Anorexia Dangers, Symptoms & Treatment
Anorexia nervosa, known as anorexia, is a diagnosable mental health disorder that is characterized by efforts to maintain a low weight through diet manipulation and/or excessive exercise.
As anorexia is a clinical mental health disorder, it is included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Health Disorders – 5 (DSM-5) in the chapter entitled “Feeding and Eating Disorders.”
According to DSM-5, the following criteria are used to diagnose anorexia:
- Ongoing restriction of caloric intake that leads to a considerable low body weight as compared to the healthy weight in the individual’s peer group
- An intense and persistent fear of becoming overweight to a point where these thoughts influence the individual’s ability to gain weight or achieve a healthy weight
- Any of the following forms of distorted thinking: (1) not having a realistic interpretation of one’s shape or weight, (2) undue focus on self-evaluation of one’s weight or body shape, or (3) an ongoing inability to accurately view one’s present low body weight
These criteria can take place during the earliest phase of anorexia and throughout the life of the disorder. In the initial stage, individuals may hear their internal voice prodding them to lose weight and/or being overly critical about body image, and respond with diet restrictions. After the weight loss begins, individuals may feel more comfortable with their inner voices and even believe they are being guided to take the right action in view of the results. In the latter stages of the disorder, weight loss begins to affect people’s mood and daily behaviors.
Prevalence and Statistics
Although it is probably the most known eating disorder, anorexia is not the most common. According to the Center for Behavioral Health Statistics and Quality, anorexia is less common among adults over 18 than bulimia and binge eating disorder (BED), occurring in less than 0.1 percent of the adult population.
According to another study from Current Psychiatry Reports, when younger women (15-19 years of age) are included, the lifetime prevalence of anorexia increases to 0.9 percent of women in the population; in addition, contrary to many perceptions, 0.3 percent of men exhibit the disorder at some point in their lives, usually later in life than women do. This results in a total of 1.2 percent of the population 15 and older that has anorexia at some point in life. This compares to a 1.6 percent total prevalence for bulimia, and 5.7 percent prevalence of BED.
Despite its lower prevalence, anorexia has historically resulted in more deaths than bulimia or BED. However, the mortality rate from anorexia has been decreasing since the late 1980s; it is assumed that the reason for this is the improvement in medical and psychological treatments since that time.
Symptoms of Anorexia
Anorexia is associated with physical, psychological, and behavioral symptoms.
For onlookers, the symptoms may at first overlap so closely with general weight loss that it is difficult to know the person is actually in the early phase of anorexia. Individuals who engage in anorexic practices may initially feel in control of the process, as if they are engaging in a reasonable weight loss plan. But over time, they will lose their grip over their behaviors. For this reason, it is critical to be aware of the possible symptoms that can manifest. Physical symptoms include but are not limited to:
- Weight loss that is extreme
- An abnormal blood count
- Constipation and dehydration
- Cessation of menstruation (in women)
- Insomnia and fatigue
- Bluish fingers
- Fainting or dizziness
- Thinning hair (it may break or fall out)
- Irregular heart rhythms
- Development of soft hairs on body
- Swollen arms and/or legs
- Dry skin or yellowing skin
- Feeling intolerant of cold weather
- Low blood pressure
There are numerous psychological symptoms that can arise when individuals are facing anorexia. These symptoms may be new or may be a more extreme expression of existing feelings, such as low self-esteem (chronic or episodic). Psychological signs include but are not limited to:
- Withdrawal from social relationships
- Depressed mood
- Not feeling hungry
- Fear of weight gain
- Preoccupation with food
- Lying about food intake
- Lack of emotion or feeling flat
- Reduced interest in intimacy
- Suicidal thoughts
Behavioral signs may be tied directly into anorexic behaviors or associated behaviors, such as efforts to hide the disorder. The following behavioral signs reflect some of the possible range of activities that may be visible:
- Calorie counting (in a diary or otherwise)
- Denying hunger or appetite
- Writing down calories burned during exercise
- Rigid practices around meals, such as chewing then spitting out food
- Fasting or inducing vomiting
- Excessive exercise
- Complaining about being “fat” or overweight
- Buying and using laxatives, enemas, diet aids, and/or herbal supplements
- Avoiding or refusing to eat in public
- Constantly weighing oneself
Dangers & Health Issues From Anorexia
- Liver problems
- Slow metabolism
- Heart disease
- Kidney problems
- Muscle wasting
- Thoughts of suicide
- Obsessive-compulsive disorder
- Irritable bowel syndrome
- Electrolyte imbalances
How to Find the Right Anorexia Treatment Center?
There are a number of treatment options for people with anorexia, including hospitalization programs, inpatient treatment centers, and outpatient therapy programs. A setting that is right for one person with anorexia may be wrong for a different person with the same disease. A doctor or other medical professional can advise the family on which setting is best, and the family’s insurance company may have a list of approved providers from which the family can choose.
A person’s overall shape and underlying weight are usually considered a matter of personal preference. Some people like to have a few curves here and there, while others prefer a leaner, longer profile. When people adjust their weight either one way or another, it’s considered a form of freedom. People can and do whatever they’d like to do with their bodies. It’s their right to do so.
But there are some people who take this sense of personal freedom to an extreme. These people use harsh starvation techniques to cut their bodies down until there’s very little body left at all.
A diagnosis of anorexia applies, according to ANAD, when people reach a weight that’s 15 percent lower than ideal, and when these people don’t have any urge or desire to pull that low weight back up again. They’re small, and they’re small on purpose, and they don’t want to change things. In most cases, people like this actually want to get even smaller, and they’ll do almost anything to make that happen.
How Anorexia Develops
ANRED suggests that about 1 percent of adolescent females have anorexia. Adolescent boys can develop the disorder, too. This condition doesn’t magically evaporate when people reach adulthood. For some, the distorted eating habits that begin in adolescence stay with them as they age.
Anorexia’s starvation habits can start very small. Sometimes, for example, people with anorexia have a history of picky eating. These people push foods into specific categories of “good” and “bad,” and they refuse to eat anything that’s on the “bad” list. This selective eating builds up a sort of tolerance for food sacrifice, and each little sacrifice can come with a sense of accomplishment. People avoiding cake at a birthday party, for example, can feel a sense of superiority over everyone else taking bite after bite of sugary sweetness. They don’t give in, so they’re automatically superior.
Everything else is banned, and a person like this can grow thinner and thinner due to the everyday mealtime restrictions that are self-imposed.
Some people, too, come into anorexia through dieting. These people begin the process with bodies that are a little soft and rounded, and they crave a slimmer, svelte appearance. Diets can do the trick, and again, they teach people how to eat in a restrictive manner. In time, people on these diets can become more than a little obsessed with comments about their weight. They enjoy the attention that comes with getting smaller and slimmer, and they can’t seem to stop the weight loss, even when they reach a weight they once considered ideal. The National Institute of Mental Health suggests that these spiraling behaviors are very common in people with eating disorders, and that they can be difficult to overcome without help.
In addition to choices about dieting and body size, the risk of anorexia can also be determined by genes coming from parents. In fact, the Eating Disorders Coalition suggests that the development of an eating disorder is 50-80 percent determined by genetics. Researchers aren’t sure what the specific anorexia gene is or where it’s located, but families with a history of anorexia tend to produce children with anorexia. It’s common.
The way parents talk to their children can also play a role. Parents who consistently remark on a child’s weight, praising thin bodies while offering suggestions for heavier ones, can set up the expectation that fatness equals punishment. That’s a hard lesson to undo, and it can be at the root of an anorexia issue.
What Treatment Options Are There?
Since anorexia causes such serious medical concerns, it’s not at all unusual for people to start their recovery journey with a trip to the hospital. According to Mayo Clinic, people with anorexia might need help with heart rhythm problems, dehydration issues, electrolyte imbalances, or psychiatric disturbances. A hospital is a great place to get this help, as there are medical professionals on hand who can deliver lifesaving medications and therapies to people in desperate need.
Some people with anorexia need to stay in the hospital for a few weeks, until their bodies return to a more standardized level of functioning. They might need around-the-clock heart monitoring, forced nutrition, or other medical therapies just to keep the body up and running.
But these medical treatments don’t assist with the distorted thinking that stands behind anorexia behaviors. While doctors may be able to manipulate the body into a more standardized level of function, an outside treatment can’t help people with anorexia to think about their bodies in a different way. They need help that comes from within, and there are two ways to tackle that demand.
Outpatient treatment centers allow people with anorexia to continue to live at home while they work on amending their eating habits. This approach allows people with anorexia to put their lessons to work right away with each meal they eat at home, and they have the freedom and the responsibility to be good stewards of their own health as they heal. For some, this is an ideal option.
Inpatient residential centers allow people to move out of their homes for a short period of time while they work on an anorexia issue. They won’t be responsible for cooking their own meals or handling their own life demands when they’re in inpatient care; it’s all handled by the staff. But facilities like this do have a residential, home-like feel that some people need in order to be comfortable with the idea of staying engaged in care.
Hospitalization programs allow people with serious anorexia issues to continue to receive in-depth medical care while they recover from an eating disorder. These facilities typically don’t have a homey, residential feel. Instead, they tend to feel a little clinical and professional, but that’s just what some people need in order to really recover from the damage anorexia can cause.
Finally, some programs provide partial hospitalization options. This allows people with anorexia to live in a hospital environment during the day, with access to all of the medical therapies and counseling that these programs entail, but they head home at night to live with their families in the neighborhoods they’re accustomed to. It’s a middle-of-the-road approach that some people find very beneficial.
How an Anorexia Treatment Center Can Help
Cognitive Behavioral Therapy, or CBT, is considered the treatment of choice for people with anorexia, according to PsychCentral. While this is a medical disorder, its roots lie in the way people think about food and how they plan their meals. Amending those behaviors is the best way to deal with an anorexia issue, and CBT can make that happen.
Anorexia treatment centers can provide CBT through licensed mental health experts with years of experience treating people with similar disorders. Since there are others in the facility who also have anorexia, there are practice opportunities galore.
CBT sessions rely on learning new skills and putting those skills into practice in a meaningful way. People need to have the chance to learn, but they need to get feedback as they learn, so they can incorporate those lessons into their everyday life. CBT sessions often involve group work as a result, so people with similar conditions can coach and guide one another through the recovery process.
This is a huge benefit that comes with enrollment in a program like this.
In addition, anorexia treatment centers often provide therapies and support for the families of people with anorexia. This, too, can be a huge benefit. A study in the International Journal of Clinical and Health Psychology suggests that families of people with anorexia tend to be characterized as noncohesive and unable to deal with stressful events. These families are dealing with crises, but they don’t know what to do to make things better. Family therapy can make a big difference to families like this.
In family therapy, the entire community that surrounds a person with anorexia can come together to learn about the disease and how people heal. They can practice real skills that lead to differences that everyone can feel. Instead of meals being the site of battles, they can provide opportunities for conversation and healing. Families can learn how to support someone with anorexia, without feeling shame or blame when the person’s behavior doesn’t shift immediately. They could all feel much better soon.
A Realistic Recovery
While anorexia therapy can be remarkably helpful, real changes can take a long time to complete. In fact, in a study in the International Journal of Eating Disorders, researchers found that about half of people that completed anorexia programs had to enroll in additional programs at a later date. While the lessons they learned in the first session probably did have an impact, they needed a few more lessons in order to make big changes.
Statistics like this just highlight how hard it can be to overcome an anorexia issue. The eating habits and body image issues are just hard to shake, and they can leave people feeling scarred for very long periods of time. That’s why families need to ensure that they really understand how anorexia works, so they can be on alert for signs of relapse. When they see those signs, they might need to get the person they love into a program that could provide the touchup help required.
A slip on eating habits doesn’t have to lead to a return to full-blown disorder. It just means that a bit more intensive treatment is required in order for the person to make lasting changes. Families that stay in touch with the treatment teams they used can access that help, and it could save a life.
Ignoring an anorexia issue just isn’t smart, as these are issues that can cause pain, suffering, and even death. While American Addiction Centers does not treat anorexia, help is available at high-quality treatment facilities all over the US, which could mean all the difference for a person struggling with body image and nutrition. Families can help by speaking up and looking for the right treatment programs that can help. Talking about the issue can be uncomfortable, but it could be the best thing a family could do for someone in need. That one conversation could spark an entire lifetime of changes, all at once.