Anorexia Nervosa: why is anorexia nervosa dangerous?

Anorexia nervosa is a severe eating disorder that can be fatal, yet it is curable. Extreme dietary restriction and a strong fear of gaining weight are its defining characteristics.

Anorexia Nervosa: why is anorexia nervosa dangerous

 A variety of approaches are typically used in treatment, such as hospitalization, nutritional counseling, and/or psychological therapy.

Anorexia nervosa: what is it?

Originally identified as anorexia nervosa, anorexia is an eating disorder. Anorexics limit the amount and variety of food they consume. They eventually lose weight or become unable to maintain a weight that is adequate for their height, age, stature, and state of physical health. They might overdo it on exercise, purposefully throw up after eating, abuse laxatives, or all.

Anorexics also have a warped perception of their bodies and a crippling fear of putting on weight. Treatment is necessary for anorexia, which is a dangerous disorder. Significant weight loss by anorexics puts them in danger of malnutrition, major health problems, and potentially even death.

Who is affected by anorexia?

persons of every age, sex, gender, race, gender, ethnicity, sexual orientation, and socioeconomic level, as well as persons of diverse body weights, shapes, and sizes, can develop anorexia. Though it occasionally affects men and is becoming more widespread in youngsters and older adults, anorexia primarily affects women in their teens and early 20s.

How widespread is anorexia?

Anorexia affects roughly 1% to 2% of the world's population, whereas eating disorders impact at least 9% of people. It impacts 0.3% of teenagers.

How is bulimia and anorexia different from one another?

Eating disorders include bulimia nervosa and anorexia nervosa. Similar symptoms, like a warped perception of one's body and a crippling fear of gaining weight, may be present. They differ in how they behave when it comes to food.

Anorexics severely restrict their calorie intake and/or purge to lose weight. Binge eaters with bulimia consume large amounts of food quickly and then take particular actions to prevent gaining weight. These kinds of actions consist of:

• Self-inflicted, purposeful vomiting.
• Misuse of prescription drugs, such as thyroid hormones or laxatives.
• Fasting or doing too much exercise.

Anorexics often have a body mass index (BMI) of less than 18.45 kg/m2 (kilogram per square meter), but bulimics frequently maintain their weight at or slightly over ideal levels.

What symptoms and indicators are present in anorexia?

Because anorexia encompasses more than just physical symptoms, it also involves mental and behavioral issues, it is impossible to diagnose anorexia from a person's outward look. Being underweight is not a need for anorexia. People with larger frames might also suffer from anorexia. However, because fat and obesity are stigmatized in society, they might be less likely to receive a diagnosis. 

Furthermore, underweight individuals may not always have anorexia. Recall that in addition to its physical components, anorexia also has psychological and behavioral aspects. Anorexic signs and symptoms are listed below:

Anorexia symptoms are mental and emotional.

• possessing a strong dread of putting on weight.
• having a distorted self-image or being unable to evaluate your weight and shape realistically.
• possessing an infatuation with food, calories, and dieting.
• feeling "fat" or overweight despite being underweight.
• aversion to particular food groupings or foods.
• being extremely critical of oneself.
• minimizing the significance of your restricted diet or low body weight.
• having a great need to be in charge.
• feeling melancholy or agitated.
• having suicidal or self-harming thoughts.

Anorexic signs in behavior.

• alterations to mealtime rituals or habits, such as switching around the sequence in which you eat or arrange your food on a plate.
• an abrupt shift in dietary choices, including giving up particular food groups or types.
• expressing concern about being overweight or "fat" while losing weight regularly.
• Purging by willfully throwing up and/or abusing laxatives or diuretics
• use the restroom straight after a meal.
• using appetite suppressants or diet medications.
• intense and compulsive physical training or exercise.
• keeping up a diet even if your weight is modest for your height, stature, and sex.
• cooking for other people but not for yourself.
• concealing weight loss and staying warm by dressing loosely or in layers.
• Eliminating social media and friends.

Physical manifestations of anorexia.

Low body weight for a person's height, sex, and stature is the most well-known physical indicator of anorexia. It's crucial to keep in mind, though, that anorexia can occur in people who are not underweight. There are physical symptoms of anorexia in addition to weight-related ones, which are essentially consequences of malnourishment and starvation.

• considerable decrease in weight over a few weeks or months.
• failing to maintain a healthy weight for your height, age, sex, stature, and physical condition.
• unexplained shift in a child's or adolescent's body mass index (BMI) during growth.

The following physical signs of anorexia that result from malnourishment and deprivation are:

• feeling lightheaded or faint.
• I'm worn out.
• Bradycardia, or a slow heartbeat, and arrhythmia, or an erratic heartbeat.
• Hypotension, or low blood pressure.
• inadequate focus and concentration.
• experiencing constant coldness.
• Menstrual irregularities or absence of periods (amenorrhea).
• breathlessness.
• stomach ache and/or bloating.
• decrease of bulk and weakening in the muscles.
• thin hair, brittle nails, and/or dry skin.
• Illness and wound healing are poor.
• The hue of the hands and feet is bluish or purple.

What causes anorexia?

All eating disorders, including anorexia, are complicated diseases. Because of this, the precise origin of anorexia is unknown; nonetheless, research points to a potential mix of genetic predispositions, psychological characteristics, and environmental variables, particularly sociocultural ones.

• Genetics: According to research, there is a 50% to 80% hereditary component to the chance of having eating disorders. Eating disorders are ten times more common in people who have first-degree relatives parents or siblings, who also have eating disorders, suggesting a genetic component. The brain reward system and neurotransmitters like dopamine and serotonin, which influence mood, hunger, and impulse control, may be altered, as well as other alterations in brain chemistry.
• Trauma: Many specialists think that persons who strive to limit food as a coping mechanism for intense emotions and overpowering sentiments are the root of eating disorders, including anorexia. A person's development of an eating disorder, for instance, may be influenced by physical or sexual abuse.
• Environment and culture: Individuals living in countries that idealize a particular body type—typically "thin" bodies may experience unjustified pressure to conform to unachievable body standards. Media representations and popular culture frequently associate being thin with success, pleasure, popularity, and attractiveness. Anorexia may develop in someone as a result of this.
• Peer pressure: This may be an extremely potent influence, especially for kids and teenagers. Anorexia can occur as a result of being subjected to body image or weight-related taunts, bullying, or ridicule.
• Emotional well-being: An individual's sense of self-worth and self-esteem can be undermined by impulsive conduct, perfectionism, and challenging relationships. They may become more susceptible to anorexia as a result.

It's critical to recognize that there are numerous ways in which eating disorders or anorexia might manifest. Inappropriate coping mechanisms that eventually turn into persistent eating habits are what many individuals refer to as "disordered eating." Some people with anorexia do follow this path to disordered eating, but not all of them do.

How is anorexia diagnosed?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association, a healthcare professional can diagnose an individual with anorexia nervosa based on the DSM-list criteria. According to the DSM-5, anorexia nervosa meets the following three criteria:

• restriction of calories consumed, which results in weight loss or, depending on an individual's age, sex, height, and developmental stage, inability to gain weight and a noticeably low body weight.
• severe anxiety over putting on weight or becoming "fat."
• possessing a skewed perception of their situation and themselves. Stated differently, the person finds it difficult to objectively evaluate their weight and form, feels that their looks greatly affect their sense of value, and rejects the medical

possessing a skewed perception of their situation and themselves. Stated differently, the person cannot objectively evaluate their form and weight, feels that their looks greatly impact their sense of self-worth, and downplays the health risks associated with their present diet and/or low body weight.

A major eating problem can exist even in the absence of all DSM-5 criteria for anorexia. The DSM-5 criterion uses body mass index (BMI) to categorize the severity of anorexia. Atypical anorexia is the term used to describe people who fit the criteria for anorexia but are not underweight despite having lost a large amount of weight.

Healthcare professionals can also use the DSM-5's diagnostic standards to assess a patient's current body mass index (BMI) to determine the severity of their ailment and whether they are in complete or partial remission (recovery).

A comprehensive medical history and physical examination are the first steps in an evaluation conducted by a healthcare professional if there are indications of anorexia. The provider or a mental health specialist will probably inquire about the following subjects:

• nutritional history (food-related attitudes, dietary restrictions).
• History of exercise.
• historical psychology.
• Body image (which encompasses actions like how frequently you weigh yourself).
• Frequency of binges and purges, as well as elimination practices (including laxatives, supplements, and diet pills).
• eating disorder history in the family.
• Menstrual status (the regularity or irregularity of your periods).
• history of medication.
• previous medical care.

It's crucial to keep in mind that early identification will maximize rehabilitation for anyone suffering from anorexia or any other eating disorder. Speak with a healthcare professional right away if you or someone you know is exhibiting anorexia symptoms.

Which tests are performed to evaluate or diagnose anorexia?

A healthcare professional may employ a variety of diagnostic procedures, such as blood testing, to rule out any medical disorders that could cause weight loss and to assess the potential physical harm that starving and weight loss may have caused. Despite the lack of specialized laboratory tests to diagnose anorexia, anorexia can nevertheless be diagnosed indirectly.

• To evaluate general health, do a complete blood count.
• an electrolyte blood panel to measure the acid-base balance and assess dehydration in your blood.
• Test for albumin in the blood to determine nutritional deficiencies and liver health.
• EKG to assess the condition of the heart.
• urinalysis to look for a variety of diseases.
• Test for bone density to look for signs of osteoporosis, or weak bones.
• testing for renal function.
• testing for liver function.
• testing for thyroid function.
• levels of vitamin D.
• a pregnancy test for those who were born with the gender of a woman and are of childbirth age.
• Hormone tests measure testosterone in individuals designated male at birth and look for signs of menstruation issues in those assigned female at birth (to rule out other causes).

How can one treat anorexia?

The hardest aspect of treating anorexia is helping the patient acknowledge and accept their condition.  A lot of anorexics contest having an eating disorder. They frequently wait until their illness is grave or potentially fatal before seeking medical attention. For this reason, it's critical to identify and treat anorexia as soon as possible. Among the objectives of anorexia treatment are:

• maintaining a weight loss trend.
• starting a nutrition rehabilitation program to gain weight back.
• Eliminating unhealthy eating habits like binge eating and/or purging.
• treating psychological problems such as skewed thought patterns and low self-esteem.
• forming enduring behavioral adjustments.

Many times, people with eating disorders like anorexia also experience other mental health problems, like:

• Depression.
• disorders related to anxiety.
• Personality disorder borderline.
• Compulsive-obsessive disorder.
• disorders related to substance usage.

If a person has one or more of these disorders, their medical team will probably advise treating the condition(s) in addition to anorexia because they can exacerbate the disorder.

The individual's needs will determine the range of treatment options available. Depending on their present level of physical and mental health, a patient may receive treatment through residential care (outpatient care) or hospitalization. The following approaches are typically combined in the treatment of anorexia:

• psychoanalysis.
• Drugs.
• diet advice.
• family therapy or group therapy.
• Being admitted to a hospital.

Psychoanalysis.

Psychotherapy is a form of individual counseling that aims to help an eating disorder sufferer change their behavior (behavioral treatment) and way of thinking (cognitive therapy). Practical methods for fostering positive attitudes toward food and weight management are part of the treatment, as are strategies for altering the patient's reaction to trying circumstances. Psychotherapy comes in a variety of forms, including:

• The aim of acceptance and commitment therapy: is to modify your behavior instead of your thoughts and feelings.
• The purpose of cognitive behavioral therapy (CBT): is to practice behavioral change (if "X" occurs, I can do "Y" instead of "Z") and to address inaccurate thoughts and attitudes regarding weight, shape, and appearance.
• Cognitive remediation therapy: This therapy develops the ability to focus on multiple things at once through guided supervision and reflection.
• Dialectical behavior therapy (DBT): is a type of therapy that aims to help you identify events or triggers that may lead to non-useful behavior in addition to teaching you new skills to deal with negative triggers. Developing mindfulness, enhancing interpersonal effectiveness to improve relationships, controlling emotions, and handling stress are examples of specific abilities.
• Family-based refeeding, often known as the Maudsley Method:  is a component of family-based therapy. It entails giving the anorexic person's parents and relatives responsibility for ensuring they receive the right amount of nutrients. It's the most efficient, clinically validated way to assist under-18 anorexics in regaining their physiological well-being.
• The goal of interpersonal psychotherapy: is to address a particular interpersonal issue. Resolving identified problems and promoting improved relationships and communication may help reduce eating disorder symptoms.
• The key to healing in psychodynamic psychotherapy: is examining the underlying causes of anorexia.

Medication.

Certain medical professionals might recommend medication to assist in managing anxiety and despair, which are frequently linked to anorexia. Olanzapine (Zyprexa®), an antipsychotic drug, might be beneficial for weight gain. Physicians may occasionally recommend drugs to aid in controlling menstruation.

Nutrition counseling.

• promoting a healthy diet and weight management strategy.
• aiding in the return of regular eating habits.
• educating people on the value of healthy eating and a balanced diet.
• reestablishing a positive connection with food and eating.

Family counseling or group therapy.

Family support is crucial to the anorexia treatment's effectiveness. Family members need to be aware of the warning signs and symptoms of eating disorders and comprehend them.

Group therapy may also be helpful for people with eating disorders because it provides a safe space for them to talk honestly about their feelings and worries with other people who have similar experiences.

Being admitted to a hospital.

Treatment for extreme weight loss that has led to malnourishment and other severe mental or physical health issues, such as heart problems, severe depression, and suicidal thoughts or actions, may require hospitalization.

What side effects might anorexia cause?

Malnutrition and hunger, which are typical in anorexics, can harm almost all of your body's organs and pose health hazards. Vital organs including your heart, kidneys, and brain may suffer harm in extreme circumstances. Even when an individual has recovered from anorexia, this harm might not be healed. If  untreated anorexia can lead to major health issues like:

• heartbeat irregularities, or arrhythmias.
• degradation of dental enamel and loss of bone mass (osteoporosis).
• harm to the liver and kidneys.
• illness of the fatty liver (steatosis).
• seizures brought on by hypoglycemia, or abnormally low blood sugar.
• Rhabdomyolysis: Rapid disintegration of skeletal muscle brought on by electrolyte/acid-base imbalances and water depletion.
• delayed physical development and puberty.
• Menstrual issues and infertility.
• sleeplessness.
• Anemia.
• An irregular heartbeat is called ventricular arrhythmia.
• Prolapse of the mitral valve (due to a decrease in cardiac muscle mass).
• arrest of the heart.
• Demise.

Apart from the physiological ramifications, individuals suffering from anorexia frequently experience additional psychological disorders such as:

• anxiety, depression, and other mood disorders.
• diseases of personality.
• OCDs are compulsive overthinkers.
• Substance abuse and alcohol consumption disorders.

If these mental health issues are not addressed, they may result in suicidal thoughts, attempts, or self-harm.

What self-care measures should I take if I have anorexia?

If you think you may have anorexia, it's crucial to tell a loved one and/or your healthcare practitioner. It can be scary and uncomfortable.

If you've already been diagnosed with anorexia, there are several things you can do to manage your condition and stay committed to recovering, including:

• Make time to sleep.
• Avoid abusing drugs or alcohol.
• Ensure you take your prescription medication regularly and don't skip any doses.
• Make sure to visit your therapist regularly if you are receiving treatment for your anorexia through talk therapy.
• Seek assistance from friends and relatives.
• Joining an anorexic support group is something you should think about.
• Visit your doctor regularly.

Finally, anorexia is a dangerous illness that can endanger life. The good news is that there is a good chance of recovery. As soon as you see any of the symptoms of anorexia in yourself or someone you know, it's critical to get treatment. While seeking treatment at any time is never too late, doing so increases the likelihood of a long-lasting recovery.