Anorexia
Many people are afraid of gaining weight, but in some the worry becomes an obsession and turns into a disorder known as anorexia nervosa that can endanger the person's life.
What is anorexia?
People with anorexia are terrified of gaining weight and adopt restrictive low-calorie diets. They also often use excessive physical activity to consume calories and facilitate weight loss.
Anorexia is most often present in adolescent females, but can also be diagnosed in older age and in the male gender.
It can manifest itself in two forms:
- Restricting: extreme restriction in food intake
- Binging/Purging: occasional bingeing with subsequent elimination behaviour (self-induced vomiting, diuretics and laxatives).
Symptoms of anorexia
The symptomatology characterising the disorder is:
- intense fear of gaining weight
- inability to maintain a weight appropriate to age and sex
- fatigue
- insomnia
- yellowish or spotty skin, covered with fine hair
- thinning and loss of hair
- constipation
- dry skin
- low blood pressure
- excessive exercise
- irritability
- social withdrawal
- depressed mood
- denial of the feeling of hunger
- use of diuretics, laxatives or anorectic drugs
Medical complications
- amenorrhoea (disappearance of menstruation for at least 3 consecutive cycles)
- hypothermia
- bradycardia
- arterial hypotension
- abnormalities of haematopoiesis (leukopenia and relative lymphocytosis)
- osteoporosis resulting in brittle bones (caused by reduced calcium intake and reduced oestrogen production)
- cardiovascular problems (cardiac arrhythmias and ventricular fibrillation)
The causes
The exact causes of anorexia are not yet fully known.
Research shows that those who develop this disorder have a negative self-image and body image, focus on perfection and try by all means to control their lives. Biological, environmental and psychological factors are also believed to play an important role in the origin of the disorder.
Biology
Genetics and hormonal factors have been noted in numerous research studies on anorexia. In particular, altered serotonin levels appear to play a role in the development and maintenance of the disorder.
Environment
Social pressure to have a thin body can be a risk factor for anorexia. Unrealistic body images continuously exposed by the media such as magazines, television and the Internet can heavily influence young people and trigger the desire to be thin in an attempt to achieve success and social approval.
The presence of another family member with an eating disorder or other psychological disorders may also be a risk factor.
Psychology
Perfectionist and obsessive personality traits may predispose more to the onset of the disorder and contribute to the maintenance of restrictive diets and extreme exercise regimes.
An important research carried out in 1945, the Minnesota Study, showed that the physical, social, cognitive and behavioural characteristics presented by those suffering from anorexia are a consequence of starvation syndrome, so it is dietary restriction that causes the disorder, and not the other way around.
How can we help you?
The findings from the extensive research on the undernutrition syndrome have helped define the most effective treatment protocols for anorexia. The most recent research has highlighted 'enhanced' Cognitive Behavioural Therapy (CBT-E) as a proven method for the diagnosis and treatment of eating disorders. Usually the therapist works in cooperation with nutritionists and psychiatrists.
Therapy phases include:
- gradual exposure and re-feeding
- cognitive restructuring
- emotion education and rebalancing emotional dysregulation
- self-esteem training
- assertiveness and social skills training