Anorexia-Nervosa

Anorexia Nervosa, Causes, Warning Signs, Treatment, Medical Problems, Eating Disorders

What is anorexia?

It’s a serious eating disorder during which a person (usually a teenage girl) becomes so obsessed with her weight and shape that she starves herself down to nothing.

Specifically, Anorexia is characterized by a loss of 15-25 per cent of usual body weight, an unnatural fear of becoming fat, a distorted perception of body image and an absence of a menstrual cycle. This extreme weight loss leads directly to malnutrition and failing health.

Like bulimia, binge-eating and other eating disorders, anorexia is fundamentally a psychological condition. Weight loss is a symptom not the cause.

The anorexia sufferer

No matter how thin she gets, the anorexic sufferer (anorectic) continues to believe that she’s too fat. In fact, her whole attitude becomes a process of denial. She denies herself food, she denies she has a problem, she denies she’s emaciated and, above all, she denies help.

Anorexia is not about being slim

It’s far more complex than that. It’s mainly about gaining control. Sufferers feel they lack control over their lives and seek to reassert it by focusing on their weight. It may seem crazy to outsiders, but to the anorexic it makes perfect sense. To her, every pound lost is a victory in her battle for control and every pound regained is a defeat.

The causes of anorexia

The exact cause of anorexia nervosa is unknown. It Anorexia can also be the delayed result of unresolved conflicts or painful experiences from childhood.

Who is likely to develop anorexia?

Anyone. However, the majority of people with anorexia are white girls from middle/upper income families, aged 12 to 18 years. Typically, they are intelligent, sensitive, well-behaved individuals but with a low self esteem. What causes them to develop anorexia? No one knows for sure. It may be a traumatic event, a failed relationship, or a build-up of things. Perhaps they are not doing well at school. Or maybe they did well at school but are now very unsure about their career or college situation.

Anorectics yearn for control

Responding to perceived stress, most anorectics start dieting to lose a few pounds. They begin to focus on their body as if to say – I might not be able to control other things in my life, but I can control my weight. Doing this makes them feel in charge. They begin to feel in control again.

Unfortunately, the dieting usually gets out of control and a few pounds leads to 20, 30, 40 pounds or more. When friends and family express concern about the anorectic’s reduced weight and shape, their concern is viewed by the anorectic as a threat to her weight control. Despite being extremely thin and underweight, she maintains a self-perception of being fat. This leads her to try to lose even more weight in an effort to retain control.

Purging, use of laxatives

As an anorectic’s weight drops to below 100 pounds, the body slows down. Breathing, pulse and blood pressure rates drop, and thyroid function slows, causing weight loss to slow down or stop, even though very little food is being consumed. This frustrates the anorectic who quickly learns other behaviors to rid themselves of weight, like: extreme exercise routines; vomiting; laxatives abuse and other behaviors to help purge their system of calories.

Medical problems associated with anorexia

In patients with anorexia, starvation can damage vital organs such as the brain and heart. Menstrual periods stop (a condition called amenorrhea), skin, nails and hair become dry and the skin becomes covered with soft hair as a natural defense mechanism against extreme weight loss. Excessive thirst and urination are also common. Dehydration contributes to constipation, and reduced body fat leads to lowered body temperature and the inability to withstand cold. The anorectic becomes vulnerable to illness. The National Institute of Mental Health estimates that 1 in 10 cases of anorexia ends in death from starvation, suicide or medical complications like heart attacks or kidney failure.

Scientists have found that many patients with anorexia also suffer from other psychiatric conditions. Most anorectics suffer from clinical depression, while others suffer from anxiety or personality disorders, and in consequence may have suicidal tendencies. Obsessive-compulsive disorder (OCD), a condition typified by compulsive, repetitive behavior, can also accompany anorexia.

Warning signs of anorexia

If you think that your loved one might be in danger from anorexia, here are some warning signs to watch out for.

  • Is she losing a lot of weight? Has she fallen 7 pounds below the normal weight range for someone of her height?
  • Is she becoming an obsessive calorie-counter? Does she eat only very low-calorie foods, like salad and fruit?
  • Is she becoming secretive or evasive about her eating habits? Does she eat out of sight or in private?
  • Has she started to become obsessive about exercise, or any other daily routine (e.g. homework)?
  • Is she suffering unusually from infections, constipation, dizzy spells, insomnia, or does she complain of the cold?
  • If she has started to develop these behavior patterns, you should definitely speak to your doctor and the sooner, the better. However, don’t expect your loved one to thank you for intervening. Most anorectics deny they have any sort of problem, let alone anorexia.

When speaking to a loved one whom you think is becoming anorexic, don’t tell them they’re looking thin..
Instead, tell them they look unhealthy and offer to go with them to see their doctor.

What is the treatment for anorexia

Anorexia is a mental problem that causes irrational / unnatural eating patterns. Treatment for this eating disorder should include both a mental health professional as well as a primary health care physician.

Clinical treatment may include ongoing medical care, regular therapy, nutritional counseling, and possibly medication. Eating disorders can be treated with anti-depressants, however, this is less effective for anorexia nervosa.

Co-occurring psychological treatment is also essential to help identify the important issues, and replace the anorectic’s destructive thoughts and behaviors with more positive ones. Support groups are also invaluable in treating anorexia. Patients may meet weekly to discuss their fears and help each other recover. Most cases of anorexia can be treated successfully, but not instantly. For many patients, treatments may need to be long-term.

How family and friends can help

The most important thing that family/ friends can offer a person with anorexia is unconditional love.
To put it another way, they should love the individual without supporting their actions.

But under no circumstances try to ‘treat’ the anorexia sufferer yourself. It is essential to seek professional medical help at the earliest possible opportunity.

Having spoken at length with several anorexia patients, the best advice I can offer in dealing with an individual anorectic is as follows: (1) Don’t lecture her, it makes things worse! Instead, listen to her. (2) Try to be patient! Remember, she doesn’t see things like you do. (3) No matter how provocative her behavior, try to be there for her. Easier said than done, I know, but it’s the only way to bridge her sense of isolation. (4) If she puts on weight, don’t mention her improved appearance. Mention something else, like her improved confidence.

Anorexia and guilt

Many parents of anorectics feel guilty that their child has developed this condition. They feel responsible. If this sounds like you, let me emphasize that anorexia could happen to any daughter, my own included. There are no firm causes and no simple solutions. If you need help, don’t delay. See your doctor.

Eating Disorders in Pre-Teens & Teens

The Problem

Reports indicate that children as young as 5 years old are becoming concerned, even obsessed, with their weight and shape. Indeed, eating disorders and significantly disordered eating attitudes and behaviors are appearing in pre-teens and teens at an increasing rate. At the same time obesity rates for these age-groups are up. An estimated 1 in 5 children is considered overweight, with obesity being the No 1. health problem among America’s kids.

What are the causes of increased eating disorders and obesity?

Technically, we don’t know, although some of the contributory causes seem pretty obvious.

  • Increased exposure to TV commercials
  • Children are exposed to more commercials for junk food and more ‘super-thin’ images and characters. They are being encouraged to eat high fat food and be thin – both at the same time!
  • Glossy magazines still utilize abnormally thin fashion models
  • The message is clear: “thin is beautiful”.
  • Lack of parental control, guidance and example
  • When Mom and Dad are fat and/or constantly dieting or using laxatives, diet pills and so on, it’s difficult for teens to avoid copying their parents bad eating and dieting habits.
  • Affluence and family fragmentation
  • More Moms and Dads are working. More kids eat and/or watch TV in their own rooms. More kids go away to college. These factors only serve to diminish parental control over their kids eating habits. They may even weaken relationships between parent and child and may indirectly lead to increased psychological stress which is an important underlying cause of eating disorders like anorexia nervosa, bulimia nervosa and binge eating.
  • Family eating disorders or abnormal attitudes to weight loss and diet
  • Ask yourself these questions:

Q. Is your child limiting her/his food intake?
Q. Is your child losing weight?
Q. Is your child claiming unreasonably that she/he is too fat?
Q. Is she talking about dieting and focusing on calories and fat?
Q. Is your child becoming obsessed with exercise?
Q. Is your child part of a family with a history of eating disorders?
Q. Has your child started to vomit regularly?

If your child has two or more of these symptoms, you should seek medical help.

Medical care for eating disorders

To begin with, your child will undergo a medical and psychological examination. This will determine if there is something to be concerned about, and if so what course of treatment or steps are required.

Treatment for eating disorders

Typically, this involves four things: Psychotherapy, Clinical Care, Nutrition Counseling, Family Support.

Psychotherapy for eating disorders

During psychotherapy, the child learns what triggers their reaction to food and how to control their eating disorder.

Clinical care for eating disorders

Your health care providers help to stabilize your child’s clinical symptoms (if any) like malnutrition, extreme weight loss, damage due to vomiting etc. and if necessary may provide medication to help control depression.

Nutritional counseling for eating disorders

During nutrition counseling, your child learns proper eating habits and is given an eating plan or menu.

Family support for eating disorders

No matter how serious the eating disorder, no cure is complete without family involvement and support. This is essential to assist the child and reduce the chance of a relapse or return to the original disordered patterns of eating. Parents and other family members may receive counseling and support from the health services and may be referrred to specific eating-disorder support groups.

How to avoid eating disorders in your children

Whether or not your child has started to develop symptoms of anorexia, bulimia or binge eating, it is a good idea to take precautions to reduce the risk of any eating disorders developing.

Set a good example : To help your children, first change your own habits. For example:

  • Are you always dieting?
  • Do you talk constantly about losing weight?
  • Do you habitually use diet pills, laxatives, or other diuretics for weight control purposes?
  • Do you regularly resort to food in order to manage stress?
  • Do you regularly serve junk food to your children?
  • Do you tease or criticize your children because you think they are too fat or too thin?
  • If so, you should consider changing these bad habits and start setting a good example. If you are unsure about what to do, see your health care provider and ask to be referred to a registered dietician.

By setting a good example, you automatically encourage your children to adopt the sort of balanced eating attitudes and habits that will help them to achieve optimum health and happiness.

How to prevent obesity in your children

Obesity is the No 1. health problem among America’s kids. Severely overweight children are at greater risk for early development of cardiovascular disease, high blood pressure, stroke, and type 2 diabetes, as well as certain types of cancers. Experts believe that successful weight loss requires a family commitment, with both parents and children addressing lifestyle modification, nutrition and physical issues.

Sadly, many parents assume that children should not have any restrictions on their fat intake, for fear that they won’t get enough nutrients for their growing bodies. This is not true. Once children escape infancy, what they eat in their early years is a significant factor in determining how successful they are in controlling their weight in adulthood.

10 ways to protect your children from obesity

  • Set your kids a good example.
  • This is the most important anti-obesity rule of all.
  • Don’t worry so much about the number of calories they consume in a day.
  • Children need quite a lot of calories to fuel their high energy levels and growing bodies. The important thing is where these calories come from.
  • No more than 30 percent of their calories should come from fat.
  • The less saturated (animal) fat, the better. So start reading labels.
  • The family diet should consist mostly of complex carbohydrates.
  • Fruit, vegetables, wholemeal or wholegrain breads and cereals are great sources.
  • Serve them a balanced diet.
  • Be creative with vegetables and serve them regularly to your kids from the earliest age onwards.
  • Teach them low-fat eating habits.
  • Serve them cooked potatoes without butter! Get them accustomed to skim or 1 percent milk.
  • Avoid fast food restaurants, except on rare occasions!
  • Many fast food meals are high fat, high calorie and nutritionally inadequate.
  • Encourage them to drink regular water.
  • Once they get used to it, kids love water. It’s great for a balanced, healthy diet.
  • Keep them active!
  • Don’t just order them outside. If possible, go with them! Get them to stay fit and increase your fitness in the process.
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