Anorexia Nervosa: Causes, Symptoms and Treatments

In recent time, almost 1 percent of all women living in the U.S. are considered to be suffering from anorexia nervosa, making it one of the most common psychiatric diagnoses in young female and the deadliest one.

Anorexia nervosa is best known to be regarded as women’s disorder a long time ago an estimated 90 percent to 95 percent of anorexia sufferers have been female. However, the disorder is now becoming more and more common among men.

It’s somehow difficult to point out the early signs & symptoms of anorexia nervosa since every patient with eating disorders seems to eat normal, and with other people in the public/family, but they eat very little, or nothing at all, when they are alone.

When everyone in the family starts noticing their behaviors associated with anorexia, if asked, they will be denying about their food intake, and they claim to follow certain food habits or rules — which can be a sign of orthorexia — and always complaining about feeling “fat” or unattractive.

Complications due to anorexia can be prevented through early intervention, such as cardiovascular damage, weak bone or decrease bone mass, infertility, and in severe cases even death.

Individual patient between the range of 5 to 20 percent will die due to the complication of the disorder, that is the condition is among the highest death rates of any mental health. While this disorder is extremely difficult to treat (many people we battle the symptoms of anorexia through their lifetime). Although there is now hope than before for treating all eating disorders.

In recent time, different kind of treatment is now available and very effective, including therapy, support groups, guided meditation and other mind-body practices, and in some cases medications.

What Is Anorexia Nervosa eating disorder?

According to the National Eating Disorders Organization, anorexia nervosa is a serious, sometimes even life-threatening type of eating disorder characterized by self-starvation and excessive weight loss.

Another way to define anorexia is “a serious physical and emotional illness in which an abnormal fear of being fat leads to very poor eating habits and dangerous weight loss.” According to Webster’s dictionary.

The major characteristic of anorexia nervosa is when a patient is being at a significantly low weight. This doesn’t mean that people who are slim/thin have anorexia, of course not, but someone cannot be diagnosed with the disorder without being extremely underweight. 

 “Almost Anorexic.” published by Jennifer Thomas explained that “A diagnosis of an individual’s patients depends on is actual weight (compared to their ‘normal weight’) rather than his or her degree of weight loss.” 

The Link Between Anorexia Nervosa and Other Eating Disorders

There’s a solid link between anorexia and other well-known eating disorders, according to experts. This is why is a little complicated to treat and diagnose anorexia nervosa correctly, which is one of the main reason why treatment is so difficult and recovering from the disorder is so hard.

• Anorexic symptoms lie on a continuum with normal eating: On one end of the spectrum, people eat in a “normal” (mostly balanced) way that usually supports their needs when at healthy body weight.
• Those on the other end of the spectrum eat in a bad way which is abnormal, so they’re diagnosed with either anorexia or other officially known eating disorders (such as binge eating disorder, bulimia, etc.), or a combination of both.
• Those who fall somewhere in the middle of the spectrum can eat in a difference of ways. While people in “the gray area” aren’t officially recognized as suffering from an eating disorder, they may not be eating in a very balanced or moderate way either.
• For example, today it’s common for many women who struggle to maintain a healthy weight to repeatedly “yo-yo diet,” lose and gain weight sometimes over and over again, or try different dietary programs throughout their lifetimes (sometimes in a restrictive way).
• When these behaviors start to contribute to negative health consequences or decrease the quality of life, an eating disorder is usually diagnosed.

Today, there are two major types of anorexia that patients are diagnosed with: 

1. Anorexia nervosa binge/purge type.
2. Restrictive anorexia nervosa.

In some situations, behaviors associated with anorexia can lead to incidents of binge eating. It’s not different for anorexic patients to report struggling with binge eating disorder along with purging due to how undereating can cause a strong instinct to overeat (for example, vomiting, taking laxatives or over-exercising).

This is often defined as “binge-eating/purging type anorexia,” which involves binge eating and/or purging behaviors, along with periods of restriction, all during the same three-month period.

      2. Restrictive anorexia nervosa.

Not every individual diagnosed with anorexia binges and purges (a key characteristic of the eating disorder bulimia nervosa). However, those who rarely ever consume large amounts of foods/calories at once, instead severely restricting their intake are called “restricting type anorexics”.

Common Signs and Symptoms of Anorexia Nervosa

Warning signs, behaviors and symptoms associated with anorexia nervosa commonly include:

• Drastic, intentional weight loss or frequent weight changes. Those without eating disorders usually maintain a relatively stable weight or slowly gain weight as they get older, but frequent weight changes that can be very extreme are warning signs of an eating disorder.
• Severely limiting the number of calories consumed and usually, the types of foods eaten.
• Intense fear of weight gain, which often leads to obsession and anxiety.
• Engaging in unusual and persistent behaviors in order to prevent weight gain. Attempting to follow rigid dietary rules is common among anorexics. For example, rules can include only eating at specific times of day, only eating a very small number of calories per day, which puts the body in starvation mode, or only eating a limited number of “safe” foods. Usually breaking these rules typically leads to extreme guilt or anxiety over weight gain.
• Low self-esteem, especially related to body image or other aspects of appearance.
• Inability to appreciate the consequences of the eating disorder, including not wanting to receive help or admit to a problem (denial of the severity of the situation).
• Denial of hunger, lying about eating behaviors, refusal to eat around other people or in social situations, withdrawal of normal social situations, and presenting consistent excuses to avoid situations involving food.
• It ’s common for anorexia to be accompanied by overtraining or “exercise addiction,” which is an unhealthy amount of excessive, rigid exercise. Exercise is viewed as a way to “burn off” calories and prevent weight gain, which helps decrease fear/anxiety.
• Withdrawal from usual friends and activities.
• Oftentimes symptoms associated with other mental illnesses are also present, including those related to depression, body dysmorphic disorder, substance abuse or prescription medication abuse.

Physical and mental complications associated with anorexia

Because anorexia causes someone to consume fewer calories than the body needs in order to function properly, many health problems can develop as a result. Physical and mental complications associated with anorexia, according to the Eating Disorder Hope organization, can include: 

• Menstrual changes, irregular periods or infertility. Amenorrhea, or the abnormal absence of menstruation for three consecutive menstrual cycles, is common among those with anorexia. Among women of reproductive age, this can cause infertility or difficulty getting pregnant, in addition to a higher risk for miscarriage and complications during pregnancy.
• Depression, fatigue, low motivation, and lethargy.
• Social withdrawal and isolation.
• Fainting/syncope
• Dental problems, such as enamel erosion, cavities, and tooth sensitivity.
• Cavities, or discoloration of teeth, from vomiting
• Cognitive impairments, including brain fog, disorientation and sometimes dizziness.
• Changes in heart rhythms and blood pressure, including palpitations, lowered heart rate and low blood pressure.
• Loss of muscle mass, weakness and sometimes achiness or pains.
• Reduction of bone density (osteoporosis). This is caused by dry, brittle bones due to low nutrient/calorie intake. This is a serious, sometimes irreversible effect of malnutrition that can develop at a young age and lead to fractures or other complications down the road.
• Dry skin and sometimes skin flaking or discoloration (including appearing very pale, sick or tired).
• Development of lanugo, which is soft, fine hair that grows abnormally on the face and body. Some believe this is the body’s way of trying to keep the internal body temperature near normal.
• Frequently feeling cold, especially in the toes, fingers, and extremities.
• Hair thinning, as low-calorie intake does not provide enough nutrients to support healthy hair growth.
• Among young females (between 15–24 years old) who suffer from anorexia nervosa, the mortality rate associated with the illness is 12 times higher than the death rate of all other causes of death.

Causes and Risk Factors Associated with Anorexia Nervosa

In the U.S., approximately 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their lives, including anorexia nervosa, bulimia nervosa, binge eating disorder or an eating disorder not otherwise specified (EDNOS).

Anorexia is most common among educated, non-Hispanic white, young to middle-aged women. The rate of development of new cases of eating disorders has been increasing since 1950, and prevalence of anorexia (especially among teenagers and young adults) continues to climb.

An article published in the Indian Journal of Psychiatry states, “Eating disorders are most prevalent in the Western culture where food is in abundance and female attractiveness is equated with thinness.” 

In general, eating disorders are not believed to be caused by one single thing, but rather due to a combination of different overlapping factors. These can include genetic susceptibility, someone’s upbringing, influences from the media, pressure or bullying from peers or family, coexisting mental disorders, a history of body distortion, and use of drugs/substances that weaken cognitive functioning.

Research also shows that neurobiological factors — such as malfunctioning of serotonin in the brain, personality traits and traumatic life experiences — can all be factors associated with development of eating disorders.

Dieting for many years is another significant risk factor. The National Eating Disorder Association states that about 35 percent of “normal dieters” are believed to progress to pathological dieting, with up to 25 percent progressing to partial or full-syndrome eating disorders, including anorexia.

Those who seem to be at the highest risk for developing anorexia include:

• Anyone with a history of repeated dieting or another eating disorder. Long-term dieting, dieting from a young age and yo-yo dieting can lead to intense fear over weight gain. As mentioned above, body dysmorphic disorder, binging, bulimia and anorexia can all coexist. Use of “purging behaviors” associated with bulimia nervosa, such as using laxatives or vomiting, can contribute to water retention and food cravings that spark even more anxiety over body image.
• Those with other psychiatric illnesses, including anxiety, depression, bipolar disorder, avoidant personality disorder, and obsessive-compulsive disorder.
• Those with a family history of anorexia or other eating disorders.
• Adolescents are the most likely to develop eating disorders, but those who are middle-aged also suffer.
• People who tend to have personalities that are very driven, ambitious, rigid, pervasive, controlling, inflexible and critical.
• Anyone who has experienced sexual abuse, physical abuse, recent trauma or suffers from a post-traumatic stress disorder. This is because of how chronic stress or traumatic emotional events contribute to decreased self-worth, social withdrawal, depression, shame, insecurity, mood swings and trouble relating to others.
• Those who have substance abuse problems, including alcohol, marijuana, prescriptions or other illegal drugs. Studies have found that alcohol and other substance abuse disorders are four times more common in people with eating disorders than in the general population.
• People who have abused “weight loss drugs,” herbs, laxatives, teas or medications in the past.

Conventional Treatment for Anorexia and Eating Disorders

Although many patients with anorexia nervosa improve over time, a substantial proportion continues to have body image disturbances, disordered eating and other psychiatric difficulties, according to studies.

Those who recover most fully receive early treatment, get ongoing support, practice emotional self-care throughout things like meditation and other ways of managing stress, and speak up when symptoms remerge.

To make a diagnosis of anorexia nervosa, which is usually prompted when a family member steps in, a doctor will perform an assessment of eating disorder symptoms aiming to identify key signs and behaviors.

The patient’s doctor may ask about any family history regarding eating disorders and other psychiatric disorders, alcohol and other substance use disorders, obesity, family interactions in relation to the patient’s disorder, family attitudes toward eating, exercise, and the patient’s current attitude toward his or her appearance.

Anorexia is usually treated through a combination of methods, including:

• Psychotherapy or psychological counseling. Cognitive behavioral therapy (covered more below) is now considered to be one of the most effective treatments used for long-term recovery.
• Help from a nutritionist or dietician in order to develop healthier eating patterns that provide enough calories and nutrients.
• Sometimes medication use, including anti-anxiety medications or antidepressants, such as selective serotonin reuptake inhibitors (Fluoxetine or Citalopram).These are usually not used long-term but can be helpful for some patients in the initial stages of overcoming the disorder when anxiety levels can be high. However, long-term use of psychotropic drugs can have negative effects.
• Monitoring provided by a team of medical doctors, sometimes during an initial hospital stay or period of rehabilitation. Doctors usually screen the patient to monitor side effects associated with anorexia, including heart problems, electrolyte imbalances, weakness, cognitive impairments and more. The patient’s doctor also typically will ask about any excessive exercise regimen that’s been practiced, along with inquiring about purging behaviors, including vomiting after eating, misusing laxatives, taking diet aids or pills, or using diuretics or enemas.

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SOURCES:

Mayo Clinic: “Anorexia Nervosa.”

National Eating Disorders Association: “Anorexia Nervosa.”

HealthTalk.org: “Eating Disorders and Thought Patterns.”

National Suicide Prevention Lifeline.

Dr draxe. “anorexia-nervosa”

Eating disorder hope organization

Indian Journal of Psychiatry states

Isreal Olabanji DST RN

Isreal olabanji a dental assistant and public health professionals and has years of experience in assisting the dentist with all sorts of dental issues.

We regularly post timely and trustworthy medical information and news on Fitness, Dental care, Recipes, Child health, obstetrics, and more.

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