Anorexia Nervosa

Anorexia Nervosa is a serious mental illness characterised by an intense, overwhelming fear of gaining weight and an obsession with food, calories and body image.

This results in extreme weight loss and often low body weight. The diagnostic criteria for Anorexia suggests that a person must have a Body Mass Index (BMI) of below 17.5 but it is possible to have a higher weight than this and still be ill. In this case, the person might be diagnosed with OSFED (Other Specified Feeding or Eating Disorder).

Sufferers will severely restrict their food intake and sometimes also abuse laxatives or diet pills, exercise excessively, or induce vomiting. They will sometimes have a distorted view of their own body and believe they are overweight despite being desperately underweight. Once someone begins to get into the cycle of losing weight, thinking can become more and more rigid. This means that the longer Anorexia has been going on, the harder it is to recover.

Anyone of any age, gender, social class, race or sexuality can get anorexia but it is often first seen in the teenage years.

The illness has the highest mortality rate of any other psychiatric illness, with 20% of people dying every year as a direct consequence of their illness or by taking their own life.

There is no clear reason why someone develops Anorexia but it is thought that there are several factors. Evidence suggests a genetic component. Some people have genes that put them at higher risk of getting it and often runs in families. Certain personality traits are also more common in people who develop eating disorders. These might be things like perfectionism, cautiousness and harm avoidance.

There might be a traumatic event or events in a person’s past that further increase the risk. An environment where thinness is highly prized such as certain sports, activities or even within a family also increases the risk. Another risk factor might be a physical illness that means appetite is affected or an event in which a person is shamed for a food choice or for the way they look.

Sometimes Anorexia is thought to be about control and anxiety. Keeping tight control of food intake, weight and exercise helps sufferers control their very high anxiety levels and other difficult emotions.

As humans, we need to eat regularly to nourish and fuel all aspects of our being – our body, mind and spirit. When we are deprived of this nourishment, chemical changes occur which affect our physical, emotional and mental functions.

The problem for those restricting their food intake to gain control over their lives is that the effects of starvation quickly take control of the body. Initially, anorexia may be a conscious decision to stop eating. However, the ability to make rational decisions diminishes with extreme weight loss and for many, the added burden of depression affects their decision making further. The weight loss, which was originally seen as the solution, has now become a problem. What was once about gaining control is now out of control and the eating disorder and its maintenance takes over the person’s life.

Anorexia can permanently damage a person’s health. Long-term effects include:

• Osteoporosis (brittle bones)
• heart damage
• problems with bowel function
• changes in the brain including a decrease in brain substance
• damage to fertility and the reproductive system

At worst, a person can die from Anorexia and 20% of sufferers ultimately do.

Behavioural

• Secrecy around food
• Obsessive calorie counting or weighing of food
• Refusal to eat in front of others
• Eating very slowly or cutting food up into tiny pieces
• Pushing food around plate
• Hiding or stashing food
• Eating only certain foods or foods low in calories
• Anger when questioned about what has been eaten
• Cooking or baking for others or a desire to feed others
• Excessive weighing 
• Increasingly rigid and obsessive thinking
• Social isolation
• Vomiting
• Excessive exercising 
• Body checking for perceived changes
• Tiredness or excessive sleeping

Physical

• Severe weight loss
• Feeling cold all the time
• Loss of periods or sporadic periods
• Growth of downy hair on the body
• Disturbed sleep
• Tiredness
• Dry or brittle hair and skin
• Poor concentration
• Fainting or dizziness
• Little interest in sex
• Constipation
• Low blood pressure
• Stomach pain
• Damage to teeth and body 
• Muscle weakness