Anorexia Nervosa: Symptoms, Causes, and Treatment

Weight, clothing, behavior, and, of course, mental and physical health – these are all indicators that may suggest that someone close to you is suffering from anorexia. But what are the signs, and how can you help and support someone struggling with an eating disorder?

Hani Skal, Chief Dietitian, Leumit Health Services

While anorexia is not the most common eating disorder, it is perhaps the most widely recognized. This recognition may stem from the extreme thinness that some individuals with anorexia exhibit. It may also be due to the difficulty many people experience in understanding how it's possible for someone extremely thin to look in the mirror and imagine themselves as overweight.

In this article, we will explore what anorexia nervosa is, its symptoms, and its impact on those who suffer from it. Additionally, we will discuss various approaches that can assist in dealing with this eating disorder.

What is Anorexia Nervosa?

Anorexia nervosa, also known simply as anorexia, is an eating disorder characterized by a distorted perception of body shape and weight. Individuals struggling with anorexia often experience intense fear of weight gain, leading them to severely restrict their food intake. This disorder typically begins during adolescence and can persist into adulthood. While anorexia is more common in young females, it can also affect males. Anorexia can be life-threatening and requires prompt intervention.

Diagnosing Anorexia Nervosa

The diagnostic criteria for anorexia include:

  • Restriction of food intake, significantly below the body's requirements, leading to significant weight loss.
  • An intense fear of gaining weight, often accompanied by behaviors aimed at preventing weight gain (even when body weight is already dangerously low), such as extreme exercise, the use of laxatives, or vomiting.
  • Distorted body weight or shape perception – individuals with anorexia often see themselves as overweight, despite evidence to the contrary.

It's important to note that anorexia is not always a straightforward diagnosis. Sometimes, distinguishing between various eating disorders and anorexia nervosa can be challenging.
There are cases where individuals may meet the criteria for anorexia during one period and later fit the criteria for bulimia. Anorexia is often defined based on Body Mass Index (BMI), with a diagnosis typically applied when BMI falls below 18.5, and severe anorexia is diagnosed when BMI is below 16.

Atypical Anorexia (AT) describes a condition where all the symptoms of anorexia are present, but the individual's BMI remains within the normal range.

Therefore, if you or someone you know exhibits similar symptoms to those described below, it's crucial to seek help even if body weight is considered normal.

Factors and Risk Factors for Anorexia Nervosa

There is no single "cause" of anorexia nervosa, but several factors may contribute to its development, including genetic, psychological, and environmental influences. Some argue that societal pressures related to thinness may increase the risk of anorexia, but there is evidence that this phenomenon has existed in different periods. Therefore, it's not accurate to attribute anorexia solely to societal influence.

Recognizing Symptoms in Someone with Anorexia Nervosa

In addition to the diagnostic criteria, numerous signs may be observed in individuals with anorexia, including:

  • Preoccupation with food without actual consumption, such as collecting recipes or hiding food.
  • Extreme reduction in food intake, limiting calories, and focusing on specific low-calorie food categories, like eating only vegetables.
  • Engaging in rituals related to food, such as cutting food into tiny pieces or refusing to mix different types of foods on a plate.
  • Rituals or compulsive behaviors related to physical activity, like swimming a specific number of laps or running a certain distance daily.
  • Avoiding eating in public.
  • Severe fatigue, feeling excessively cold, and an inability to adapt to weather conditions.
  • Dry, brittle hair and hair loss, sometimes accompanied by the growth of fine body hair in areas not typically covered.
  • Menstrual irregularities.
  • Low mood.

Not all of these symptoms need to be present simultaneously, and they may vary from one individual to another. However, if you recognize these signs, it's essential to be alert and seek professional help.

Different Approaches to Treating Anorexia Nervosa

Treating eating disorders requires addressing three main aspects:

  • Psychological treatment, usually involves a combination of psychotherapy (talk therapy) and, in some cases, medication prescribed by a psychiatrist.
  • Nutritional counseling and guidance by a registered dietitian specializing in eating disorders.
  • Medical treatment to address any physical complications resulting from the eating disorder.

In some cases, hospitalization may be necessary to provide intensive treatment. There are specialized treatment centers that offer comprehensive care for eating disorders, including facilities tailored to children and adolescents with these conditions.

Psychological Impact of Anorexia Nervosa

Anorexia has a significant psychological impact on individuals suffering from it. They may experience depression, anxiety, and other emotional difficulties. Research also indicates that individuals previously diagnosed with anorexia may have a higher likelihood of experiencing depression.

It's important to note that individuals with eating disorders, including anorexia, may also engage in self-harming behaviors unrelated to food. Suicidal thoughts and attempts may occur as well. If you encounter a situation resembling what we've described, immediate medical assistance is crucial.

The Role of Family and Friends in Supporting Those Affected

Family and friends play a vital role in providing support to individuals with eating disorders. It's essential to understand that eating disorders, including anorexia, can sometimes seem irrational to others. If someone close to you is struggling with an eating disorder, try to be as non-judgmental as possible. Supporting someone through their recovery is not always easy, but it is incredibly meaningful.

Self-Help Strategies: How to Cope with Anorexia Nervosa

The journey to recovery from anorexia is complex, requiring time and effort. In addition to professional treatment, it's crucial to find ways to cope independently within this challenging process. If you are struggling with anorexia, there are several steps you can take to alleviate the burden:

  • Join a support group for individuals dealing with eating disorders.
    Share your feelings and experiences with someone close to you.
  • Practice positive self-talk and self-acceptance regarding your body and weight, even though it may be difficult.
  • Limit exposure to content related to body image and weight on social media and other platforms.
  • Pursue hobbies and interests that are unrelated to eating or exercise and make you feel good about yourself.

In conclusion, overcoming an eating disorder is a complex journey, both for the individual and their close circle. We have emphasized the importance of seeking professional help, but we also want to address those who support someone with an eating disorder. If someone close to you is struggling with anorexia, remember to take care of yourself as well. It can be challenging to witness someone you care about in distress, and you may also need support throughout this process.

 

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