What Is Anorexia Nervosa?

Anorexia nervosa, anorexia for short, is an eating disorder marked by obsessive weight loss and food refusal. Persons with anorexia see achieving thinness as an overriding goal in their lives, even if the resultant low body weight is unhealthy and a threat to wellbeing. Weight loss is typically attained through self-starvation or food purgation, as well as over exercise and the inappropriate use of laxatives and dietary aids. The negative effects of anorexia can include hair loss, organ damage, osteoporosis or bone-thinning, heart and cardiopulmonary issues, electrolyte imbalances, and death.

Symptoms of anorexia usually appear first in adolescence. Women suffer from this disorder more frequently than men. Anorexia is also common in professions where weight control is important, such as athletics, acting, and modeling. Persons with anorexia often display evidence of other psychological conditions, including anxiety and depression.

Anorexia nervosa should be taken seriously; it poses a genuine risk to a person’s physical and psychological health. If someone you know is exhibiting signs of anorexia, the health-care experts at Baptist Health may be able to help.

What Are the Symptoms of Anorexia Nervosa?

The physical symptoms of anorexia are closely related to those of starvation:

• Extreme weight loss and thinness
• Weakness and fatigue
• Hair loss
• Discolored skin and extremities
• Dental decay
• Insomnia
• Dehydration
• Low blood pressure and heart arrhythmias
• Cold intolerance
• Lightheadedness and fainting
• Constipation
• Loss of menstruation in women

Anorexia has behavioral and attitudinal characteristics as well:

• Meal skipping and food refusal
• Adoption of strict dietary regimens and eating rituals
• Unwillingness to eat in public
• Lying about amounts of food eaten
• Fear of weight gain
• Frequent complaints about appearance
• Unrealistic views about body size, shape, and appearance
• Irritability or emotional withdrawal
• Dressing in layered or dark-colored clothing
• Loss of interest in sex

Though associated with bulimia, cycles of binging and purging are also indicative of anorexia. A major difference between the two conditions is that persons with anorexia tend to have low body weights while bulimia sufferers are closer to normal weights for their height and build.

What Are the Causes of Anorexia Nervosa?

Scientists are unsure of the cause or causes of anorexia nervosa. There are several possibilities:

• Psychological factors: Psychological factors seem prominent in the development of anorexia nervosa. Many persons experiencing anorexia show evidence of other psychological conditions, including anxiety, depression, and obsessive-compulsive disorder (OCD). There is also an element of perfectionism involved; an impossible-to-achieve weight and appearance must be obtained, regardless of the damage it does to a person’s health.
• Biological factors: Genetic factors are also being explored as an underlying cause of anorexia. If certain that the psychological traits involved – perfectionism, for example – have a biological basis, some individuals might be more prone to an eating disorder than others.
• Environmental factors: Environmental factors might also play a role. Beauty and thinness are associated in many (though not all) cultures. This association could be reinforced by peer pressure among certain groups, especially adolescent females.

Individuals in families with other members that have experienced eating disorders are at a greater risk of developing anorexia. There is also evidence suggesting that stressful life events, including dieting itself, can trigger the onset of this condition.

How Is Anorexia Nervosa Diagnosed?

Here are some steps your medical providers are likely to take in diagnosing anorexia nervosa:

• Physical exam: In addition to recording weight and height, a physical exam will focus on areas of the body that exhibit evidence of an eating disorder: skin, nails, teeth, joints, heart, lungs, and abdomen. Heart rate, blood pressure, body temperature, and other vitals will be documented.
• Lab work: Blood tests, X-rays, a urinalysis, and an electrocardiogram may be conducted. Signs of anorexia can sometimes be seen in blood counts, bone porosity, electrolyte levels, and kidney, thyroid, liver, or heart functions.
• Psychological evaluation: A psychological evaluation will address thoughts, feelings, personal history, and patterns of behavior. This may be conducted orally or by written questionnaire.

How Is Anorexia Nervosa Treated?

Anorexia nervosa is a complex disorder that requires a team approach to treatment. Caregivers include physicians, nutritionists, mental-health providers, and other medical professionals. Among the treatment options are:

• Medical care and hospitalization: Anorexia’s starvation-like symptoms may require immediate medical care, up to and including hospitalization, depending on the severity of the individual’s condition. If necessary, feeding will be conducted through a tube.
• Nutrition therapy: The medical team will work with the patient, teaching him or her proper nutrition, and how to reach and maintain a healthy body weight.
• Psychotherapy: Psychotherapy will focus on creating awareness of the thoughts and behaviors responsible for anorexia, and then work to substitute healthier responses.
• Support groups: Meetings with other persons dealing with anorexia nervosa can offer valuable support in combating this condition.
• Medications: There are no medications that can cure anorexia, but antidepressants and antianxiety drugs are sometimes used to treat related psychological conditions.

There are also steps you can take at home. Follow your medical team’s treatment plan, eat regularly and nutritiously, take any recommended vitamins or supplements, and resist stepping on the scale or looking in the mirror. An obsessive preoccupation with personal appearance is one facet of the unhealthy behavior that gave life to anorexia’s starvation diet.