Anorexia Nervosa

Anorexia nervosa is a type of eating disorder which is characterised by eating a very small amount of food in order to lose weight. People who have anorexia nervosa have a deep-seeded fear of putting weight on and for this reason they eat very little, thus putting their health at risk. Often, people with anorexia also do a lot of exercise to burn off calories and lose weight. Anorexia is not as simple as starving to lose weight and cannot merely be treated by telling someone that they need to eat more. It is a complex mental health condition, which requires very careful treatment. People with anorexia do not feel they are thin and think they look fat, even though they look extremely underweight in comparison to others.

Anorexia nervosa is more common in women than men and symptoms tend to develop during the teenage years. However, in recent years there has been an increase in the number of men and children developing the condition. Anorexia is not a common condition but it is the most common cause of death related to mental health disorders in the UK. Anorexia nervosa affects 1 in 200-250 women and 1 in 2000 men in the UK.

What causes anorexia nervosa?

There is no exact cause of anorexia nervosa and a combination of factors can often contribute to an individual developing the condition. Experts also believe that some people have personality traits that make them more likely to suffer from anorexia nervosa, such as those who are perfectionists, worriers and those who are extremely competitive.

People who have anorexia nervosa are more likely to suffer from other mental health problems, including:

• Anxiety.
• A lack of confidence.
• Low self-esteem.
• Depression.
• Obsessive compulsive disorder (OCD).

Environmental factors also play a part and many experts are worried about the growing influence of the media on the way people view themselves, especially as magazines and television programmes are full of pictures of models, actresses and singers who tend to be thin and fit a certain mould. This is particularly prominent in the Western world, where the number of cases of anorexia is higher. Celebrity culture is also an important issue, as the media criticises celebrities for putting on weight or showing cellulite, which sends a negative message to the public.

People who work in industries where being thin is desirable or necessary are also more likely to develop anorexia, for example ballet dancers, models and athletes.

There is evidence to suggest that eating disorders can run in families and many people are influenced by the eating habits of their siblings and parents. Stressful and traumatic events can also cause anorexia.

Symptoms of anorexia nervosa

Anorexia affects both the mind and body and is a serious condition. It can be life-threatening and so it is important to seek medical help if you, or somebody you know, experience the following symptoms:

Habits:

• Eating in secret.
• Lying to others about what, when and how much you have eaten.
• Skipping meals and making excuses.
• Weighing and measuring yourself obsessively.
• Exercising on a regular basis at high intensity.
• Restricting certain foods.
• Making yourself sick.
• Taking laxatives.

Thoughts and feelings:

• Feeling depressed.
• Obsessing about food and thinking about it all the time.
• Mood swings
• Losing interest in other people and hobbies.
• Denying that you have a problem.
• Feeling like you look fat.
• Lack of concentration.

Physical symptoms:

• Weight loss.
• Looking underweight and unhealthily thin.
• Feeling the cold more than usual.
• Hair growth on the arms, face and legs.
• Missing periods.
• Constipation.
• Disturbed sleep patterns.
• Looking pale and unwell.
• Delayed development during puberty.

Complications of anorexia nervosa

Anorexia is a serious condition and can be fatal. People with anorexia have a higher risk of health problems and conditions, including:

• Osteoporosis (brittle, weak bones).
• Heart failure.
• Infertility.
• Cardiovascular problems and poor circulation.
• Low potassium levels (known as hypokalaemia).
• Anaemia.
• Low blood pressure.
• Liver and kidney damage.

How is anorexia nervosa diagnosed?

If you think you may be anorexic or are worried about somebody close to you, you should visit a GP. They will ask you questions about your symptoms, medical history and ask about your weight, eating habits and how you feel about your appearance. Your GP will also weigh and measure you to work out your BMI (body mass index). If your BMI is less than 18.5 this means that you are underweight; people with anorexia usually have a BMI of less than 17.5. Your GP will probably also check your blood pressure and pulse.

If your GP thinks you may have anorexia nervosa they will refer you to a specialist with expertise in eating disorders. The specialist may carry out further tests before drawing up a treatment plan.

Treatment for anorexia nervosa

The sooner anorexia is treated the better. Treatment usually involves a combination of psychological therapies, medical treatment to ease symptoms and treatment for existing problems, and help from a dietician to help you start to gain weight safely and gradually.

Each individual will have a personalised treatment plan and patients will be cared for by a multi-disciplinary team, which includes specialist doctors, nurses, a psychologist, a counsellor and a dietician. The aim of treatment is to prevent any further damage to the body and to help the individual form a positive relationship with food and increase their confidence and self-esteem.

Therapies, such as counselling and cognitive behavioural therapy, can be helpful with identifying sources of distress, anger and the causes of the unhealthy relationship with food. Therapies also help to build confidence and allow patients to identify ways of dealing with problems in a healthier, more constructive way.

Patients are usually advised to keep a food diary and their weight will be monitored closely during the treatment process. Treatments will also be given for symptoms and illnesses caused by anorexia. However, medication is not used as a treatment for anorexia, but it may be prescribed to reduce symptoms of depression.

In extreme cases, when an individual has very severe anorexia, they may require hospital treatment and private clinics also provide rehab treatment.

Help and support

There are charities such as BEAT which help those affected by anorexia and there are also many support groups. You can ask your GP for details of support groups in your area.