Anorexia nervosa is a type of eating disorder. It is marked by weight loss either as a failure to gain weight in kids or by trouble keeping weight proper for age, height, and build. This leads to a distorted body image.
People with anorexia nervosa have a strong fear of gaining weight and often see their bodies wrongly. They feel desperate to keep their weight and body shape even if it harms their life.
Some ways anorexia patients try to control weight include:
- Cutting calories a lot.
- Limiting food types.
- Exercising compulsively.
- Getting rid of food by using laxatives, vomiting, enemas, or overeating.
Like other eating disorders, anorexia can become a big problem that’s hard to get rid of and sometimes can threaten a person's life. Usually, anorexia happens because of psychological, emotional issues or disorders. So people use food to deal with these feelings. Someone with anorexia sees their worth based on their weight and body shape. They try really hard to be thinner and thinner, more and more.
Anyone can get anorexia no matter their age, gender, or race. Historians tell stories of people struggling with anorexia for thousands of years. It mostly starts in teenagers, but data shows more kids and adults are getting it now. This doesn't mean anorexia only affects skinny people. you might see someone overweight with anorexia too. So diagnosis isn’t just about how someone looks.
What are the causes of anorexia?
The exact cause of anorexia is unknown right now. But like other disorders, it’s thought to be a mix of biological, psychological, and environmental factors.
1- Biological factors:
No one knows exactly which genes cause anorexia. Some genetic changes might make certain people more likely to get it. Some people might have a genetic tendency towards perfectionism, sensitivity, or orderliness.
2- Psychological factors:
Some anorexia patients have personality traits like OCD, which makes it easier for them to stick to strict diets even when hungry. They might have a strong drive for perfection that makes them feel they’re never thin enough and causes high anxiety. So they limit their food to control their anxiety.
3- Environmental factors:
Today’s idea of beauty is linked to being very thin. This often connects success and worthiness to thinness. You can see this clearly in the pressure from classmates at school or coworkers, especially among teenage girls and young women.
What are the risk factors linked to anorexia nervosa?
Girls and women are more likely to get anorexia, but that doesn’t mean guys and boys aren’t affected. Eating disorders have grown among them too because of more social pressure. While it mostly happens in teens, it can affect any age. It’s less common over age 40. Teens are more at risk because their bodies change a lot, they face more peer pressure, and they’re more sensitive to criticisms or quick remarks about their weight or body shape.
Some things can raise the chance of getting anorexia nervosa. These include:
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GenesGenetic changes can make someone more likely to have this disorder. Having a close family member with anorexia also raises your chances.
- Dieting and food deprivation: Unhealthy diets are one factor linked to the development of eating disorders. There’s strong evidence showing a close connection between anorexia symptoms and starvation symptoms since starvation affects the brain and causes mood changes like rigid thinking, anxiety, and loss of appetite. In people prone to these disorders, starvation and weight loss may change how the brain works, alter eating habits, and make it hard to return to old eating patterns.
- TransitionWhether it’s moving to a new school, new home, new job, or even shifting from one life situation to another like a breakup, losing a loved one, illness of someone close, or other cases, this change can cause emotional stress and raise the chances of anorexia.
What are the symptoms of anorexia?
Anorexia symptoms include some physical signs from starving the body and other behavioral and emotional signs.
Physical symptoms:
- Severe weight loss or not gaining weight as expected during growth stages.
- Thinness.
- Abnormal blood test results.
- Fatigue.
- Insomnia.
- Dizziness, or fainting.
- Blue fingers.
- Weak hair and hair loss.
- Increased softness and fineness of body hair.
- Missed periods.
- Dry skin and yellowing of the skin.
- Inability to tolerate the cold.
- Irregular heartbeats.
- Low blood pressure.
- Dehydration.
- Swelling in the arms or legs.
- Calcifications on the joints from induced vomiting.
- Stomach cramps and other digestive problems like acid reflux, constipation, and others.
- Anemia.
- Low thyroid hormone levels.
- Low potassium.
- Dental problems like tooth enamel erosion, cavities, and tooth sensitivity.
Some people with anorexia nervosa binge eat then get rid of food by vomiting or other ways, like those with bulimia. but bulimia patients usually have a normal or higher weight while anorexia patients mostly have low weight.
Psychological and behavioral symptoms:
1- Behavioral symptoms might include:
- Eating much less by following a certain diet or by fasting.
- Exercising excessively.
- Binge eating large amounts of food, then getting rid of it by forced vomiting, or using laxatives, enemas, herbs, and others.
2- Emotional and psychological symptoms include:
- Being very preoccupied with food, like making perfect meals for others but not eating any yourself.
- Refusing to eat or skipping meals.
- Refusing to admit being hungry or making excuses not to eat.
- Eating certain types of food they consider safe because they have low fat and limited calories.
- Following strict diets or adopting certain eating habits like spitting food out after chewing.
- Not wanting to eat in public or in front of others.
- Lying about how much food they ate.
- Fear of gaining weight, which might show when they weigh themselves or keep taking their measurements.
- Always looking in the mirror to spot flaws in their body.
- Complaining about being fat or having fat in certain areas.
- Wearing layers of clothes.
- Flat mood, meaning no feelings.
- Social distancing and wanting to be alone.
- Nervousness.
- Insomnia.
- Lack of desire to have sex.
- Feeling a strong urge to control.
- Mental block.
- Feeling ineffective.
Complications of anorexia nervosa:
Anorexia nervosa can lead to many complications, including sudden death in severe cases, even if the person's weight isn't extremely low. Death can happen due to irregular heartbeat or imbalances in electrolytes and minerals like sodium, potassium, and calcium that keep body fluids balanced. There are other complications of anorexia nervosa like:
- Anemia
- Heart problems like mitral valve prolapse, irregular heartbeat, or heart failure.
- Bone density loss (osteoporosis), which raises the risk of fractures.
- Muscle loss
- In females, missed periods.
- In males, low testosterone levels.
- Digestive problems like constipation, bloating, and nausea.
- Electrolyte imbalance like: low potassium in the blood, sodium, and chloride.
- Kidney problems.
A patient with anorexia nervosa might end up damaging every organ in their body because of severe nutrition loss like the heart, kidneys, and brain. This damage can be permanent, meaning the affected organ can’t return to normal even after the anorexia is controlled. Besides these physical risks, the patient may face many mental health issues, such as:
- Depression, anxiety, and other mood disorders.
- Personality changes.
- Obsessive-compulsive disorders.
- Alcohol and drug abuse.
- Self-harm, suicidal thoughts, or suicide attempts.
When should you go see a doctor?
At first, most anorexia patients refuse treatment because their desire to keep their thin body beats their fear for their health. So if someone close to you shows these symptoms, advise them to see a doctor. If you are that person with some of these symptoms or suspect you have an eating disorder, you should also quickly get help from a doctor.
How is anorexia diagnosed?
This illness is diagnosed based on several key factors that must be present in the patient, which are:
1- Reducing energy intake compared to what the body needs, leading to a noticeable weight drop for age, gender, growth path, and physical health.
2- An intense fear of gaining weight even if their weight is below normal, the patient still feels this way.
3- Disturbance in how the person views their body image, which controls their self-esteem, plus refusing to admit the serious danger of their severe low weight.
Sometimes, these conditions may not all be present. but the person is diagnosed with anorexia because there is a clear eating disorder to the doctor. This is called atypical anorexia and occurs in people who fit the diagnostic factors but have weight under normal despite significant weight loss. Research shows no difference in medical and psychological effects between anorexia and atypical anorexia.
How to avoid getting anorexia nervosa?
There is no sure way to avoid anorexia nervosa. Family doctors or pediatricians may spot early symptoms in patients. Then they can take steps to treat it early on before it gets worse. If you or someone close to you shows the symptoms mentioned above, see a specialist right away.
