Anorexia nervosa is an eating disorder portrayed by extreme weight loss. People with anorexia tend to restrict their diet to a certain calorie intake each day that can result in life-threatening risks. Research shows that Anorexia nervosa has the highest death rate of any psychiatric diagnosis. The mortality rate is conclusively twelve times higher than the death rate of all causes of death for females within 15-24 years old. Severe anorexia cases are known to irritate professionals due to the complexity of approaches used. Since people with anorexia restrict their diet, their body is being denied of essential nutrients and can be the cause of major health consequences.
People often mistake mistake anorexia nervosa with other types of eating disorders. Bulimia is mostly mistaken for anorexia due to the similarity of food restrictions, excessive exercise and a strong desire to not gain weight. The difference is that bulimia is characterized by binging and purging behavior to prevent weight gain. Purging behavior incorporates vomiting, diuretic or laxative abuse. Pica is another eating disorder mistaken for anorexia nervosa, this is because a patient eats food that have no nutritional value such as cotton. You might have seen some examples on the TV show My Strange Addiction, where people eat non-food items. Purging disorder is when a person purges without bingeing. This of course can be a major risk to the health such as ulcers, chronic gastric reflux, irregular heart rhythm, etc.
There is no single cause associated with anorexia nervosa. Anorexia can be a coping mechanism for some patients who are going through traumas or life stressing matters. Such ones may be facing divorce or family separation, the stress of academic pressures, transitions, developmental challenges or any change in their life. Anorexia is also found in patients whose families are well functioning. The encounter of puberty and adolescence are also common causes of anorexia. Research claims that patients of anorexia may come from families with autistic spectrum traits, perfectionist, obsessive, and competitive traits.
The factors of anorexia are divided to predisposing, precipitating, and perpetuating factors that trigger and maintain an eating disorder. A patient might begin with harmless dieting which can become extreme with time. Family influence is also another key, a patient might be called names by family as a joke which could take a negative turn on a person, especially when they are already dealing with body insecurities. Parents are not the blame for the condition of an anorexic child because it is an eating disorder caused by improper brain functioning. Low levels of serotonin (one of the brain chemicals involved in depression) can be a cause of anorexia. 33% -50% of anorexic patients have mood disorders, such as depression.
The diagnosis of anorexia has become common over the years, it affects people of different racial groups, ethnic, sexes, age, and socioeconomic status. The effects of this disorder may worsen as a patient becomes more obsessed with their weight. The patient may begin to fail academically, lose faith in religion, face career disruption, and isolate themselves from friends and family. This happens because the patient has prioritized their time to pay attention to their weight and nothing more. Since their body is restricted from essential nutrients, they are prone to complications to many bodily functions.
The heart is the most important muscle in the body, because it pumps blood throughout the body, supplying it with oxygen and essential nutrient, while discarding waste such as carbon dioxide. With intense weight loss, the heart muscle can weaken and give out, resulting in death. The heart can also experience irregular heartbeat, low blood pressure, fatal heart decompensation, and fainting. The stomach might shrink due to loss of muscle in the gastrointestinal track, which can cause constipation and minimum movement of food through the tracks. The patient might feel full or really bloated after consumption of a small meal, the liver might become inflamed due to fatty deposits. Urine might become highly concentrated and urine production might increase when the kidneys fail. An anorexic woman may experience absence of menstrual cycle because of iron deficiency, they are at a very high risks for being diagnosed with osteoporosis. Red blood cells that carry the oxygen might become low, as well as, white blood cell.
As a result of anorexia, both male and female may experience widespread endocrine disorder. It involves the hypothalamic-pituitary-gonadal axis which is noticeable in women as amenorrhea and in men loss of sexual interest and potency. Male and females may experience changes in the peripheral metabolism of thyroid hormone and abnormalities of insulin secretion, as well as concentration of growth hormone and increased cortisol. If patient becomes anorexia before puberty, then the sequence of puberty might be delayed or even arrested.
0.9% of American females are affected by anorexia nervosa in their life span. Women are the target group for this eating disorder. This is because in general, women with eating disorders try their absolute best to please others and are extremely sensitive to critics. They see themselves as perfectionist in what they do and don’t easily accept to change. Adolescences, especially females, are vulnerable and feeble during this time. Females begin to build bone density and are more sensitive to acceptance and self esteem, and social issues. Anorexia is also a growing disease for males but this research paper has narrowed its focus on females.
So many eating disorder myths are often mistaken for diets, especially anorexia nervosa, because it is characterized by restricting calories like weight-loss diet. Someone on a diet decides to stick to a meal plan because they are aware of the guilt that will haunt them if they fail to stick to the meal plan, but a person with anorexia might become fearful in the presence of food because the imbalance of the brain chemicals. Rather than thinking of the positive and negative consequence for eating certain meals, persons with anorexia might have the feeling of distaste. A person who is on a healthy diet might see a scale as a way to tract their progress instead of personifying an inanimate object as a best friend or archenemy.
Persons with anorexia nervosa share common personality traits among themselves. They tend to be competitive and are quite impelled to succeed because they see fast results in weight loss. They do not support a stable person on a healthy diet, they tend to set unrealistic goals and try every way to accomplish them. Such goals may include wanting to see the appearance of ribs or have no amount of fat or loose skin. They do not do these things based on personal expectations but on what others will think. This is different from other people who tend to judge themselves based on internal standards. When an anorexic person fails to meet a certain goal they set, they have a strong urge of dissatisfaction with themselves. This might cause a patient to punish themselves because when they now look at the mirror, they don’t just see a fat person, they also see a failure. Due to mental inflexibility, patients may not know that their behaviors are extreme, and there are other ways to be satisfied and happy aside from weight loss.
Eating disorders are sometimes biologically inherited and tend to run in families. Research studies have shown that inherited genetic factors contribute 56% of the risk for an individual to develop the disorder. This is why it is important for health care providers to know any family history of a disease, so it can be prevented from an earlier stage. A person with a sister, or mother with anorexia nervosa is twelve times more likely to develop anorexia than other individuals without a history of anorexia. Since women are the target group for eating disorders, it makes sense why the risk would be higher. Studies of twins have shown that identical twins are more likely to have an eating disorder than fraternal twins or other siblings. Research suggests altered levels of dopamine are prevalent in the brains of women who develop anorexia nervosa. This can cause hyperactivity, repetition of behaviors (food restrictions) and anhedonia. This explains why they keep on restricting their diets but yet, still feel minimum pleasure from it.
People often refuse to accept a diagnoses when dealing with mental health. To diagnose a patient with anorexia nervosa, the doctor will need to analyze cause of weight loss and if the doctor suspects that a person might have anorexia, a referral is made to a mental health professional. The mental health professional will then asses the patient against a list of criteria outlined in Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5). DSM-5 is a manual in which mental health professionals diagnose mental health disorders. During a physical examination, the doctor may check on a person’s body mass index (BMI). While laboratory test may include blood and urine test.
In order to minimize the risk of becoming anorexic, Individuals may need to minimize pressures that we face both academically and socially, we also need to minimize family issues and change intense cultural attitudes. Individuals should focus on having healthy role models and having realistic attitudes towards weight. Parents, peers, siblings, teachers, and health care professionals should be pay attention to behavior and attitude change in a person. Some warning signs of anorexia nervosa we need to pay attention may include, but are not limited to, dramatic weight loss, maintaining excessive exercise regimen, feeling cold all the time, female loses menstrual period etc.
In order to treat anorexia nervosa, a patient should be willing to try monitoring and nutritional rehabilitation to restore normal weight. Psychotherapy is another treatment which is focused on the patient’s irrational preoccupations with weight and shape. Interventions involves monitoring a patient’s weight gain and prescribing competent diets and admitting patients who fail to regain a certain weight. The National Association of Anorexia Nervosa and Associated Disorders (ANAD) is a non-profit organization spreading awareness for anorexia. Other non-profit organizations that specialize in spreading awareness for anorexia and other eating disorders nationally includes national eating disorders association, eating disorder hope, eating disorder foundation etc. Local non-profit organizations that advocates for eating disorders such as anorexia are Court Appointed Special Advocate (CASA), Eating Disorder Network of Maryland (EDN), Columbia Maryland Support Group etc.
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