Overcome Anorexia Nervosa – Do not deny hunger

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Body obsession usually develops in a person who suffers from extreme body dissatisfaction. The thoughts and feelings about body image becomes an obsessive fixation. People with body obsession are preoccupied with their physical appearance, for which they go to great lengths to modify themselves. Mostly due to the peer pressure and constant body shaming, individuals usually adolescent girls usually resort to strict dieting and exercising regimes. They perceive extreme diet as the best way to shed those extra pounds; however, they fail to understand that they end up developing an eating disorder. This deadly disorder is called anorexia nervosa, many celebrities have suffered from this condition, a famous pop singer Karen Carpenter even succumbed to this disorder.

What is Anorexia Nervosa?  

Basically, anorexia nervosa is an eating disorder, in which an individual intentionally restricts the food or beverage intake because of an intense fear of weight gain. This resulting weight loss, further leads to malnourishment followed by serious complications, including death. Obsessions and anxiety about weight gain and perfectionism causes extreme diet control rituals, including reluctance to be seen eating by others.

Causes of Anorexia Nervosa

There are many different factors, which can be divided into predisposing, precipitating, and perpetuating factors. Anorexia nervosa often commences as regular dieting to “get a flawless body” or to “get healthier” but it eventually progresses to rigorous diet, causing unhealthy weight loss.  The societal norms regarding body appearance, along with neurochemical and developmental factors contributes to the development of anorexia nervosa. A family history of anxiety, depression or obsessive-compulsive disorder is also found in these individuals. Research suggests that there are certain areas of the brain which function differently with an active eating disorder.

Who is Affected?

The cases of anorexia nervosa have become more common in the past 20 years. Mostly females of the age group 12 and 25 are affected. Initially, cases were more prevalent in the upper- and middle-class families, however, now it is known to affect both males and females, covering all ages, socioeconomic, and ethnic groups. Typically, anorexia nervosa has been seen in some adolescent females who are perfectionistic, introverted, and highly self-critical. They fear body shaming, and avoid risky behaviours or situations. Initially, such extreme diet control does help in reducing anxiety, stress and help alleviate negative thoughts by giving the person a sense of control of her/his life.

The first few pounds shed, restores their self-esteem and they start enjoying the validation from the society for the same, however gradually, even they do not realise when they have slipped into the spider web, and have become obsessed with dieting and maintain their image.

Statistics and Facts:

  • Of all mental illnesses, anorexia nervosa has the highest mortality rate
  • In approximately 1 out of every 10 anorexia nervosa cases, the patient dies within 10 years, after the first diagnosis.
  • 4 out of every 10 adolescent girls have an eating disorder.
  • Reports suggest 6% of youth in the U.S.A, will develop an eating disorder, between the ages of 12 to 18 years
  • 6 year-olds have shown symptoms of body obsession and fixation to stay healthy and fit.
  • Approximately 8 out of every 10 individuals with anorexia have symptoms of depression.
  • Compared to the general masses, victims of anorexia are 31 times more likely to die by self- harm.
  • Being unhappy or unsatisfied with one’s body is a major risk factor in anorexia nervosa.

Types of Anorexia

   There are generally two types of anorexia nervosa:

Restricting type – In this type of anorexia nervosa, the patient places severe restrictions on the quantity and quality of food items, that they eat. This includes calculating calorie intake, skipping meals, restricting major food items (mainly carbohydrates) and following obsessive patterns. These behaviors are usually accompanied by exercise.

Binge eating or purging type –In this type of anorexia nervosa, the patient follows extreme diet, however, it’s also associated by binge eating or purging. The person first binge eats, then ‘compensates’ for this by purging the food   through vomiting, abusing laxatives, diuretics or enemas.

Associated Disorders:

Individuals with anorexia nervosa often have other co-occurring mental disorders as well.  The most common are:

  • Depression
  • PTSD (posttraumatic stress disorder)
  • Anxiety disorders
  • Personality disorder
  • OCD (obsessive-compulsive disorder)
  • Substance abuse

Risk Factors:

The risk factors for the development of anorexia:

  • Perfectionism
  • Peer pressure – Societal pressure as well as ridicule or remarks on physical appearance, can trigger an obsession with being thin
  • Influenced by social influencers or models, the patient may start thinking physical appearance is crucial for the glam and fame, which may pressurize them to be thin or lose weight.
  • Stress, relationship breakups, a major move, or the loss of a loved one
  • A family history of eating disorders
  • Low self-esteem
  • emotional instability

Signs of Anorexia Nervosa:

 It is difficult to diagnose in the early stages the preoccupation with being thin, accompanied by frequent dieting and exercising. 

  • Changes in personality or behavior, particularly pertaining to body image and dietary changes.
  • Excessive thinness – clinically, anorexia is defined as body weight that is 85% or less than the individual’s ideal weight.
  • Stubborn or ritualistic food preparation and eating behaviors.
  • Extreme fear of gaining weight
  • Compulsive or excessive exercise regime
  • Irregular menstrual periods
  • Excessive restriction of food intake
  • Dieting even when emaciated
  • Constantly measuring their body weight
  • Obsessed with physical flaws
  • Highly self-critical
  • Adamant refusal to maintain a healthy weight
  • Skipping meals
  • Purging
  • Denying hunger
  • Perceiving themselves as fat even when they are underweight
  • Avoid social events
  • Insomnia
  • Extreme mood swings
  • Suicidal or self-harm thoughts

Other physical signs include:

  • Cold or heat intolerance
  • Thinning or brittle hair
  • Fuzzy facial hair
  • Brittle Nails
  • Cavities in teeth  
  • Dry, yellowish, or pale skin
  • Fatigue, malaise
  • Nausea, bloating, constipation
  • Inflamed arms or legs
  • Irregular heartbeat, heart rhythm

Treatment :

Due to the complexity and seriousness of anorexia nervosa, treatment typically involves a combination of:

  • Medical care / Dietary supplements– Medical care is necessary to monitor and address the immediate and potential health issues associated with anorexia, such as low blood pressure and electrolyte imbalances. Nutritional supplements are also prescribed to overcome the malnourishment.
  • Nutritional counselling – The primary treatment goals for individuals with anorexia is gaining back the healthy weight. A registered dietician (RD) is consulted for the same.
  • Psychotherapy– Psychotherapy helps understanding anorexia, along with its underlying issues. Some of the most effective types of psychotherapy are:
    • Cognitive Behavioural Therapy
    • Dialectical Behaviour Therapy
    • Interpersonal Therapy
  • Medications –Antidepressants and other medications are prescribed to decrease symptoms of depression, anxiety, and other associated disorders.

Family intervention and support:

Apart from medical help, the patient has to be equally taken care and supported at home too. Anorexia nervosa can be a challenging disorder to cope with and overcome.  Following are several ways by which the family can play a crucial role in helping the patient:

  • Educating about anorexia nervosa for better understanding about what your child is going through
  • Do not resort to physical punishment or scolding, to encourage to eat, instead handle the situation with composure.
  • Do not judge or criticize the patient and his suffering.
  • Be patient and understanding
  • Pay attention to the eating behaviors, exercise routines, and mood swings to spot the warning signs of a relapse.  It will also help for more effective management of his or her eating disorder by recognizing the triggers and patterns.
  • Make family meals relaxing and enjoyable.
  • Follow healthy eating and self-acceptance yourself. Be a good role model.
  • Avoid stressful situations at home
  • Avoid nagging; have open and honest conversations.