What is anorexia?

Anorexia nervosa, more commonly known as simply anorexia, is a serious eating disorder and psychological condition characterised by the desire of the individual to keep as low a body weight as possible. It is a mental health disorder associated with low weight, a fear of gaining weight, and control over diet and exercise. In those with anorexia, a high value is placed upon control over the weight and shape of the body, to the extent where it interferes in daily life.

The condition increases the risk of death in sufferers, through complications associated with anorexia, or suicide. Each individual with anorexia seeks to control their weight and shape in different ways, including restriction of food and diet, excessive exercising, misusing laxatives and/or diet aids, and vomiting after consuming food. Some individuals binge (consume large amounts of food), then purge (vomit), as seen in those who have bulimia nervosa.

What are the main symptoms?

Symptoms of anorexia nervosa are not simply associated with weight loss, as the disorder is psychological, meaning symptoms displayed are also emotional, and behavioural.

Physical signs of the condition include:

• fatigue
• insomnia
• brittle, dry hair, which falls out or breaks easily
• yellow skin
• lack of periods
• dry skin
• dizziness
• extreme weight loss
• difficulty passing stools (constipation)
• abnormal blood count
• low tolerance to the cold
• tinges of blue in the fingers
• soft hair all over the body

Symptoms associated with behaviour and emotional symptoms include:

• self-induced vomiting
• the use of laxatives, enemas or diuretics
• periods of binge-eating
• refusal to eat
• not wanting to eat in public
• worries about food or lack of interest
• irritability
• suicidal thoughts
• depression or depressed mood
• lack of interest in socialising
• skipping meals

What exactly leads to anorexia? How does it develop?

The cause of anorexia is currently unknown, and it is likely a combination of several factors, including biological, psychological, and environmental factors. Genetics may play a role in the development of anorexia, as it has a greater chance of developing in those with a family history of the condition. Some genetic traits such as perfectionism, and sensitivity are associated with anorexia nervosa.

Psychological factors may also contribute to anorexia, with some who develop the condition exhibiting obsessive-compulsive traits which make it easier for them to stick to routine or a controlled diet. Some may try to control anxiety and other psychological conditions through their anorexia.

Finally, environmental influences also have a part to play in the development of anorexia. Particularly among women, success and self-worth are equated with beauty standards such as being thin.  

How is anorexia treated?

Treatment for anorexia is not a simple course, as many who have the condition do not wish to seek help. Treatment is given through a combination of factors and resources, including therapy, nutritional education, and medical treatment in cases of severe malnutrition or other related medical complications of anorexia nervosa.

In those with severe cases of anorexia, feeding the patient through a specially-designed tube may be appropriate, as they may refuse to eat, or be severely malnourished. Treatment for anorexia must focus on different factors. The patient must be brought to a healthy weight, and learning about nutrition is a key factor. Patients are often given meal plans and nutrition goals to work towards. 

As treatment progresses to restore healthy eating habits and proper nutrition, patients may benefit from therapy sessions, including family therapy with younger adults and with teenagers. Ongoing therapy is especially important, as recovering from anorexia is highly stressful, and patients are in need of a great deal of support. 

At what age does one typically start to develop anorexia?

Anorexia typically starts in the mid-teens but can occur at any age. Both men and women can suffer from anorexia. 

Can long-term anorexia lead to serious health complications?

Yes, long-term anorexia certainly puts those suffering from it at a higher risk of developing many serious health conditions. The main long-term anorexia-associated complications include: 

• weakened immune system
• kidney or bowel problems
• seizures
• memory issues and difficulty concentrating on simple tasks
• poor circulation
• irregular heartbeat
• low blood pressure
• heart valve disease or heart failure
• oedema (swelling in the feet, hands, and/or face)
• loss of sex drive
• fertility issues
• chronic fatigue
• problems with bones and muscles or physical development problems in children and young adults

What are the warning signs of anorexia in someone else?

There are quite a few tell-tale signs that a friend, partner, or family member may be suffering from anorexia. The main signs to watch out for are as follows: 

• avoidance of eating with others
• dramatic weight loss
• cutting up of food into very small pieces to conceal the quantity actually being eaten
• wearing baggy or loose clothing to try to hide weight loss

How common is anorexia?

Anorexia is the third most common chronic health condition in teenagers, only less common than asthma and obesity. Anorexia is typically more common in females than in males, but that's not to say that men don't suffer from the condition. It is thought that roughly 0.4 per cent of young women suffer from the food and weight-related illness every year. 

Are people suffering from anorexia always skinny?

This is a common misconception. It is simply not possible to judge whether someone has an eating disorder or not just by looking at their physical appearance. Individuals suffering from atypical anorexia will typically start developing anorexia with a high amount of body weight. They may not lose weight, but can still have atypical anorexia. 

Are some individuals more likely to suffer from anorexia?

Yes. There are certain risk factors that can increase one's chances of developing and suffering from anorexia. The main risk factors include the following: 

• being female
• having type 1 diabetes
• having an anxiety disorder
• having a family member who has an eating disorder
• being bullied
• having autistic social traits
• having experienced childhood trauma

What is the difference between anorexia and bulimia?

While anorexia centres on food restriction, bulimia is an eating disorder whereby an individual suffering from it will typically feel out of control when they eat, and will feel like they can't stop.