Anorexia Nervosa

DisclaimerThis page is not here to be used as a self-diagnosis, self-identification, or promotion - it's simply here to be informational. Whether or not one self-diagnoses, self-identifies, and/or seeks a professional diagnosis is up to them.Body ImageThe following page includes discussions of body image, including starving oneself, binging and purging, exaggerated self-analysis, and body dysphoria. If you are uncomfortable or get triggered by this topic, it is recommended to not read this page.

**Anorexia Nervosa**, often simply called **Anorexia**, is an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight, and a distorted perception of weight. Individuals with anorexia place a high value on controlling their weight and shape, using extreme efforts that tend to significantly interfere with their lives.

Anorexia isn't really about food. It's an extreme unhealthy and sometimes life-threatening way to cope with emotional problems. When one has anorexia, they often equate thinness with self-worth.

## Signs & Symptoms

It may be difficult to notice the signs and symptoms because of what is considered a low body weight is different for each individual, and some individuals may not appear extremely thin.

### Physical Signs

* Extreme weight loss or not making expected developmental weight gains.
* Thin appearance.
* Abnormal blood counts.
* Fatigue.
* Insomnia.
* Dizziness or fainting.
* Bluish discoloration of the fingers.
* Hair that things, breaks or falls out.
* Soft, downy hair covering the body.
* Absence of menstruation.
* Constipation or abdominal pain.
* Dry or yellowish skin.
* Intolerance of cold.
* Irregular heart rhythms.
* Low blood pressure.
* Dehydration.
* Swelling of arms or legs.
* Eroded teeth and calluses on the knuckles from induced vomiting.

### Emotional and Behavioral Signs

* Preoccupation with food, which sometimes includes cooking elaborate meals for others but not eating them.
* Frequently skipping meals or refusing to eat.
* Denial of hunger or making excuses for not eating.
* Eating only a few certain "safe" foods, usually those low in fat or calories.
* Adopting rigid meals or eating rituals, such as spitting food out after chewing.
* Not wanting to eat in public.
* Lying about how much food has been eaten.
* Fear of gaining weight that may include repeated weighing and measuring of the body.
* Frequent checking in the mirror for perceived flaws.
* Complaining about being fat or having parts of the body that are fat.
* Covering up in layers of clothing.
* Lack of emotion.
* Social withdrawal.
* Irritability.
* Insomnia.
* Reduced interest in sex.

Attempts to lose weight may include:

* Severely restricting food intake through dieting or fasting.
* Exercising excessively.
* Bingeing and self-induced vomiting to get rid of food.

### Diagnosis

To be diagnosed with anorexia nervosa, the following criteria in the DSM-5 must be met:

* Restriction of energy intake relative to requirements leading to significant low body weight in the context of age, sex, developmental trajectory, and physical health.
* Intense fear of gaining weight or becoming fat, even though underweight.
* Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

## Causes

Anorexia and all eating disorders are complex conditions. Research suggests that a combination of certain genetic factors, psychological traits and environmental factors (especially sociocultural factors) might be responsible.

* Genetics.
* Trauma.
* Environmental and culture: cultures that idealize a particular body type, usually thin bodies, can place unnecessary pressure on individuals to achieve unrealistic body standards. Popular culture and images in media and advertising often link thinness to popularity, success, beauty and happiness.
* Peer pressure.
* Emotional health.

## Treatment

The biggest challenge in treating anorexia is helping the individual recognize and accept that they have an illness. Many individuals with anorexia deny that they have an eating disorder.

The goals of treatment for anorexia include:

* Stabilizing weight loss.
* Beginning nutrition rehabilitation to restore weight.
* Eliminating binge eating and/or purging behaviors and other problematic eating problems.
* Treating psychological issues such as low self-esteem and distorted thinking patterns.
* Developing long-term behavioral changes.

Hospitalization might be needed to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications, such as heart disorders, serious depression, and suicidal thoughts or behaviors.

## References

https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591

https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia

https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa