Anorexia Nervosa: Causes, Symptom and Treatment

Introduction

Anorexia nervosa is a severe eating disorder that can be life-threatening. It is marked by a strong fear of gaining weight, a distorted view of body image, and a constant quest to be thin, resulting in self-starvation and significant weight loss.

This disorder is quite challenging, impacting both physical and mental health. It mainly affects young women and girls, but it can happen in boys, men, and older individuals too.

Those with anorexia often see their body weight and shape incorrectly, leading to extreme dieting, excessive exercise, and actions that harm their health.

Without help, anorexia can cause serious health issues, like organ failure and even death. However, with the right treatment, recovery is achievable.

Causes

The reasons behind anorexia nervosa are complicated and involve many factors:

• Genetics: Having family members who have eating disorders raises the chance of developing anorexia, suggesting a genetic link. Differences in genes connected to mood, appetite, and reward systems may play a part.
• Biological Factors: Imbalances in brain chemicals, particularly serotonin and dopamine, can affect mood and eating habits.
• Psychological Factors: Traits like perfectionism, obsessive behaviors, and a strong need for control are often linked to anorexia. Those with low self-esteem and high sensitivity to criticism may be at greater risk.
• Sociocultural Factors: Pressure from society to meet certain beauty and thinness ideals, often pushed by media and peer influence, significantly contributes to the onset of anorexia.
• Environmental Factors: Stressful experiences like trauma, bullying, academic pressure, or relationship issues can trigger or worsen anorexic behaviors, especially in those already vulnerable.

Symptoms

Anorexia nervosa displays various physical, behavioral, and psychological symptoms:

1. Physical Symptoms:

• Extreme Weight Loss: Those with anorexia usually have a body mass index (BMI) much lower than normal.
• Fatigue and Weakness: Caloric restrictions and malnutrition can lead to extreme tiredness and weakness.
• Dizziness and Fainting: Low sugar and dehydration can result in dizziness or fainting.
• Cold Intolerance: Low body fat and a slow metabolism create sensitivity to cold.
• Amenorrhea: Women may stop menstruating due to hormonal issues.
• Hair Thinning and Loss: Malnutrition can harm hair health, causing it to thin or fall out.
• Lanugo: Soft, fine hair may grow on the body and face in response to cold.
• Gastrointestinal Issues: Common problems like constipation, bloating, and stomach pain can occur from reduced food intake.

2. Behavioral Symptoms:

• Restrictive Eating: Very few calories are consumed, often limited to “safe” foods.
• Excessive Exercise: Engaging in too much physical activity to burn calories or as a form of punishment.
• Ritualistic Eating Habits: Activities like cutting food into tiny pieces, taking a long time to eat, or arranging food in specific manners on the plate.
• Avoiding Eating in Public: Skipping meals with others due to embarrassment or a desire to hide disordered eating.

3. Psychological Symptoms:

• Intense Fear of Gaining Weight: There is often a powerful and irrational fear of becoming “fat” or gaining weight.
• Distorted Body Image: Individuals may see themselves as overweight, even when they are underweight.
• Perfectionism and Control Issues: High demands for self-control and perfection contribute to restrictive eating. Behaviors.
• Denial of Hunger and Illness: A person with anorexia might say their illness is not that bad or claim they are not hungry even with obvious signs of not eating well.

Risk Factors

Multiple things can make someone more likely to get anorexia nervosa:

• Gender: Women get anorexia more often than men, but men are getting it more too.
• Age: Young people, especially those aged 15 to 25, have a higher chance of getting it.
• Genetics: If someone in your family has eating disorders, depression, or anxiety, you might be more at risk.
• Personality Traits: People who are perfectionists, have obsessive behaviors, or are very self-critical may be linked to anorexia.
• Cultural and Societal Pressure: Living in a society that praises thinness or certain body types can raise the risk.
• Activities Focusing on Appearance: Sports and jobs that focus on body size, like gymnastics, ballet, and modeling, see more cases of anorexia.

Differential Diagnosis

Anorexia nervosa has symptoms that overlap with other conditions, making it important to differentiate:

• Bulimia Nervosa: This includes binge eating followed by behaviors to get rid of food, like purging. People with bulimia may be at a normal weight, while those with anorexia usually are not.
• Body Dysmorphic Disorder: This condition involves seeing flaws in one’s appearance, but not necessarily linked to worries about food or weight.
• Major Depressive Disorder: Losing weight and not feeling hungry can happen in depression, but generally, those with depression don’t have the same fears about gaining weight or being thin.
• Hyperthyroidism: Weight loss and increased appetite can happen because of an overactive thyroid, not a food restriction.
• Celiac Disease or Digestive Disorders: Conditions like celiac can lead to weight loss and discomfort but lack the psychological aspects of anorexia nervosa.

Investigation

To diagnose anorexia nervosa and check the extent of its physical and mental effects, a detailed evaluation is needed:

• Medical History and Physical Examination: A detailed account of weight changes, eating habits, and symptoms, plus an exam to look for signs of malnutrition.
• Psychological Evaluation: A mental health expert may look for signs of anorexia and other issues like anxiety or obsessive thoughts.
• Laboratory Tests:
  • Complete Blood Count (CBC): To find anemia or infections.
  • Electrolytes: Malnutrition can cause imbalances in important electrolytes like potassium and sodium.
  • Liver and Kidney Function Tests: To see how malnutrition affects these organs.
  • Hormone Levels: Tests on reproductive, thyroid, and cortisol hormone levels may be done.
• Bone Density Test: Malnutrition can cause weak bones, especially if periods have stopped.
• Electrocardiogram (ECG): Long-term malnutrition and imbalances can lead to heart issues such as irregular heartbeats.

Treatment

Anorexia nervosa treatment involves many aspects, focusing on both physical and mental health. It usually needs a team that includes doctors, dietitians, and mental health experts.

1. Nutritional Rehabilitation

• Weight Restoration: Gradually increasing calorie intake helps individuals reach a healthy weight, often with meal plans from a dietitian.
• Monitoring and Medical Support: Weight gain should be monitored by a doctor, as rapid increases can lead to severe health issues.
• Nutritional Counseling: Teaching about balanced diets shows the importance of eating enough for mental and physical well-being.

2. Psychotherapy

• Cognitive-Behavioral Therapy (CBT): CBT is the best treatment for anorexia nervosa. It helps people recognize and change wrong beliefs about weight, body image, and food. It also replaces bad habits with better ways to cope.
• Family-Based Therapy (FBT): This is called the Maudsley method. It includes family members in the treatment, which is helpful for teens by aiding their understanding and support for recovery.
• Interpersonal Therapy (IPT): IPT looks at social and personal issues that might worsen anorexia. It aims to enhance relationships and social support.
• Dialectical Behavior Therapy (DBT): DBT is useful when there are additional problems, like self-harm. It helps with controlling emotions.

3. Medications

• Antidepressants: SSRIs, like fluoxetine, can help with anxiety and depression symptoms in people with anorexia, but they are not the main treatment for the eating disorder.
• Antipsychotics: For severe anxiety or obsessive-compulsive symptoms, low doses of antipsychotics like olanzapine may help reduce troubling thoughts and assist with weight gain.

4. Inpatient or Residential Treatment

Very severe cases of anorexia nervosa, particularly when there are very low body weights or serious health issues, may need inpatient care. Patients in these facilities get detailed medical treatment, structured nutrition, and therapy.

Residential programs create a focused environment for weight recovery, coping skills, and getting ready to return to regular life.

5. Long-Term Support and Relapse Prevention

• Ongoing Therapy: It is often important to continue therapy after weight is restored to tackle underlying issues and stop relapse.
• Support Groups: Many find it helpful to join support groups for eating disorders. Here, they can share their stories and get encouragement from others recovering.
• Regular Medical Monitoring: Ongoing medical check-ups are important to track health, manage risks, and support long-term recovery.

Conclusion

Anorexia nervosa is a serious eating disorder that impacts physical, mental, and social well-being.

Its causes are complex, involving genetics, psychology, and culture, making it vital to have a full treatment approach. Early diagnosis and prompt treatment lead to better results. Treatment usually includes nutrition rehab, therapy, and sometimes medication.

With continuous therapy, medical help, and family support, many people with anorexia can recover and achieve a healthier life.