Anorexia nervosa is a type of eating disorder. Anorexics restrict their calorie intake and the kinds of food they consume. They eventually lose weight or cannot maintain optimum body weight for their height, age, stature, and physical health. Also, they may exercise obsessively or purge their food through purposeful vomiting or laxative abuse. Lastly, individuals suffering from anorexia have a skewed self-image of their body and a profound fear of gaining weight.

By the age of twenty, one in every eight children may develop at least one eating problem. Eating disorders can affect people of all ages and genders. Anorexia nervosa and bulimia nervosa affect around 0.3% and 1% of teenage girls, respectively.

Eating disorders are caused by genetic, environmental, and social factors. When other aspects of their lives are out of control, some people with eating disorders may resort to extreme efforts to regulate their food. An unhealthy approach to coping with difficult emotions or sentiments is to get obsessed with eating. Eating disorders are more about controlling emotions than food.

Anorexia nervosa is a disorder in which patients forgo eating, severely restrict food, or eat only tiny amounts of specific foods. They may also weigh themselves several times. Even if they are critically underweight, they may perceive themselves to be overweight.

Anorexia nervosa is classified into two subtypes: restrictive and binge-purge.

Individuals with the Restrictive type lose weight by fasting or excessive exercise.

Individuals with the Binge eating/purging type binge on excessive amounts of food and then purge. They puke on purpose and use laxatives and diuretics to purge.

Among the symptoms include:

• Severe limitations in eating;
• Extreme thinness (emaciation);
• An obsession with thinness and a reluctance to maintain a normal or healthy weight;
• Anxiety about gaining weight;
• Body image distortion, self-esteem greatly impacted by views of body weight and form, or denial of the severity of low body weight.

According to the DSM-V, the three criteria for anorexia nervosa are as follows:

• Calorie restriction resulting in weight loss or inability to gain weight resulting in very low body weight; 
• Anxiety over gaining weight or becoming “fat”;
• Having a distorted perception of themselves and their situation.

This includes a denial of the seriousness of their current low body weight or food restriction and views their appearance as their primary sense of worth.

A person can have an eating disorder even if the DSM-5 criteria for anorexia are not satisfied. The DSM-5 criteria categorize the severity of anorexia based on body mass index (BMI). Atypical anorexia occurs when a person meets the criteria for anorexia but is not underweight despite considerable weight reduction.

Doctors may use several diagnostic procedures, including CBC, ECG, and liver function tests, to rule out any medical disorders that might cause weight loss. Additionally, to assess the potential physical harm that weight loss and hunger may have caused. However, there are no specific laboratory tests designed to diagnose anorexia nervosa.

Treatment

Many anorexics refuse to acknowledge that they suffer from an eating disorder; which is why helping them identify the condition is the first step. They frequently wait until their disease is critical or life-threatening before seeking medical attention. 

The treatment combines psychotherapy, medications, nutrition counseling, and hospitalization if necessary. All these treatment options are aimed to:

• stabilize weight loss;
• start a dietary rehabilitation program to get back in shape;
• put an end to purging and other unhealthy eating habits, including binge eating;
• address problems, including poor self-esteem and distorted thinking patterns;
• establish sustained behavioral changes.

Not all cases of anorexia may be prevented, although early intervention is helpful. Teaching and promoting appropriate eating practices and realistic views toward food and body image may also help stop the onset or worsening of eating disorders. If a person wants to switch to any diet, it’s necessary to consult a nutritionist and a doctor with an expertise in eating disorders.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Balasundaram P, Santhanam P. Eating Disorders. [Updated 2022 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK567717/

Cleveland Clinic (2022). Anorexia Nervosa. Retrieved October 22, 2022, from https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa