Anorexia, or anorexia nervosa, is a mental health condition that manifests as an eating disorder. It can have a huge impact on people's day-to-day lives and it can become life-threatening. It's a complex disorder, which makes it difficult to treat if not addressed early on.
Each person varies in their individual symptoms and severity, but the disease has common characteristics: the restriction of food or calories in order to lose weight, the fear of gaining fat or weight, and a distorted body image (seeing yourself as fat when you have a normal or low body weight).
Some may feel compelled to control their weight by excessive exercise, skipping meals, lying about food intake, wearing baggy clothes to cover up their body size, and the use of laxatives or other drugs to control weight.
With a lack of nutrition and consequent hormonal changes, physical appearance can change. Downy hair may appear on the body and they may suffer dry skin. Girls or women may lose female characteristics post-puberty, or fail to develop these if before or during puberty. Periods may stop or not have started. Constipation, dizziness and fainting are common.
Other mental health conditions can run alongside, or develop as a consequence of anorexia, such as depression, social withdrawal or anxiety, and difficulty with sleep and concentration.
Left untreated, children may experience stunted growth or bone development problems. It can lead to health problems such as osteoporosis, anaemia, a lowered immune system, and heart problems or dangerously low blood pressure. It is because of these health problems that anorexia can become life-threatening.
Anorexia can affect anyone. It’s more common in teenagers and young adults, but is ten times more common in females than males - men and boys can also suffer, but the diagnosis is more likely to be missed. About 9 in 1,000 women develop anorexia features at some time in their lives.
It’s hard to pinpoint an exact cause, but a combination of genetic, societal and psychological factors are likely, meaning it is usually a combination of these.
You are at higher risk of developing anorexia if you live in western society, if a family member suffers from anorexia, if you have low self-esteem or if you’ve suffered childhood trauma. You’re also at higher risk of developing any eating disorder if you’re a competitive athlete in sports that places an emphasis on body shape or weight, such as dancing or gymnastics.
Most would assume that anorexia causes a low body weight or body mass index (BMI). It’s also possible to have a normal weight with anorexia, especially if someone is sporty – muscle mass can give a normal body weight that masks their anorexia – or they may experience bulimia nervosa alongside, where they purge intermittently with food restriction.
It’s important to seek help early when you notice any signs or symptoms that could be related to anorexia or any other eating disorder. If you already have a diagnosis, see your doctor if your symptoms are getting worse or not improving. If you start to feel dizzy or faint or have palpitations (when your heart beats hard or fast), call 111 or book an urgent doctor's appointment. In the event of someone collapsing, call 999 immediately.
The doctor will ask you about your symptoms and about eating, exercise, body image, your mental health, and your periods if relevant. They will also ask about your past medical history, any relevant family history, and any medication or drug use. They’ll check your vital signs including heart rate and blood pressure, and – with your permission – they will check your weight and height. You can tell them if you feel ok being weighed but don't wish to be told your weight.
They may also take blood tests and will discuss with you the next steps and the right support and treatment for you. This may include a referral to a specialist eating disorder team for further support.
Your doctor won’t judge anything you say – they’ve seen many cases of anorexia and are there to support your physical and mental well-being as well as getting you the right kind of help when you need it.
There is no specific cure for anorexia and treatment for anorexia is usually a combination of looking after your physical health (maintaining vitamin and mineral levels, making sure your heart is well) along with psychological therapies and support with nutrition from trained psychologists, psychiatrists and nutritionists.
You may be offered psychological therapies such as cognitive behavioural therapy (CBT) or sessions with a psychologist, either one to one, in group therapy or in family therapy (for those under 18). Medications may help but should be used in combination with talking therapies. For severe or life-threatening anorexia, in-patient treatment in a hospital, dedicated eating disorders centre or a mental health hospital may be necessary.
Even with treatment, anorexia can take a very long time to recover from and many sufferers find they continue to have long-term issues with eating. Around half of people with anorexia get completely better, around 3 in 10 improve enough so that it has much less impact on them, and 2 in 10 continue to live with it long-term. It’s a sad fact that even with modern treatments around 3% of people with anorexia die from it, either from infection, dehydration, kidney failure or – in some cases – suicide.
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