UNDERSTANDING ANOREXIA

Eating Disorders are a serious condition that is related to continual eating behaviour that has a negative impact on health, emotions and one’s ability to function in important areas of daily life. Some very common eating disorders are anorexia nervosa, bulimia nervosa, binge eating disorder, rumination disorder, avoidant /restrictive food intake disorder. These generally are seen to develop among teenagers and young adults, although they are likely to develop at other stages of life.

 

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What is Anorexia nervosa? (Eating Disorder)

Anorexia (an-o-REK-see-uh) Nervosa- commonly called anorexia is an eating disorder which is a serious psychological condition and has potentially life-threatening characteristics; an individual may have abnormally low body weight, intense fear of weight gain or obese, a distorted perception of one’s weight and shape, changes in an emotional state. An individual tends to lose more weight than what is healthy for their height and age( BMI). Someone with anorexia might see themselves as being overweight, even if they are alarmingly underweight.

There are two subtypes:

 

RESTRICTING SUBTYPE, imposing severe restrictions on the amount of food one eats. Includes calorie counting, restricting certain food groups, skipping of meals, obsessive rules and rigid thinking such as only eating food of particular colour. This may be followed by excessive physical training.

 

BINGE EATING/PURGING SUBTYPE, imposing severe restrictions on the quantity and type of food one consumes, also show purging behaviour along with binge eating behaviour.

 

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Signs and Symptoms

Anorexia is a complex condition and one of the most usual sign seen is severe weight loss. One may observe several behavioural changes, physical changes, psychological and emotional changes. A few common ones are mentioned below;

BEHAVIOURAL signs such as;

• Reluctance and refusal to eat
• Excessively exercising and
• Use of laxatives, vomiting after consuming food
• The preoccupation in preparing food for others, recipes and nutrition
• Sudden and radical changes in food preferences ( suddenly disliking food that they had liked for a long time, complaining about allergy-related to a certain food, becoming vegetarian)
• Obsessive rituals and  preparation with food and eating ( cutting in a certain size, eating slowly, insisting that meals be served to them at a particular time only)
• Antisocial behaviour
• Compulsive or excessive exercising
• Self-harm, substance abuse or suicidal thoughts.

 

Some PHYSICAL signs and symptoms as a result of not consuming the right nutrition;

• Dizziness or lightheadedness
• Severe loss of muscles mass
• Fatigue, exhaustion, low energy  and not sleeping well, insomnia
• Blood pressure
• Low body temperature( cold feet and hands) even in hot weather
• Irregularities in menstrual cycle or loss of menstruation in girls and women; in men there is decreased libido
• Hair loss or alopecia, Brittle nails, dry skin
• Infertility
• Irregular, abnormal heart rhythms
• Feeling bloated, constipated or development of food intolerance.
• Fine hair appearing on the face and body
•  Facial changes ( pale skin, sunken eyes)

 

PSYCHOLOGICAL signs that can be observed are;

• Excessive concern about being fat, obese and with bodyweight, extreme body image dissatisfaction.
•  Repeatedly measuring their own weight, inspecting one’s body in front of the mirror
• Lying about food intake, not eating or refusal to eat
• Depressed mood or lack of emotions
• Self-denial, irritability
• Memory loss
• Obsessive-compulsive behaviour
• Food n consumption of food becomes associated with guilt.
• Low self-esteem and perfectionism
• Rigid thoughts about food being ‘good ‘or ‘bad’ ( black and white thinking)

 

Individuals with an eating disorder will not acknowledge that there is something wrong with their behaviour and at most times may refuse to seek help.  However, it is very important for the family members and friends to try and persuade them to get help if not it could lead to severe COMPLICATION in the future such as;

• Cardiovascular / heart problems, kidney, liver failure
• Depression and anxiety
• Work and school-related issues
• Blood problems, anaemia, low blood sugar
• Problems with growth and development
• Substance use disorders
• Gastrointestinal problems
• Hormonal problems
• Bone fractures, osteoporosis
• Suicide/Death

Now after discussing what anorexia is. Signs and symptoms of an individual who is anorexic and the complications that are associated with this eating disorder, it is important to understand the various factors that could be contributing to the development of anorexia.

 

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Causes of anorexia

Anorexia nervosa can be understood to be a BIO-PSYCHO-SOCIO illness. That means that the illness is the interplay of the biological, sociological and psychological aspects of one’s life and there is no one single or particular cause in most cases. A few causes include;

BIOLOGICAL, PHYSIOLOGICAL and GENETIC causes; certain genetic makeup of an individual may be prone to the development of the eating disorder.

Biological factors could include an imbalance in certain brain chemicals that control hunger, digestion and appetite that may play a role in eating disorder. Research has put forward that there is greater chances of developing an eating disorder if an immediate family member has one as well.

ENVIRONMENTAL factors; may involve the hormonal changes that take happens during puberty, feelings of anxiety, stress, guilt. Some other types of environmental causes could be some kind of physical, sexual, emotional abuse, pressure to succeed, a stressful life event, family or relationship problems, economic status, diet trends and exercise programs glorified by media and celebrities, unrealistic views on body image,

PSYCHOLOGICAL causes contributing to anorexia are that individuals tend to be a perfectionist and have high achieving beliefs that contribute to their obsessive behaviour to be the thinnest rather than being thin. These individuals have low self-directedness, low self-esteem leading to behaviour which causes long term negative effects. Have rules that are rigid and illogical with regard to food and calorie intake.

Along with these certain risk factors leading to its cause are other mental health disorders such as depression, obsessive-compulsive disorder, anxiety disorders, mood disorder and social phobia. Dieting and starving oneself difficulty in handling stress, excessive worry, doubt about future, negative self-image. Also as one starts to lose weight, a low calories diet and low weight put them into a vicious cycle of the desire to continue the behaviour.

 

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How Is Anorexia Different From Healthy Fasting?

It is very likely that anorexia could be developed eventually from normal dieting and one may not be aware of, as among all the eating disorders it has the closest resemblance to fasting. However, there are ways that can help one understand the difference between healthy fasting and an eating disorder.  We need to understand that an individual voluntarily fasts for the medical , spiritual or psychological reason for a specific time period, but anorexics do not have a choice as their behaviour of not eating is driven by distorted irrational thoughts and compulsive behaviour. Healthy Fasting is not an addictive behaviour however eating disorders bear a strong resemblance to behavioural addictions wherein there is denial and unwillingness to accept any harm that they are causing to self.  Occasional healthy fasting is a way to train our body to work more efficiently, improve the immune system. Eating disorders are more to do with how one views food and their own body. In healthy fasting and individual does not starve themselves but in the case of anorexia, one starves them leading to health complications later.

 

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Conclusion

Anything excessive is harmful. Anorexia causes the development of unhealthy eating habits. Might start with an obsession with food, body weight or body shape and it is reported to have the highest mortality rate of any mental illness. Studies have found that seeking immediate professional help for anorexia can help increase the chance of full and complete recovery. Early diagnosis and treatment minimizes the risk of complications.

Diksha Duarah