Eating Disorders - Anorexia Nervosa

Author: Jody Cross

Anorexia nervosa is more than an eating disorder; it is also a psychological disorder. The person suffering from anorexia nervosa starts out trying to lose weight. Psychologically, over time, the weight loss becomes secondary, and the sense of power achieved from dieting becomes primary. At that point, in order to feel in control of his/her body, the individual engages in restrictive eating to a point close to starvation. Any eating brings fear of losing control. This restrictive eating becomes an obsession, just as physically and psychologically powerful as any drug addiction.

Anorexia can happen to anyone, male or female, young or old; but typically it first manifests itself during early adolescence. Ninety-five percent of anorexics are female. Caucasians are more often affected than people of other racial backgrounds, and it is found most commonly in middle and upper socioeconomic groups. Especially at risk, are people in professions that openly value thinness as an especially desirable trait, for example: models, dancers, actors, and some athletes.

No one knows for sure what causes anorexia. Some researchers believe it is the result of cultural pressure to be thin and attractive; others believe it’s the result of a particular type of dysfunctional family situation, where members become so interdependent on each other that the children fear growing up, and so are not able to develop a sense of their own identity. Still others search for possible genetic or organic causes.

Perfection and control are critical issues to the person suffering from anorexia. These people are often high achievers, who come from families that appear to be “perfect.” They often do very well in school and often regularly overextend themselves with activities.

Although control and perfection are critical issues to the anorexic, certain aspects of their life, other than eating, are often either out of control or have been out of control in the past. It is often found that a person suffering from anorexia will have, or will have had, a history of alcohol or drug abuse, or an addiction to gambling, or shopping, or sex, or excessive exercise, or even housework.

As anorexia progresses the individual becomes obsessed with food and thoughts of food; collecting recipes, preparing huge calorie-laden meals for friends, developing eating rituals regarding how food is cut, or in what order food is eaten; food may be horded or hid.

Anorexia is divided into two subtypes: The binge eating/purging type and the restrictive eating type where food intake is severely limited.

The symptoms of anorexia are cloaked in denial and secrecy, making the disorder difficult to diagnose. Individuals with anorexia often lack insight into their problem, and rarely seek professional help until family members intervene. Diagnosis typically comes only after other medical complications have surfaced.

The grossly underweight anorexic may suffer from depression, sleep deprivation, irritability, difficulty interacting with others, social withdrawal, and lapses in attention and concentration.

Criteria for diagnosis of anorexia include:

• Weight at or below 85% of normal
• A grossly distorted self-perception; weight loss is not acknowledged
• An intense fear of gaining weight or becoming fat
• Women will have missed three consecutive periods unless a hormone has been administered

Anorexia causes disturbances in the heart and circulatory systems, the endocrine system, kidney function, electrolyte imbalance, and frequently causes anemia. Other than the obvious weight loss, other physical signs of anorexia include: Dry, flaky, yellowish skin, the growth of fine, downy hair on the face, back of arms and legs, hair loss on the head, brittle nails, and the eroding of dental enamel, and eventual tooth loss from the frequent vomiting.

Complications from the disease cause about a 6% death rate, with the most common medical causes of death being cardiac arrest and electrolyte imbalances; suicide is also a cause.

Anorexia has one of the highest death rates of any mental health condition. Early diagnosis and treatment can improve the overall prognosis. About half of those affected will make a full recovery. Many will require on-going treatment over many years, and some for life.

A psychiatrist is possibly the best choice for treatment of anorexia, but anorexia has been successfully treated by medical doctors and clinical psychologists. Appropriate treatment must address the underlying issues of control and self-perception. Often the family is included in the treatment plan. During the recover, stage group counseling and support groups are often beneficial.

The ultimate goal of treatment is to enable the individual to lead a physically and emotionally healthy life through the development of self-acceptance.