For people with anorexia, the desire to lose weight isn’t as simple as making a choice to be healthier, or for aesthetic reasons.
The desire to lose weight comes as a result of a number of psychological factors that when combined, consume the individual’s life and thoughts.
Anorexia nervosa, commonly referred to as simply anorexia, is a psychological illness that is characterised by a severe fear of gaining weight, and body image distortion that manifests into severe food restriction.
The Effects of Anorexia Nervosa
Anorexia has severe physical consequences including malnutrition, starvation and dangerously low body weight. Because of these physical consequences, anorexia has the highest mortality rate of any psychiatric disorder.
The onset of anorexia usually occurs in adolescence, and it is most common in young women. Despite this common misconception that anorexia is a condition that only affects young women, it can occur in both males and females of all ages.
The causes of anorexia are different for everyone however there is known to be a genetic predisposition as well as a combination of environment, social and cultural factors that contribute.
Certain personality traits, such as perfectionism and low self-esteem, put individuals at greater risk of developing anorexia, as does restrictive dieting. For a person with a predisposition for eating disorders, restrictive dieting can lead to a cascade of obsessive behaviours and further restriction.
Eating disorders have a core pathopsychology of over valuation of, and an over investment in, controlling weight and shape. They are also characterised by severe disturbances in eating.
Anorexia nervosa specifically is defined as:
- Persistent restriction of energy intake leading to significantly low body weight (in context of what is minimally expected for age, sex, developmental trajectory, and physical health);
- Either an intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes with weight gain (even though significantly low weight);
- Disturbance in the way one’s body weight or shape is experienced, undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
Anorexia has a number of psychological and behavioural signs. These include the three criteria above that form the diagnosis of anorexia, but there are many other signs that can indicate that someone might have anorexia or have disordered eating patterns that might be leading to a diagnosis of anorexia. The signs include:
- Obsession over diet, weight and body shape;
- Strict dieting and obsessive food rituals;
- Secrecy around eating or hiding food;
- Low self worth;
- Anxiety and irritability over meal times;
- Social withdrawal;
- Slowed thinking and lack of concentration.
In addition to psychological and behavioural signs, due to the severe restriction in energy intake, anorexia manifests into a number of physical symptoms. These symptoms affect most of the major systems in the body and are generally caused by starvation and purging if it is apparent. These include:
- Being underweight for the person’s age and height;
- Irregular or absent periods, loss of libido, infertility;
- Cold hands and feet due to loss of blood flow;
- Headaches, fatigue and fainting;
- Fine hair over the body;
- Irregular or slow heart rate;
- Anaemia (low iron);
- Muscle wasting;
- Kidney failure.
Management of Anorexia
The long term goals of treatment are to reduce risk and encourage weight gain and normal eating and exercise behaviours.
Because of the psychological and physical aspects of this condition, a multi-disciplinary approach is usually required. This may involve interventions from GPs, psychologists, psychiatrists, dietitians, counsellors and social workers.
Psychological treatment is individualised but can involve different therapies including cognitive behavioural therapy (CBT) and family therapies.
The nutritional recovery of an eating disorder focuses on taking small steps towards eating regular, nutritious food, starting with eating regular meals. This helps to provide structure to the day, improve metabolic rate, assist gastrointestinal functioning and provide regular supply of nutrition throughout the day.
Following this, the next goals are to improve the quality and quantity of meals.
The final steps are around minimising the social and psychological impacts of the condition – these are to be able to eat socially, and have flexibility in eating habits. It is important to seek help from health professionals to manage all aspects of anorexia.
The Facts About Anorexia Nervosa
The development of anorexia does not necessarily happen overnight. You might notice small changes in thoughts or behaviours around food. If you are worried that you, or someone you know, might be developing an eating disorder, seeking help now might mean that you can prevent the transition into anorexia nervosa, or another eating disorder.
For more information about anorexia and eating disorders in general, have a look at http://eatingdisordersinfo.org.au, a site which has been developed by the National Eating Disorders Collaboration to help young people with eating disorders.
Author: Ashleigh Hamilton, BHlthSc (Nutr & Diet), MSc (Diet), APD.
Accredited Practicing Dietitian and Nutritionist, Ashleigh Hamilton, is passionate about a whole of body approach to health which encompasses both physical and mental aspects. She works with people to make lifestyle changes that will benefit their health for the future, using a range of counselling techniques including aspects of cognitive behavioural therapy, mindfulness and person-centred therapy.
To make an appointment with Brisbane Dietitian and Nutritionist, Ashleigh Hamilton, try Online Booking – Mt Gravatt or call Vision Psychology (Mt Gravatt) on (07) 3088 5422.