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What is anorexia?
Anorexia, also known as anorexia nervosa, is an eating disorder.
Someone with anorexia has three main symptoms: They have an intense fear of gaining weight, they restrict food (causing significant weight loss), and they may have a distorted view of their body (and think they are overweight when they are not).
There are two types of anorexia: restricting and binge-eating/purging type. The restricting type is when someone restricts their food and calorie intake, leading to extreme weight loss.
The binge-eating/purging type is when someone regularly overeats (binges) and then makes themselves throw up or uses laxatives to flush food out of their system. Although this sounds like bulimia (which is a different eating disorder), there are subtle differences. People with binge-eating/purging type anorexia restrict calories, while those with bulimia do not. Typically, people with anorexia lose a great deal of weight, while people with bulimia may not.
Anorexia stems from a combination of genetic, social, and emotional problems such as poor body image, low self-esteem, stress, history of abuse, or control issues.
It is a very serious condition if not treated. It can lead to heart issues, infertility, anemia, and hormonal complications.
Treatment includes talk therapy, nutritional counseling, family therapy or a support group, and possibly medication.
Most common symptoms
People in your life will tell you to “just eat.” A common misperception is that this is possible for someone struggling with anorexia. Although it is hard for your friends and family to understand, we know you can’t “just eat.” —Dr. Bobbi Wegner
Anorexia is a serious eating disorder where you have an intense fear of gaining weight. You may see yourself as overweight (when you are not), and restrict the food you eat to lose weight.
The main symptoms of anorexia fall into four categories: behavioral, emotional, physical, and cognitive.
- Eating a very small amount of food and restricting food
- Purging through either induced vomiting, using laxatives and diuretics, fasting, or exercising excessively
- Secretive behavior (such as pretending to eat food or eating alone)
- Social withdrawal
- Feeling irritable
- Fear of weight gain
- Feeling overwhelmed
- Feeling out of control
- Dizziness, fainting
- Loss of your period
- Hair growth (on body and face)
- Thinning of hair on the head
- Bluish fingernails
- Loss of interest in sex
- Irrational thinking
- Negative thought patterns
- Obsessive-compulsive thoughts around food
- Being overly focused on food
Anorexia is a complex illness. Anyone with anorexia needs to see a mental health professional. Ask your doctor for a referral. Or check your insurance company for a list of covered providers. Also, psychologytoday.com has a list of therapists that you can search.
If not treated, anorexia can lead to other types of problems like anxiety, depression, and substance abuse. It can also cause serious medical conditions like heart and infertility issues.
If you have thoughts about harming yourself, go to the ER or call 911. The National Suicide Prevention Lifeline is 800-273-8255 and offers free, confidential support any time of day.
Treatment of anorexia nervosa
Anorexia is a serious mental health and medical issue. It goes well beyond just wanting to be thin. Anorexia is a form of self-starvation and has serious medical consequences including cardiac issues and even death. I share this not to scare you, but to seek help sooner than later. —Dr. Wegner
Treating anorexia often requires more than one kind of therapy. You may work with a psychiatrist, a psychologist, a social worker, and a dietician. The National Eating Disorders Association has more resources on information and support.
Types of therapy include:
- Talk therapy. In sessions with a therapist, you explore your relationship between thoughts, emotions, and your behaviors. The goal of treatment is to learn to notice unhealthy thought patterns and behaviors while developing positive coping skills.
- Family therapy can teach family members more about anorexia and how they can best support their loved one.
- Support groups are a way of sharing information and getting emotional support from others going through the same thing.
- Nutritional counseling can be helpful in developing a healthier relationship with food and healthy eating habits. You’ll also learn how to follow your natural hunger cues.
- Medication. Antidepressant medications, like fluoxetine (Prozac), are often used to treat anorexia. Other antidepressants are sometimes given to treat underlying mental illness, such as anxiety or depression.
Who is likely to have it?
- Anorexia affects females at a higher rate than males, although it affects both genders.
- Teenage girls and young women are at higher risk.
- It affects people of all races and ethnicities.
- People who are hardworking, perfectionist, controlling, introverted, and self-critical are at increased risk of developing anorexia.
- People from high income families are at increased risk of anorexia.
Control is most often a huge part of anorexia. When people feel out of control in other parts of their life, one coping mechanism is through controlling their food intake and body. —Dr. Wegner
No one knows for sure what causes people to develop an eating disorder. Experts agree that certain factors increase the risk of getting anorexia. Possible causes include:
- Family history of anorexia
- High-income, high-achieving families
- Poor body image
- Low self-esteem
- Being involved in a sport or other activity that focuses on appearance and performance, such as ballet
- History of abuse or trauma
- General stress
There is no one clear way to prevent anorexia. Many factors, including genetics, play a role. Following healthy lifestyle habits can make a difference. Parents can help their children by modeling healthy relationships with food.
- Develop a healthy approach to food and eating. Try lots of food, eat when hungry, and stop when full.
- Practice mindful eating, where you pay close attention to food as you eat it, without judging.
- Develop a healthy body image, focusing on the function of your body, not the form.
- Try to manage stress and anxiety.
- Notice people who have unhealthy relationships with food among those closest to you (family and friends).
- Get help with a mental health specialist at the earliest sign of changes in unhealthy eating or thoughts around food.
Dr. Bobbi Wegner is a Supervising Clinical Psychologist at Boston Behavioral Medicine, a Lecturer in Human Development and Psychology at Harvard Graduate School of Education, and CoFounder of nouVenu: a virtual platform that provides real support for real parents from real experts. She is on The Board of Advisors of Ignite Mental Health, developed out of Harvard Innovation Lab (like Buoy). Dr. Wegner writes and speaks nationally on modern families, stress, and coping, and also has a specialization in Clinical Health Psychology. She has a column on Psychology Today (Perfectly Imperfect Parenting), is a Parenting Expert on NBC News Learn, and is on the Today Show Parenting Team. Her book on raising boys is due out Spring 2021 with New Harbinger.