Anorexia Nervosa

Written by Carmella Wint and Winnie Yu | Published on 25 July 2012
Medically Reviewed by George Krucik, MD

Overview

Almost everyone worries about gaining too much weight. But in some people the worry becomes obsessive, causing a condition called anorexia nervosa. Anorexia nervosa is an eating disorder that can result in severe weight loss. The obsessive worry focuses on body weight and the food you eat.

People with anorexia nervosa may exercise excessively. They may eat an extremely low calorie diet. Those affected by anorexia nervosa have an excessive fear of gaining weight. They often feel better about themselves when they lose weight. According to the National Alliance on Mental Illness, anorexia is most commonly diagnosed in adolescent women, but it’s been diagnosed in children as young as age seven and adults as old as 80. (NAMI)

What Causes Anorexia Nervosa?

The exact cause of anorexia nervosa is not known. People who develop anorexia may have a negative body image. They may be focused on being perfect. They may be looking for ways to control their lives. Other factors are believed to play a role:

Biology

Genetics and hormones might have an effect on the development of anorexia nervosa. Some evidence suggests a link between anorexia and serotonin, a chemical produced in the brain.

Environment

Pressure from society to look thin may also contribute to the development of anorexia nervosa. Pictures on magazines and television can greatly influence young girls and spark the desire to be thin.

Psychology

Someone with obsessive-compulsive disorder (OCD) might be more predisposed to maintaining the strict diet and exercise regimen that those with anorexia nervosa often maintain. People with OCD strive for perfection and may feel like they will never achieve it.

Recognizing the Signs and Symptoms of Anorexia Nervosa

Those with anorexia nervosa lose weight and maintain their extremely low weight in different ways. While some put severe restrictions on their calorie intake, others exercise excessively. Some employ a binge and purge method, similar to that used by those with bulimia. Others use laxatives, vomiting, or diuretics to eliminate food they’ve eaten. If you have anorexia nervosa, your symptoms will likely include:

  • refusal to maintain a normal weight
  • fatigue
  • insomnia
  • skin that is yellow or blotchy and covered with soft, fine hairs
  • hair thinning or falling out
  • constipation
  • more than three cycles without a period
  • dry skin
  • low blood pressure

You may also notice behaviors such as:

  • excessive exercise
  • pushing food around the plate instead of eating it, or cutting food into small pieces
  • irritability
  • withdrawal from social activities
  • depressed mood
  • hunger denial
  • use of diuretics, laxatives, or diet pills

How Is Anorexia Nervosa Diagnosed?

Your doctor will need to rule out other possible causes for the weight loss, such as celiac disease and inflammatory bowel disease.

A physical exam will be performed to check your blood pressure and heart rate. Blood tests may also be performed to check your electrolyte levels and liver and kidney function. A psychological exam that asks about your eating habits and feelings may be done, too. In addition, your doctor may check your bone density and look for heart irregularities.

What Treatment Is Available for Anorexia Nervosa?

One of the biggest obstacles in the treatment of anorexia nervosa is realizing that you need help. Many with anorexia nervosa don’t believe they have a problem. That can make treatment difficult.

The main goal of treatment is to restore your body to a normal weight and establish normal eating habits. A dietitian will help you learn how to eat properly. It might also be recommended that your family take part in therapy with you. For most people, anorexia nervosa is a lifelong challenge.

Therapy

You and your family must work hard to overcome anorexia nervosa. Group, family-based, and individual therapies are often an integral part of treatment.

Individual Therapy

A form of therapy called cognitive behavioral therapy is often used to treat anorexia nervosa. CBT helps change unhealthy thoughts and behaviors. Its goal is to help you learn to cope with strong emotions and build healthy self-esteem.

Family Therapy

Family therapy gets family members involved in keeping you on track with your healthy eating and lifestyle. Family therapy also helps resolve conflicts within the family. It can help create support for the family member suffering from anorexia nervosa.

Group Therapy

Group therapy allows people with anorexia nervosa to interact with others who have the same disorder. But it can sometimes lead to competition to be the thinnest. To avoid that, it’s important that you attend group therapy that is led by a qualified medical professional.

Medication

While there is no medication at this time that is proven to treat anorexia nervosa, antidepressants may be prescribed to deal with the anxiety and depression common in those with anorexia. These may make you feel better. But antidepressants do not diminish the desire to lose weight.

Hospitalization

Depending on the severity of your weight loss, your doctor may want to keep you in the hospital for a few days to treat the effects of your anorexia nervosa. You may be put on a feeding tube and intravenous fluids if your weight is too low or if you are dehydrated. If you continue to refuse to eat or exhibit psychiatric issues, your doctor may have you admitted into the hospital for intensive treatment.

What Is The Long-Term Outlook?

Many people recover from anorexia. But a small percentage do not. In some the condition can be deadly. Still others may go on to develop other eating disorders. For some people, overcoming anorexia takes lifelong treatment and maintenance. Joining a support group for anorexia can help.

Can Anorexia Nervosa Be Prevented?

There is no proven method to prevent anorexia nervosa. But looking out for signs of the disorder can help with quick diagnosis, treatment, and recovery. If you find yourself or a loved one obsessing about weight, excessively exercising, or being dissatisfied with their appearance, you may want to seek professional help.

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