Anorexia Nervosa

Anorexia is a serious mental illness characterised by an intense, overwhelming fear of gaining weight and an obsession with food, calories and body image.

This results in extreme weight loss and, often, low body weight. The diagnostic criteria for Anorexia Nervosa suggest that a person must have a Body Mass Index (BMI) of below 17.5 to be diagnosed with Anorexia but it is possible to have a higher weight than this and still be quite ill. In this case, the person might be diagnosed with OSFED (other specified feeding or eating disorder)

Sufferers will severely restrict their food intake, and will sometimes also abuse laxatives or diet pills, exercise excessively and obsessively, or induce vomiting. They will sometimes have a distorted view of their own body and believe they are ‘fat’ despite being desperately underweight. Once someone begins to get into the cycle of losing weight, thinking can become more and more rigid, meaning that the longer Anorexia has been going on, the harder it is to recover.

Anyone of any age, gender, social class, race or sexuality can get anorexia but it is often seen first in the teenage years.

The illness has the highest mortality rate of any other psychiatric illness, with 20% of people dying every year as a direct consequence of their illness or by taking their own life.

Why do people get Anorexia?

There is no clear reason why someone develops Anorexia but it is thought that there are several factors. Evidence suggests a genetic component – some people have genes that put them at higher risk of getting it than others and it does often run in families. Certain personality traits are also more common in people who develop eating disorders – these might be things like ‘Perfectionism’ and ‘Cautiousness’ and ‘Harm Avoidance’.

There might be a traumatic event or events in a person’s past that further increase the risk as well as an environment where thinness is highly prized such as certain sports or activities or within a family. Another risk factor might be a physical illness that means appetite is affected or an event in which a person is shamed for a food choice or for the way they look.

Sometimes Anorexia is thought to be about control and/or anxiety. Keeping tight control of food intake, weight and exercise helps sufferers control their very high anxiety levels and other difficult emotions.

What is happening?

As humans, we need to eat regularly to nourish and fuel all aspects of our being – our body, mind and spirit. When we are deprived of this nourishment, chemical changes occur, which affect our physical, emotional and mental functions.

The problem for those restricting their food intake to gain control over their lives is that the effects of starvation quickly take control of the body, which then begins to fight for survival. Initially, anorexia may be a conscious decision to stop eating. However, the ability to make rational decisions diminishes with extreme weight loss and for many, the added burden of depression affects their decision making even further. The weight loss, which was originally seen as the solution, has now become a problem. What was once about gaining control is now out of control and the eating disorder and its maintenance takes over the person’s life.

Anorexia can permanently damage a person’s health. Long-term effects can be osteoporosis (brittle bones), heart damage, problems with bowel functions, changes in the brain including a decrease in brain substance, and damage to fertility and the reproductive system. At worst, a person can die from Anorexia and 20% of sufferers ultimately do.

What are the signs and symptoms of Anorexia?

Behavioural

Physical


“I saw a SWEDA support worker on campus at university. I had been struggling with binge eating disorder and compulsive exercise for about ten years. The SWEDA support worker was able to help me look at my relationship with food and my body in a different way. I have learned to be kinder to myself and they taught me techniques which helped me to slow down my thinking. Now I can go out and have fun without worrying all the time.”

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