearing oversized clothes
- Consuming laxatives, diuretics, or using enemas
- Complaints about appearance
- Constantly checking oneself in the mirror
- Excessive exercise
- Lying about food intake
- Abusing substances
- Rigid dieting or fasting
- Restricting or limiting types of food consumed (e.g. eating only certain vegetables, etc.)
- Denial of hunger
- Engaging in ritualistic behaviors when preparing food (e.g., cutting food into small pieces, weighing food before eating, chewing food and then refusing to swallow, etc.)
- Frequently weighing oneself
- Electrolyte disturbances
- Suppression of immune system
- Low hormone levels
- Dry skin
- Thinning hair / hair loss
- Brittle nails
- Decrease in bone density / broken bones
- Extreme weight loss / emaciated appearance (adults with a BMI between 17.0 and 18.5)
- Flat affect
- Swelling of tissues
- Broken blood vessels
- Yellowing of the skin
- Swollen glands
- Erosion of enamel on teeth due to purging
- Low blood pressure
- Slowed heart rate / irregular heart beat
- Delayed onset of menstrual cycle / total absence of menstrual cycle (females only)
- Presence of fine hair on arms and legs
- Abdominal pain
- Excessive energy
- Intolerance to cold / hypothermia
- Desire to control situations and environment
- Poor impulse control
- Obsessions / compulsions / preoccupation with food, weight, or body shape
- Low self-esteem
- Low self-worth
- Feelings of ineffectiveness
- Intense fear of gaining weight or becoming overweight
- Depressed mood
- Drastic shifts in mood
- Low range of emotions
Effects of Anorexia Nervosa
The longer an individual battles anorexia nervosa, the likelihood for a number of devastating effects occurring in that person’s life increases exponentially. With the most serious outcome being death as a result of the medical complications known to occur for those with anorexia, the following effects are also known to take place should a person not seek treatment for this perilous form of disordered eating:
- Development of another mental illness
- Substance use or abuse, of which could lead to addiction
- Kidney failure
- Digestive system damage
- Damage to vital organs
- Heart attack / failure
- Inability to attend work
- Inability to adhere to responsibilities or roles
- Social withdrawal or isolation
- Loss of muscle mass / weakened muscles
- Suicidal ideation
- Suicide attempts
It is quite common for those battling anorexia nervosa to also struggle with the symptoms of an additional mental health condition. It is also rare for an eating disorder to exist in isolation. For this reason, Sierra Tucson supplies treatment for anorexia nervosa as a secondary diagnosis. For some, these additional disorders are present before the onset of anorexia symptoms, while others develop symptoms of these illnesses when engaging in the destructive eating habits and thought processes that are cornerstone to anorexia nervosa. The following mental health conditions are those that are often diagnosed alongside anorexia nervosa:
- Obsessive-compulsive disorder
- Anxiety disorders
- Depressive disorders
- Bipolar disorder
- Substance use disorders
What is Anorexia?
Anorexia Nervosa is a psychological and potentially life-threatening eating disorder. Those suffering from this eating disorder are typically suffering from an extremely low body weight relative to their height and body type.
Often referred to as BMI (Body Mass Index) is a tool that treatment providers often use to assess the appropriateness of body weight for an individual struggling with an eating disorder. Additionally, observations of eating patterns, exercise, and personality traits may give indications of an anorexic diagnosis. Those struggling with anorexia frequently fear gaining weight and have a distorted body image. They often believe they appear much heavier than they are.
Additionally, women and men who suffer from this eating disorder exemplify a fixation with a thin figure and abnormal eating patterns. Anorexia nervosa is interchangeable with the term anorexia, which refers to self-starvation and lack of appetite.
Major Types of Anorexia
There are two common types of anorexia, which are as follows:
- Binge/Purge Type – The person struggling with this type of eating disorder will often purge after eating. This alleviates the fear of gaining weight and offsets some of the guilt of having ingested forbidden, or highly restricted food. The compensatory purge behavior by the individual with Binge/Purge Type anorexia may purge by exercising excessively, vomiting or abusing laxatives.
- Restrictive – The individual suffering from restrictive anorexia is often perceived as highly self-disciplined. They restrict the quantity of food, calories and often high fat or high sugar foods. They consume far fewer calories than are needed to maintain a healthy weight. This is a heartbreaking form of self-starvation.
Though two classifications of this eating disorder exist, both types exhibit similar symptoms, such as an irrational fear of weight gain and abnormal eating patterns.
Causes of Anorexia
It has been said that genetics load the gun and environment pulls the trigger in eating disorders. This eating disorder is based on genetic predisposition, personality traits, and environmental factors.
Examples of environmental factors that would contribute to the occurrence of this eating disorder are:
- The effects of the thinness culture in media, that constantly reinforce thin people as ideal stereotypes
- Professions and careers that promote being thin and weight loss, such as ballet and modeling
- Family and childhood traumas: childhood sexual abuse, severe trauma
- Peer pressure among friends and co-workers to be thin or be sexy.
Examples of biological factors include:
- Irregular hormone functions
- Genetics (the tie between anorexia and one’s genes is still being heavily researched, but we know that genetics is a part of the story).
Anorexia Signs & Symptoms
An individual suffering from anorexia nervosa may reveal one or several signs and symptoms such as:
- Chronic restrictive eating or dieting, beyond the norm
- Rapidly losing weight or being significantly underweight and emaciated
- Obsession with calories and fat contents of food
- Engaging in ritualistic eating patterns, such as cutting food into tiny pieces, eating alone, and/or hiding food
- Continued fixation with food, recipes, or cooking; the individual may cook intricate meals for others but refrain from partaking
- Amenorrhea: an abnormal absence of menstruation, or loss of 3 consecutive menstrual cycles
- Depression or lethargic stage
- Development of lanugo: soft, fine hair that grows on face and body
- Reported sensation of feeling cold, particularly in extremities
- Loss or thinning of hair
- Avoidance of social functions, family, and friends. May become isolated and withdrawn
Dieting Vs. Anorexia
Though the restrictive eating patterns that characterize this anorexic eating disorder are similar to dieting behaviors, there are stark differences between the two. The effects of the extreme behaviors resulting from this disease are far more devastating and consequential than any ill effects from dieting.
While someone may diet in an attempt to control weight, anorexia nervosa is often an attempt to gain control over one’s life and emotions, especially in the light of traumatic events or a chaotic environment.
While someone might diet in an attempt to lose weight as the primary goal, in anorexia they may diet because they perceive losing weight as a way to achieve happiness and self-mastery.
Seeking anorexia recovery from a well-qualified team of eating disorder specialists, consisting of a therapist, physician and nutritionist are recommended. Effective, holistic eating disorder treatment of anorexia involves three necessary components:
- Medical: The highest priority in the treatment of anorexia nervosa is addressing any serious health issues that may have resulted from the eating disordered behaviors, such as malnutrition, electrolyte imbalance, amenorrhea and an unstable heartbeat.
- Nutritional: This component encompasses weight restoration, implementation and supervision of a tailored meal plan, and education about normal eating patterns.
- Therapy: The goal of this part of treatment is to recognize underlying issues associated with the eating disorder, address and heal from traumatic life events, learn healthier coping skills and further develop the capacity to express and deal with emotions.
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Articles on Anorexia Nervosa
- How Dangerous Are the Long-Term Effects of Anorexia?
Anorexia Nervosa has the highest mortality rate of any mental health issue. The physical dangers of starvation and consequences of declining mental and physical health are numerous. Learn more about the debilitating health consequences of anorexia nervosa… Read This Article
- Atypical Anorexia Nervosa: Signs and Symptoms
Atypical anorexia nervosa is featured in the Diagnostic & Statics Manual, Edition 5 (DSM-5) category of Other Specified Feeding or Eating Disorders (OFSED). Frighteningly, many individuals who have Atypical Anorexia do not believe they have an eating disorder and are less likely to seek the life-saving treatment they need. Learn about the dangers and concerns of Atypical Anorexia Nervosa… Read This Article
- Anorexia Recovery and Overcoming Physical Side Effects of an Eating Disorder
A highly regarded physician specializing in treating acute eating disorders outlines the health consequences of Anorexia Nervosa and the challenges faced in recovering from this life-threatening eating disorder. Learn about electrolyte imbalances, dehydration, edema and other physical consequences of anorexia nervosa… Read This Article
- Anorexia Nervosa – Highest Mortality Rate of Any Mental Disorder: Why?
Many psychiatric disorders are dangerous, but when it comes to death, Anorexia holds the unfortunate leading cause of death in anyone with a psychiatric disorder. Issues related to refeeding syndrome, impaired brain function, and kidney failure all contribute to the potential of death from anorexia. Learn more about these life-threatening conditions experienced by males and females struggling with anorexia… Read This Article
- Inspiration Stories of Anorexia Nervosa Recovery
Successful people outline their encouraging stories of overcoming disordered eating, extremely restrictive caloric consumption, over exercise other forms of unhealthy weight control methods. Find hope and proof that anorexia recovery happens and that you can recover from this eating disorder, too… Read This Article
- How Malnourishment Affects the Brain: Research on Anorexia and Neurobiology
Many individuals who deal with anorexia nervosa are extremely bright, talented and gifted. However, the low body weight and lack of adequate caloric consumption can literally cause the brain to shrink. Cognitive impairment, emotional instability, and poor judgment often accompany anorexia nervosa… Read This Article
- Anorexia and Amenorrhea: What are the Consequences?
Underweight women often stop menstruating and it can have long-term consequences on their health. In anorexia, the undereating, low weight and lack of nutritional needs being adequately met can lead to concerning health consequences such as orthopenia, orthorexia, and infertility struggles… Read This Article
- Long-Term Effects of Anorexia Nervosa
Under the societal pressure to be thin, many people forgo their common sense knowledge about nutrition and health in order to look thin and feel accepted. Sadly, some of these individuals end up in full-blown anorexia nervosa battles that threaten their health and wellbeing… Read This Article
- Refeeding Patients with Anorexia Nervosa: What Does Research Show?
It seems that weight gain and food are the cure for anorexia, however, the process of regaining weight is fraught with danger. It is crucial to understand the dangers of refeeding someone in recovery from anorexia nervosa. Learn more about the health risks and best practices of increasing eating and weight gain in the treatment of anorexia… Read This Article
- Anorexia and Friendship: How Do I Help My Friend?
How to offer love and support to a friend you are concerned may have Anorexia Nervosa. Tips are provided here include respecting boundaries, communicating your worries about their low weight and/or restrictive eating, etc. This is one of the top questions posed to our team at Eating Disorder Hope, learn now how to best address your concerns regarding anorexia nervosa and your loved one… Read This Article
Page Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on February 14, 2018
Published on EatingDisorderHope.com, Eating Disorders Information & Resources