Nutrition

Anorexia Nervosa: The Complete Guide

Anorexia nervosa is a complex eating disorder characterized by severe restriction of food intake, intense fear of gaining weight, and a distorted body image. The condition affects both men and women but is more common in women. Around 6% of the population suffers from anorexia.

However, in adolescent and young adult females the rate of occurrence is between 19-30%. The incidence among younger women and men (less than 19 years of age) is on the rise.

Causes of Anorexia Nervosa 

Anorexia nervosa is caused by a combination of genetic, biological, psychological, and social factors. Pressure from the environment in the form of peer group pressure and unrealistic beauty standards set by media celebrities as well as social media is also a major contributor to the rising incidence of anorexia, especially in young women.

Studies have shown that individuals with anorexia nervosa have an abnormal response to the hormone leptin, which regulates appetite and metabolism. They may also have abnormal levels of other hormones, such as cortisol and thyroid hormones, that can affect metabolism and weight.

 In terms of psychological factors, studies have found that individuals with anorexia nervosa are at a higher risk of having other mental health disorders such as depression and anxiety. They may also suffer from, low self-esteem and tend to strive for perfection which may cause them to have a distorted body image.

One of the most challenging aspects of anorexia nervosa is that it is not just about food or weight – it is a complex disorder that can affect every aspect of a person’s life. Individuals may believe that they are overweight even when they are underweight. This distorted body image can lead to a relentless pursuit of thinness, which can have serious physical and psychological consequences.

Diagnosis

The diagnosis of anorexia nervosa is made based on the criteria established by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These criteria include-

  • Restriction of energy intake leading to a significantly low body weight
  • Intense fear of gaining weight or becoming fat
  • Distorted body image.

Signs and Symptoms 

  • Fear of eating which may be observed as missing meals, eating very little, or avoiding eating any foods a person sees as fattening.
  • A feeling of being overweight or obese when in reality the person could be having healthy weight or could even be underweight.
  • An unusually low body mass index (BMI).
  • Taking appetite suppressants.
  • Irregular menses or delayed menarche.
  • Giddiness, faintness, and weakness.
  • Hair loss or dry skin.

Some people with anorexia may also do an extreme amount of exercise, or use laxatives or diuretics to stop themselves from gaining weight.

Complications of Anorexia

  • Poor energy levels.
  • Osteoporosis, and problems with physical development in children and young adults.
  • Infertility.
  • Loss of sex drive.
  • Circulatory complications – including poor circulation, an irregular heartbeat, low blood pressure, heart failure.
  • Neurological complications – including fits (seizures), and difficulties with concentration and memory.
  • Kidney or bowel problems.
  • Having a weakened immune system or anemia.

Anorexia may sometimes be life-threatening. It is one of the leading causes of death related to mental health problems. Deaths from anorexia may be due to physical complications or suicide.

Treatment 

It is crucial to seek help from a qualified medical professional, and mental health professional along with supportive nutritional and lifestyle intervention. 

Treatment for anorexia nervosa typically involves a combination of psychotherapy, medication, and nutritional counseling. Cognitive Behavioral Therapy (CBT) is effective in treating anorexia nervosa. Other therapies for anorexia include Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) and specialist supportive clinical management (SSCM).

Medications, such as antidepressants, may also be used by psychiatrists to help alleviate symptoms such as depression and anxiety. Nutritional counselling helps to ensure that the patient is receiving the necessary nutrients and making the correct food choices to gain weight. In extreme cases of severe malnutrition or other medical complications due to anorexia, hospitalization may be necessary. Early diagnosis and treatment are essential to prevent complications and improve outcomes.

It also makes a huge difference if the people around the patient suffering from anorexia are supportive. Immediate family and friends can encourage patients to seek medical help, and reinforce their confidence through encouragement and reassurance. Youngsters should be motivated to realize the importance of self-acceptance and not be swayed by unrealistic media or peer pressure standards.

 Author – Dr Harsha Joshi

References

Doyen C. L’anorexie mentale chez les adolescents prépubères [Anorexia in prepubescent adolescents]. Soins Pediatr Pueric. 2017 Sep-Oct;38(298):34-37. French. doi: 10.1016/j.spp.2017.06.011. PMID: 28890102.

Gravina G, Milano W, Nebbiai G, Piccione C, Capasso A. Medical Complications in Anorexia and Bulimia Nervosa. Endocr Metab Immune Disord Drug Targets. 2018;18(5):477-488. doi: 10.2174/1871530318666180531094508. PMID: 29848283.

Herzog W, Friederich HC, Wild B, Löwe B, Zipfel S. Magersucht [Anorexia nervosa]. Ther Umsch. 2006 Aug;63(8):539-43. German. doi: 10.1024/0040-5930.63.8.539. PMID: 16941399.

Akridge K. Anorexia nervosa. J Obstet Gynecol Neonatal Nurs. 1989 Jan-Feb;18(1):25-30. doi: 10.1111/j.1552-6909.1989.tb01613.x. PMID: 2647923.

 

 

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