Anorexia is a mental health disorder that is recognized in the official American Psychiatry Association guide, the Diagnostic and Statistical Manual of Mental Disorders – 5 (DSM-5). Anorexia is often discussed in the media or society at large without any reference to its different phases. A person begins to develop anorexia-involved thoughts and actions often long before anyone notices that the disorder is present.
Anorexia is often associated with its later stages, as the effects are typically highly visible on the affected individual. As a result, the public’s conception of anorexia is skewed toward the latter end of its timeline. A more expansive understanding of anorexia could be helpful to individuals who develop this eating disorder. The earlier risks or symptoms can be detected, the more likely it is that appropriate and effective intervention can occur.
Individuals who experience anorexia do not follow the same trajectory of development, nor will they experience the same symptoms. Although there are no established stages, for illustrative purposes, consider the disorder as being spread out over six stages. The following discussion describes some of the hallmarks of each of these phases.
During the first stage, individuals move from mere contemplation of restricting their diets and/or engaging in an intensive exercise program to beginning these activities. At this point, an onlooker may think the person is only being health-conscious or trying to “get in shape.” The individual who is dieting and exercising may not yet have a specific intention to go to extremes to meet weight loss goals. At this point, the main health risk will be the side effects associated with sudden weight loss and the risk of developing a more severe case of anorexia or adding in bulimic practices.
In the second phase, individuals typically begin to obsess about their level of food intake and/or exercise. As they progress to the third phase, they may keep a detailed journal of daily caloric intake, exercises performed, and subsequent calories burned. As time progresses, a review of these journal entries may reveal less caloric intake and more calories burned. As the food and/or exercise obsession takes hold, individuals will likely be heard complaining about their bodies.
Individuals in this phase often suffer from malnutrition. The following are some of the health risks associated with malnutrition:
During the fourth stage, individuals with anorexia may celebrate their body appearance in various ways, such as counting their exposed ribs or checking to see if their collarbone or spine protrudes. These activities may be kept hidden. Individuals may feel good about their thinness but have a sense that others would be concerned. To protect their eating disorder, they may hide its symptoms from others. This stage can be thought of as the beginning of a dangerous downward spiral. Individuals with anorexia may experience any number of serious side effects at this point (discussed below).
The fifth stage may involve a malnourished person “upping the ante,” so to speak. The individual may want to accelerate weight loss through extreme behaviors, such as starving to the point of fainting. During this stage, fainting may occur often.
In the sixth stage, the disorder continues to spiral out of control. In addition to fainting spells, the individual may experience any of the following serious health effects:
The Alliance for Eating Disorders Awareness has published, on its official website, the personal story of a young woman named Brenda. Starting in 6th grade, and continuing for nearly 11 years, Brenda considered anorexia to be her friend and thought that a life without her anorexic practices was not worth living. Brenda could never imagine herself in recovery; to her, that would have been like abandoning a much loved and trusted partner. Brenda starved herself, ate then purged, and excessively exercised for years.
When Brenda entered college, she decided to stop dancing and thought her anorexia would disappear. It did not. Brenda found herself on the college rowing team, rowing up to four hours a day, and obsessing about each calorie she consumed. Although college is a social environment, Brenda withdrew from other students to hide her anorexic practices. She felt she had a problem that made her unlovable. Eventually, during crew training practice, Brenda collapsed.
Like so many others afflicted by eating disorders, Brenda recovered. Her recovery included traditional treatment approaches, such as therapy (individual and group), nutritional education, support group meetings, and journaling. Brenda notes that her journey from anorexia to a healthy body, mind, and spirit had its ups and downs, but she committed to making her health an ongoing priority. She shares that she is a testament to how individuals with anorexia can change their relationship with this disorder; whereas she used to feel like she couldn’t live without her eating disorder, she now understands that it is not possible to live with it. Brenda hopes her story will encourage others to seek help regardless of the severity of their condition.
Anorexia is a treatable condition that can be effectively addressed with proper rehabilitative care. It’s imperative that those suffering from anorexia seek comprehensive care that includes medical supervision and therapeutic counseling. While AAC facilities do not treat anorexia, various reputable centers across the country treat this disorder. With inclusive care, true recovery is possible.