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Anorexia Nervosa

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Anorexia Nervosa

Many individuals wish that they would look different or could fix a thing or the other

about ourselves, that’s only being human. However, if an individual is preoccupied with being

slender, to an extend that it has overshadowed one’s thoughts, eating habits and life, then one is

considered to have an eating disorder. To an anorexic person, weight loss becomes priority. An

individual may fail to see who they truly are. There are many individuals going through the same

thing mostly affecting those aged between twenty and forty five years old (Omodei, 2015).

These self-destructive patterns caused by anorexia are not permanent. With the right support and

treatment, an individual could regain self-confidence and most importantly, health.

Anorexia Nervosa is a grave eating disorder that is defined by the fear of weight gain,

determined restriction of energy intake and a disturbance of self-perceived image including

shape and weight (Omodei, 2015). It has been categorized as a mental illness that affects

individuals of all ages, gender, ethnicities, races and sexual orientations. Although, the disorder

has been thought to commence during adolescence, an increasing number of older adults and

children are being diagnosed (Omodei, 2015). It has been found mainly in females and rare in

men. The current culture is obsessed with one’s image. Individuals worry about putting on

weight. However, with anorexia extreme lengths are gone to maintain low body weights

(Omodei, 2015). Thoughts about food and dieting take up most of one’s time leaving out friends

or family. It involves a relentless pursuit of intense loss of weight and no matter how thin one

gets, it is never enough. Eating and mealtimes become very stressful as one may try absurd

methods of losing weight for example excessive exercise or vomiting after eating (Omodei,

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2015). Death by physical means for those with anorexia nervosa is five times more than expected

while death by suicide is thirty two times that expected.

Types

Anorexia nervosa can be subdivided into two including restricting type and purge type

(Omodei, 2015). Individuals with the restricting type limit themselves on the food type and

amount they consume. They achieve this by restricting particular food groups for example

carbohydrates and fats (Omodei, 2015). Also they place rules and have rigid thinking for

example eating foods that are of one color. These individuals go to the extent of skipping meals

and counting calories. Excessive exercise may accompany these restrictive behaviors.

Individuals with the purging type not only restrict their food amounts, but also exhibit binge

eating and purging behaviors (Omodei, 2015). Binge eating involves losing a sense of control

while eating food in large amounts while purging behaviors involve deliberate use of laxatives,

enemas, diuretics or self-induced vomiting to compensate the food ingested (Omodei, 2015).

Causes

Genetics has been thought to be anorexia nervosa’s source while the environment

accentuates the eating disorder (Harrington, 2015). Eating disorders are determined by

personality traits, factors in the environment and the genetic predisposition. Some of the

environmental factors that contribute to its occurrence include absurd cultures and beliefs of the

current age that places being slender as the ideal stereotype (Harrington, 2015). Also, there are

professions that can only employ individuals with certain weights and are slender for example

modelling and ballet. Additionally, childhood and family traumas for example sexual abuse may

induce this type of disorder (Harrington, 2015). Being damaged psychologically and

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emotionally, one may be obsessed with trying to fit in and be accepted, that is being of the right

weight and shape (Harrington, 2015). Peer pressure is one of the major causes whereby co-

workers or friends insist that being slender is sexy.

Diagnostic Criteria

According to the Diagnostic and Statistical Manuals of Mental Disorders (DSM-V), one

can be diagnosed with anorexia nervosa when he or she has met certain criteria (Harrington,

2015). Firstly, an energy intake restriction that leads to a considerably low body weight in

relation to sex, age, physical health and developmental course. Secondly, a disturbance in the

experience of one’s body shape or size, self-evaluation influenced by body image and denying

that his or her current body weight is serious (Harrington, 2015). Lastly, deep dread of weight

gain even though an individual is underweight. A serious eating disorder might still be present

even if all the criteria are not met. Researchers have found no differences in the psychological

and medical impacts of atypical anorexia and anorexia nervosa (Harrington, 2015). Atypical

nervosa involves individuals who meet the criteria for an eating disorder, have lost weight

significantly but aren’t necessarily underweight (Harrington, 2015).

There have been a variety of conditions misdiagnosed as anorexia nervosa for example

bulimia nervosa or eating disorder not otherwise specified (ENOS) (Harrington, 2015). Also

those with depression and schizophrenic disorders are characterized by odd eating behaviors due

to delusional presumptions about food. Slight changes in attitudes or behavior might change the

diagnosis from binge eating type to bulimia nervosa. A thin line of physical gap weight separates

the two. An individual with bulimia nervosa may be ordinarily at overweight or a healthy weight

while one with binge eating would normally be underweight (Harrington, 2015).

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Signs and symptoms

An individual with anorexia nervosa eating disorder reveals one or several warning signs

that may either be emotional and behavioral or physical. Emotional and behavioral signs include

dressing in a layer of clothes to hide weight loss or to keep warm (Harrington, 2015). One

refuses to eat and progresses to sanction a whole category of food for example carbohydrates.

Additionally one may deny being hungry or may develop food rituals that may involve excessive

chewing or following an order while eating (Harrington, 2015). Despite fatigue, the weather or

injuries, an individual may insist on extensive and rigid exercising regimen. One has limited

social spontaneity, need for control and an overly controlled initiative and expression of emotion.

Some of the physical factors may include dizziness, concentration difficulties, fatigue or sleep

problems (Harrington, 2015). Females may experience menstrual difficulties, amenorrhea. It may

occur while one is on hormonal contraceptives. Dry skin, brittle hair and nails with fine body

hair referred to as lanugo. An individual may experience muscle weakness, poor healing of

wounds and an impaired functioning of the immune system (Harrington, 2015).

The restrictive type of anorexia nervosa exhibits discipline in what is being consumed

and is similar to dieting behaviors. However, stark differences exist between the two. The effects

of this disorder are far more detrimental and devastating than any of the effects experienced

while dieting. An individual may diet to avoid weight gain but an anorexic individuals often

restrict themselves to gain control over their emotions and lives especially after a traumatizing

event. Anorexic individuals consider weight loss as the primary source of happiness (Harrington,

2015).

Health Consequences

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Anorexia nervosa has a vicious cycle of self-starvation. When the body is denied

nutrients, it fails to function properly. All processes in the body are forced to slow down to

conserve energy (Agh et al., 2016). This results in serious medical consequences including

increased risk of heart failure due to low blood pressure and a slow heart rate, vividly showing

heart muscle failure. Purging causes electrolyte imbalances as ions such potassium, chloride and

sodium are lost resulting in irregular heartbeats (Agh et al., 2016). There is also muscle wasting,

weakness and severe dehydration which could lead to kidney failure. Additionally, osteoporosis

may result, which is bone density reduction. I in turn causes bones to be brittle and dry. Frequent

vomiting may result in possible esophagus rapture or inflammation, tooth cavity and

discoloration from the released stomach acids. Laxative abuse may lead to irregular and chronic

bowel movements plus constipation (Agh et al., 2016).

Treatment

Recovery from anorexia nervosa requires a skilled multi-disciplinary team consisting of a

therapist, physician, eating disorder specialist and a nutritionist (Lock & Le Grange, 2015).

Nutritional help encompasses implementation and supervision of a personalized meal plan,

weight restoration and education about normal patterns of eating. Medication such as Prozac, an

antidepressant, integrated with therapy is offered to help manage conditions such as social

phobia, depression and anxiety. Antidepressants are rarely given to underage individuals.

Therapies for example cognitive behavioral therapy (CBT) or psychoanalytic therapy for adults

are very helpful (Lock & Le Grange, 2015). Maudsley treatment that is family based and

specialized outpatient treatment are therapies for young people. CBT comprises of talking to a

therapist to make healthy food choices and understand the effects of starving oneself. Maudsley

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therapy involves helping a patient understand the cause of the disorder, focusing on what is

important to the individual and enacts behavior change (Lock & Le Grange, 2015).

Young people may also undergo family therapy where the individual and the family, talk

to a therapist. It helps the individual explore anorexia, how it has affected his or her relations and

how the individual’s family can support him or her. Also, adolescent-focused psychotherapy

which normally includes up to forty sessions for a period of twelve to eighteen months (Lock &

Le Grange, 2015). It helps the individual cope with fears and understand the importance of being

healthy. These therapies are meant to help the individuals learn how to deal and express their

emotions and also learn coping skills that are healthy. It also recognizes other issues associated

with the disorder, addresses it and helps in healing. Individuals may also seek further support

from organizations that support individuals with anorexia for example Anorexia and Bulimia

Care (Lock & Le Grange, 2015). Additionally, one may join a support group where one would

connect and share experiences with others. This offers inspiration and hope to find strength to

continue on their paths to healthy living.

Conclusion

Eating disorders such as anorexia nervosa, are serious and life-threatening conditions. It

is not just a phase and people just don’t catch an eating disorder. They are intricate, devastating

and real life disorders that have adverse effects on productivity, relationships and health.

Individuals struggling with anorexia nervosa should seek professional help. Early treatment

increases the likelihood of emotional and physical recovery.

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References

Agh,T., Kovacs, G., Supina, D., Pawaskar, M., Herman, B.K., Voko, Z., & Sheehan D. V.

(2016). A systematic review of the health-related quality of life and

economic burdens of anorexia nervosa, bulimia nervosa, and binge eating

disorder. Eating and Weight Disorders-Sudies on Anorexia, Bulimia and

Obesity, 21(3), 353-364

Harrington, B. C., Jimerson, M., Haxton, C., & Jimerson D.C. (2015). Initial evaluation,

diagnosis and treatment of anorexia nervosa and bulimia nervosa. Am Fam

Physiscian, 91(1), 46-52.

Lock, J., & Le Grange, D. (2015). Treatment manual for anorexia nervosa: A family based

approach. Guilford Publiations.

Omodei, D. (2015). Claorie Restriction and Anorexia Nervosa: Molecular markers and

pathogenic mechanisms.

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