I’m Not Hungry: An Overview of Anorexia Nervosa

Anorexia nervosa is an eating disorder that is characterized by extreme low body weight, body image distortion, and an obsessive fear of weight gain. Those who suffer from anorexia nervosa have a body weight less than 85% of the normal weight for their age and height. However, because patients are convinced that they are overweight, they attempt to control their bodies through dangerous diet habits such as excessive exercise, misuse of laxatives, and voluntary starvation.

What are the Symptoms?

Signs and symptoms of anorexia nervosa include:

• Amenorrhea (loss of menstrual period)
• BMI of less than 17.5
• Refusal to eat in public
• Anxiety
• Weakness
• Brittle skin
• Shortness of breath
• Obsessive calorie intake

Those who suffer from anorexia may also have pale complexions, sunken eyes, creaky joints and bones, tooth decay, dry skin, chapped lips, frequent headaches, and stunted growth. Anorexia nervosa is a serious disease: Compared to other eating disorders, anorexia has the highest mortality rate. One in five of those who suffer the disorder will experience related complications that lead to their death.

Who is at Risk?

The National Institute of Mental Health estimates that 1 in 100 adolescent girls suffers from anorexia nervosa, and although 95% of anorexia cases are diagnosed in women, men can develop the disorder as well. Caucasians succumb more often to disordered eating than to women of other racial backgrounds, and anorexia is more common amongst those of the middle and upper socioeconomic classes.

What Causes Anorexia?

The development of anorexia nervosa has been linked to both negative body image developed at the onset of puberty and the negative body image that develops as a result of internalization of media standards of beauty, but as is the case with other mental illnesses, eating disorders are believed to be caused by a complex interplay between social, psychological, and biological contributors.

Much is expected socially from many of the adolescents that suffer from anorexia nervosa. Their families often push them to achieve, and place strong emphasis on the importance of physical appearance.

Psychologically, girls with anorexia nervosa are often perfectionistic and suffer from both body image distortion and low self-esteem. They are critical of themselves, and feel anxiety when they struggle to achieve. Anorexia nervosa is often comorbid with GAD, clinical depression, and OCD – because chemical imbalances of serotonin, norepinephrine, and the stress hormone cortisol are all implicated in the development of anorexia, it seems that disordered eating may be a maladaptive coping mechanism developed to cope with negative emotions.

It is also important to realize that anorexia nervosa is highly heritable. Young women who have a sibling that suffers the disorder are ten to twenty times more likely to develop the disorder than other girls of their age and status.

What Are Treatment Options?

Treatment of anorexia nervosa depends on the severity of the case, but often includes three components: First, if a woman’s physical health is endangered because she is underweight or malnourished, she will first be hospitalized to ensure that her weight is safely returned to an acceptable level.

Next, treatment generally addresses psychological issues related to the disorder. Patients may be treated for their depression and anxiety, and may psychotherapy, family counseling, or group therapy to address their issues with food. Nutritional counseling is a common treatment approach; a nutritional counselor will help their pateints develop and follow meal plans that include enough calories to reach and maintain a healthy weight. Patients who receive nutritional counseling will also learn about healthy diet habits, proper nutrition, and balanced meals.

Finally, those who suffer from anorexia nervosa will likely undergo behavioral counseling  to reduce or eliminate thoughts and behaviors that lead to their disordered eating. The goal of behavioral therapy is to prevent relapse – although lapses may occur once treatment has begun, therapy and early intervention speed and encourage recovery.

If you or someone you love has anorexia, call the National Eating Disorders Association’s hotline at 1-800-931-2237 for referrals, information, and advice. Don’t let anorexia nervosa be deadly – the disease can be beaten.