Anorexia is a disease which predominantly affects women but is becoming increasingly common in men. It is a psychological illness that results in an abnormal relationship with food and an obsession with losing weight. Anorexia is very serious and it can potentially prove fatal so it should be treated as early on as possible. People with anorexia want to lose weight because they want to be thin and they have a deep-seated fear of being fat; people with anorexia also usually have a distorted image of the way they look and often feel they look fat when they may actually look extremely thin.
What causes anorexia?
Anorexia can be caused by a range of different factors but it is most common amongst people with a history of mental illness or an obsessive personality; more than 60 percent of people with anorexia have depression and a third of people with anorexia have OCD (obsessive compulsive disorder). Other possible causes of anorexia include:
- Stress (usually at school, home or work)
- Physical or mental abuse
- History of being overweight
- Pressure to stay thin (to look like others or be under a certain weight for work (such as modelling) or to participate in sporting activities (such as being a gymnast or jockey)
Recognising the symptoms
Anorexia nervosa can be extremely damaging so it is important to be able to recognise the symptoms and get treatment quickly. Common symptoms include:
- Avoiding meal times
- Eating much less than normal and restricting calories
- Increasing the amount of exercise you do (to a harmful level)
- Spending time looking at your body in the mirror
- Spending less time with other people
- Lying about food and meals
- Hiding food instead of eating it
- Making yourself sick
- Taking laxatives
- Taking slimming pills
- Drinking lots of diet drinks (these fill you up without providing any calories)
- Low self-esteem
- Distorted body image
- Being emotional
- Losing concentration
- Feeling exhausted
Symptoms of advanced anorexia:
- Increased growth of body hair (this is to help the body cope with the cold in the absence of fat)
- Decreased heart rate and circulation
- Low blood pressure
- Fainting and dizziness
- Abdominal pain
- Infertility (under a certain body weight, girls start to stop having periods to conserve the body’s energy)
- Increased feeling of the cold
- Organ failure
If left untreated, anorexia may result in death.
Diagnosing anorexia nervosa
A GP will usually use a series of tests to determine whether or not a patient has an eating disorder. Usually, this will involve a combination of tests and questions to determine a person’s psychological state and tests to assess blood pressure, heart function and body weight. Doctors will measure the patient’s BMI (body mass index) which is usually below 17.5 if they have an eating disorder.
If the doctor thinks you might be suffering with an eating disorder, they may conduct a more complex assessment or they may refer you to a specialist.
Treating anorexia nervosa
Anorexia nervosa is a psychological illness but it can result in a number of physiological health conditions; consequently a multi-faceted approach to treatment is required. Often a number of different health professionals may be involved in the treatment of anorexia.
What types of treatment are available?
Treatment usually involves a combination of therapy and counselling and nutritional advice. Counselling and therapy will be used to boost self-esteem and confidence, allow you to talk about any worries you have with a qualified professional, enable you to build trust in another person and help you to address the causes of the disease and find effective ways to deal with stresses in the future. Types of psychological treatments include:
- Cognitive behavioural therapy
- Cognitive analytic therapy
- Interpersonal therapy
- Focal psychodynamic therapy
Nutritional advice will also help you to talk openly about food and work out which foods you need to eat to improve your health.
During the psychological treatment, patients’ physiological health will also be monitored closely; this will involve them being weighed regularly and having their heart rate, pulse and blood pressure tested frequently. Some people may also be put on a course of medication.
Gradually, the patient will be encouraged to start eating more and will usually be allowed to stop regular treatment once they have reached a healthy weight; they may continue to have their weight, heart rate and blood pressure checked regularly but this will usually done in outpatient’s clinic or by their GP.
In some cases, where patients are very ill but refuse treatment they may have to be sectioned in accordance with mental health legislation. This usually only happens when the patient is very poorly and has advanced anorexia; usually the intervention prevents the patient from dying.
Where does treatment happen?
Treatment programmes usually start with your GP and then most people attend outpatient clinics on a regular basis. In advanced stages, it may be necessary to receive treatment in hospital, especially if the condition is severe. There are also a number of private clinics which are specifically designed to cater for people with eating disorders.