Anorexia Nervosa

What Is Anorexia Nervosa?

Anorexia nervosa, commonly called anorexia, is a deadly illness. But unlike the flu or a sexually transmitted disease (STD), anorexia isn’t spread by bacteria or a virus. Instead, anorexia stems from your thoughts and emotions.

Currently, more than eight million Americans suffer from eating disorders. Ninety to 95 percent of those who suffer are female, and the number of males with eating disorders is increasing. There are many men and adolescent males who go undiagnosed either because of the lack of reporting the disorder or because of misdiagnoses. According to H. W. Hoek and D. van Hoeken’s article in International Journal of Eating Disorders (2003), 40 percent of the newly diagnosed cases of anorexia are girls and young women who are between the ages of fifteen and nineteen.

Doctors are slowly beginning to better understand anorexia. There are now treatments that can help people who have anorexia gain self-esteem and get healthy.

About Anorexia Nervosa

You may have heard the term “anorexia” used before—maybe you talked about it in health class, read about it in a magazine, or heard someone talk about how actress Mary-Kate Olsen was being treated for it. Your mom may get upset if you don’t want to finish your dinner and say, “Please eat! You haven’t been eating enough food lately. You’ve lost some weight already—are you still concerned about losing more weight? You aren’t becoming ill are you?”

Chances are, eating-related issues probably influence your life or that of a family member or friend right now. You, he, or she might already feel a few of the forces that cause an eating disorder to kick in: insecurity, peer pressure, and society’s pressure to be thin.

The word “anorexia” literally means “loss of appetite.” But anorexia is more like self-starvation— becoming so obsessed with losing weight and dieting that you ignore your body’s hunger signals. Although people with anorexia are always hungry, they take pride in denying hunger, feeling more in control and independent. This belief has very dangerous consequences. If anorexia progresses far enough, you can lose massive amounts of body weight—enough to cause psychological problems, physical problems, and even death.

Eating Disorders

How do you feel about food? You probably don’t have a simple answer.

You need food in order to survive and grow. But eating also has emotional and social importance for everyone. It’s how people bond with each other on holidays, at the movies, and at home. And sometimes there are expectations, even pressures about what and how much you eat.

If you have a healthy relationship with food, you’re able to eat when you are hungry and enjoy what you eat. If you don’t have a healthy relationship with food, eating can cause discomfort, guilt, conflicts with others, and even self-hatred.

An eating disorder usually arises when other influences, such as low self-esteem, abuse in the home, or peer pressure, contribute to the food becoming an avenue to control something in a person’s life or a symptom of other things that might be happening in a person’s life.

An eating disorder usually arises when other influences, such as low self-esteem, abuse in the home, or peer pressure, contribute to the food becoming an avenue to control something in a person’s life or a symptom of other things that might be happening in a person’s life. These negative feelings about food become overwhelming enough to interfere with your health and nutrition. Your eating becomes “disordered,” causing both physical and emotional troubles.

Categories of Anorexia

People who have anorexia do one or both of these things:

• Restrict the amount of food they eat, and/or exercise all the time to keep their weight down. Someone with anorexia might eat only a tiny portion of food and then jog in place for thirty minutes to work off the calories.

• Eat a lot of food at once (called bingeing) and then get rid of the food by vomiting, taking laxatives or diuretics (such as drugs that reduce fluids), or using enemas (called purging) regularly. This bingeing and purging behavior resembles bulimia nervosa, an eating disorder in which binge eating is followed by purging, fasting, or excessive exercise. Many bulimics are usually preoccupied with the fear of gaining weight. People with anorexia usually refuse to eat, whereas people with bulimia usually binge eat but then purge. Anorexics also usually deny to themselves and to others that there is a problem. Bulimics are often aware that there is a problem, but they may try to keep it a secret from others.

Who Gets Anorexia?

Anyone can get anorexia—male or female, young or old, and from all walks of life. However, anorexia is much more common in teens than in adults. It seldom sets in after age twenty-five. There is also a higher rate of anorexia among females than among males. This may be because society puts much more pressure on young women than on young men to be thin. Also, since anorexia is thought of mainly as a woman’s problem, men may be too shy to seek help, so they may be underrepresented in the statistics.

Because not all people with an eating disorder seek help, no one is sure exactly how many people suffer from anorexia. But the U.S. National Library of Medicine indicated in 2004 that it’s estimated that 1 to 2 out of every 100 women have struggled with anorexia at some time in their lives. The numbers may even be as high as 10 out of every 100 adolescent girls, according to the Mayo Clinic in 2006. The National Association of Anorexia Nervosa and Associated Disorders (ANAD) reported that young women with anorexia are twelve times more likely to die than women who don’t have anorexia—the highest death rate of any emotional problem. Anorexia is much less common in boys and men than in girls and women. Only 1 or 2 out of every 1,000 males have anorexia.

You could become anorexic if you tend to have very low self-esteem or if you are frequently a high achiever. Many people use anorexia as a way to gain more control over their lives. If you feel that your parents or teachers get to make all your decisions for you, you may start to restrict the amount of food you eat to gain control at least over that part of your life.

Anorexia: The Basics

You may have anorexia if any of these statements apply to you:

• You weigh 15 percent less than the normal body weight for your height and age. For example, if your doctor says you should weigh 100 pounds and you weigh only 85 pounds, you’re 15 percent below your normal body weight. It’s not anorexia if you have a health problem that is causing you to lose weight, though, because that’s weight loss you can’t control. But if you are trying to keep your weight low on purpose—that is, if you refuse to gain weight—you may have anorexia.

• You’re very afraid of gaining weight, even if you aren’t overweight. If you obsess about every bite of food that you put in your mouth, worrying that it has too many calories, you may have anorexia. That fear can begin to control you to the point where you think about avoiding food all the time.

• You don’t like what you see in the mirror. Even though everyone tells you that you’re thin, you see a fat person staring back at you.

• You have amenorrhea, the absence of menstruation by the age of sixteen or so or where the menstrual cycle has stopped for about six months or for the time of about three menstrual periods.

Anorexia and the Body

Anorexia can have a big effect on your body and mind. If you have anorexia, you are afraid of getting fat, so you avoid eating. The result is weight loss. At first, the drop in weight may not be noticeable or look unhealthy. But in a short time, the weight loss becomes dramatic and threatens your health.

Anorexia affects all of your body functions. As the disorder progresses, your digestion slows down and you become constipated. Later, during the progression, you’re always cold because you’ve lost the protective layer of fat that insulates you. Fine hair, called lanugo, grows all over your body. If you’re female, your menstrual period stops. You also will look and feel tired and weak, have a pasty complexion, lose your hair, and have fainting spells and headaches. The soles of your palms and feet turn yellow because your body is lacking many of the nutrients it needs to function properly. Some of these side effects may not occur until severe weight loss has occurred.

When you aren’t getting enough nutrition from food, your body will start to break down muscles in order to produce energy. Your liver and kidneys are damaged from this stress, leading to kidney failure. This can be fatal, or require you to be on dialysis for the rest of your life.

Anorexia may make females infertile, or unable to have children, because fertility depends on having a certain amount of body fat. You may also develop osteoporosis—a condition in which your bones become brittle and may even break. Low bone mineral density in adolescent women who suffer from anorexia is a common problem, partly because of low calcium intake. Even young women who take calcium in their food or in supplements can get osteoporosis because amenorrhea can prevent their bodies from totally absorbing the calcium.

Your heart can be especially affected. Anorexia disturbs the mineral balance in your body, which can cause cardiac arrest and death.

Anorexia and Emotions

Anorexia often begins because of emotional reasons. People who suffer from eating disorders are trying to use food as a way to fill emotional needs, such as love and belonging, to ease loneliness, or to avoid difficult feelings and/or memories.

Yet anorexia actually worsens a painful emotional cycle. You become stressed out when you’re around food because you feel tempted to eat. And if you do eat, you feel defeat and regret—you may even hate yourself. These feelings become so overwhelming, it’s common for depression to set in.

Anorexia makes it hard for you to think and perceive things normally. When your body isn’t getting the nutrients it needs, you run on adrenaline (a hormone that kicks in when you’re fearful or stressed) instead of on energy from food. These chemical changes affect your personality. You have wider mood swings and a quicker temper.

Also, the more weight you lose, the more distorted your body image becomes. You see fat on your body when you really are dangerously thin. Thought distortion occurs because of the lack of nutrients. You also might not be able to concentrate.

Other Eating Disorders

If you have anorexia, you might have had a bout with another eating disorder, although this should not be assumed. Besides anorexia, the most common eating disorders are bulimia nervosa and compulsive eating (also called binge-eating disorder). Experts estimate that almost 50 percent of people with anorexia have also struggled with another eating disorder at some time.

Bulimia Nervosa

People who suffer from bulimia nervosa, or bulimia, binge (eat a large quantity of food in a short time) and then purge (eliminate the food, usually by vomiting, using laxatives, or taking diuretics, also known as water pills). Bulimia also does major damage to the body.

It can cause ulcers (holes or tears) in the stomach, throat, and mouth. People with bulimia can develop yellow, damaged teeth from the acids brought up into the mouth through repeated vomiting. Abusing laxatives causes painful stomach cramps and weakens the digestive system.

Compulsive Eating

Compulsive eating is a disorder in which a person eats uncontrollably but doesn’t purge afterward. People with compulsive eating disorder eat large amounts of food very quickly whether or not they feel hungry. They usually do this in private and feel unable to control how much or what they eat. People who regularly overeat may forget how to read their body’s normal hunger signals and may not know how to satisfy them.

Other Eating-Related Problems

Having an eating disorder doesn’t mean only restricting what you eat. Many eating disorders have different diagnoses from anorexia, based on the other behaviors involved with the eating disorders. Many people with eating disorders exercise compulsively or abuse medicines. Compulsive exercise is an unhealthy drive to overexercise in order to burn calories and stay thin. This may mean running dozens of miles a day or vowing to do twenty sit-ups for every bite of food you take. Compulsive exercise puts stress on your organs and joints, causing stress fractures and torn muscles.

People with eating-related problems may also abuse medicines and drugs. This includes taking appetite suppressants (drugs that speed up your metabolism), diuretics (drugs that make your body lose water through frequent urination), laxatives (drugs that bring on a bowel movement), and drugs to induce vomiting.

By forcing food and water out of your body, you are upsetting your body’s normal functions. Abusing laxatives can cause you to lose control over your bowels. When you stop using laxatives, your body becomes swollen from retaining water. Other over-the-counter diet drugs can help bring on mineral imbalances that lead to heart failure.