Anorexia

Also known as anorexia nervosa

Anorexia is an eating disorder that predominantly affects young females (about 0.5% to 3.7% of this age group), but also men.

People with anorexia often start with dieting, which develops into an obsession to control food intake. They develop obsessive eating habits such as avoiding eating, eating only small amounts of certain foods, or extremely careful weighing and measuring of their food, despite suffering hunger pangs.

Other habits to maintain low body weight may also include frequent, intense exercise and purging mechanisms such as forced vomiting, and abuse of laxatives, enemas and diuretics. Girls with anorexia nervosa often experience delayed onset of their periods.

The outcome of patients with anorexia nervosa varies from recovery after a single episode, fluctuating weight gain and loss, or chronic illness that causes health deterioration over many years. The most common fatal complications of anorexia nervosa are imbalances in electrolytes (the body's essential fluids and salts), which can lead to cardiac arrest, and suicide. Kidney, bladder, bowel and brain function can also deteriorate.

Key points

  1. Anorexia is defined as being 15% or more below the ideal weight for height.
  2. Anorexia is seen more in girls and women, (about 0.5% to 3.7% of this age group), but boys and men can also be affected
  3. People with anorexia have a fear of putting on weight or of getting fat – even if they are already slim or underweight
  4. They will avoid eating, or eat only small amounts of certain foods – even if this leads to them becoming dangerously thin
  5. Anorexia can lead to dangerously low body weight, which puts the body’s vital organs at risk
  6. Early treatment leads to better outcomes.

Symptoms

Anorexia most commonly occurs during adolescence and includes physical and emotional symptoms such as:

  • an intense fear of becoming fat or putting on weight - even if already underweight
  • distorted views of weight or shape image
  • denying the seriousness of extremely low body weight
  • resistance to maintaining a normal body weight
  • severe sensitivity to cold
  • growth of down-like body hair
  • infrequent or no menstrual periods in females who have reached puberty
  • irritability, inability to concentrate/think clearly
  • obstinate behaviour, unhappiness, depression.

Causes

Factors involved can include:

  • low self-esteem
  • poor body image
  • a reluctance to mature – physically, sexually and emotionally
  • a feeling of not being in control of your life
  • life crises, eg, changed relationships, death, childbirth, can act as trigger.

Self care

Self care and getting support from others is vital in recovering from an eating disorder and feeling happy again.

  • Learn about the condition
  • Seek professional help early – the longer you leave it, the harder it is to get well
  • Don’t be so hard on yourself – seek support and learn strategies to help you deal with negative emotions and thoughts
  • Learn about nutrition and develop a healthy relationship with food
  • Learn tips to improve your body image
  • Feeling good about yourself is key – make time for pleasurable activities and spend time with people who can boost your mood.
  • Make a decision to recover, see your doctor and get the treatment you need
  • Create a Wellbeing Plan with help from your GP or counsellor.

Treatment

Those with anorexia need to realise they have a serious problem. Because of the complexities of eating disorders, treatment should be started as early as possible for best outcomes, and should involve comprehensive specialist care. Family, whanau and friends should try to encourage the person to take personal responsibility in seeking help, and to learn to accept their strengths/weaknesses and successes/failures as being part of life.

There are three treatment goals for anorexia:

  • Restoring body weight.
  • Psychological treatment for issues such as body image disturbances and low self-esteem.
  • Long term remission or full recovery from the condition.

If weight loss has been rapid or severe, initial treatment involves hospitalisation to stabilise weight loss and fluid and electrolyte imbalances. Adequate nourishment can also help restore better thinking processes, helping the person be better able to take part in subsequent therapy programmes.

Selective serotonin re-uptake inhibitors (SSRIs) – a class of antidepressants – have been used to maintain weight gain, treat mood and anxiety symptoms associated with anorexia and prevent relapse. SSRIs are generally used only after the patient has recovered their weight loss.

It is important to remember:

  • Early recognition can help prevent more serious eating disorders developing.
  • While dietary monitoring and advice are important, effective treatment must address any underlying psychological issues.
  • The same approach will not work for all people with an eating disorder.
  • Do not give up if the first treatment approach does not work.

Learn more

Seeking help Central Region Eating Disorder Services (NZ)
Treatments & Drugs Mayo Clinic (USA)
Eating disorders explained Eating Disorders Association of NZ (EDANZ) 

Credits: Health Navigator. Reviewed By: Editorial team Last reviewed: 15 Mar 2015