Anorexia Nervosa

Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation, excessive weight loss, intense fear of gaining weight or becoming fat and disturbance in the way in which one's body weight or shape is experienced.

Anorexia: Four Primary Symptoms:

• Resistance to maintaining body weight at or above a minimally normal weight for age and height.
• Intense fear of weight gain or being fat, even though underweight.
• Disturbance in the experience of body weight or shape, undue influence of weight or shape on self-evaluation or denial of the seriousness of low body weight.
• Loss of menstrual periods in girls and women post-puberty.

Of all mental illnesses, anorexia nervosa has one of the highest death rates. However, eating disorders experts have found that early intervention improves the chances of anorexia recovery. Therefore, it is important to be aware of some of the warning signs of anorexia nervosa. Anorexia nervosa is characterized by self-starvation, excessive weight loss, an intense fear of gaining weight, and a relentless pursuit of thinness. While misconceptions are common, anorexia nervosa is not a strategy for attention or a diet gone awry. It is, in fact, a mental illness. The age of onset is typically between the ages of 13 and 20. People of all ages, genders, and ethnicities suffer from anorexia nervosa, although females represent 90% of all cases. Sometimes dangerous strategies of weight control are used such as compulsive exercise, limited food intake, laxative abuse, vomiting, or a combination of these behaviors. Sufferers are fixated on food, calories, and fat intake and have a distorted perception of their appearance. Someone who has anorexia nervosa bases his or her self-worth on thinness or muscularity and generally feels fat, flawed, or disgusting despite being below normal body weight for specific age and height. Restrictive eating becomes the primary method for coping with feelings of loss of control and fears about loss and imperfection. No matter how much weight is lost, those who struggle with this disorder are never satisfied.

Malnutrition and the associated low blood sugar, low blood pressure, high cortisol (stress hormones), and lack of appropriate sex hormones can change the brain leading to greater negative emotions, obsessional thinking, and self-critical thoughts. Body image distortion is at least in part brain-based and will not reverse until nutrition is restored. Although organ damage and heart failure lead to significant mortality, suicide is also a significant cause of death. Patients should be screened for heart, endocrine, bone, kidney, and metabolic problems.

Behavioral Signs and Symptoms of Anorexia Nervosa

Preoccupation or fear of gaining weight or being fat

Rejection or failure to maintain a minimum appropriate weight

Rigid eating patterns & rituals, such as cutting food into very tiny pieces

Compulsive exercise

Excessive amounts of time spent missing important activities & not resting

Vomiting without binge eating

Avoidance of eating with others, in restaurants or without knowing exactly how the food is prepared

Restrictive eating, such as eating low calorie foods, avoiding fats, & compulsive calorie counting

Skipping meals

Hiding body in loose clothing, avoiding mirrors or frequent body checking

Physical Signs and Symptoms of Anorexia Nervosa:

Dizziness, due to low blood pressure

Cold intolerance, due to low body temperature

Fatigue and weakness, due to a low pulse

Insomnia & poor sleep

Reflux

Constipation

Irregular periods, loss of sex drive, which is due to low estrogen and testosterone levels

Slowing of growth and not growing the expected amount

Common Psychiatric Symptoms

Depression, Irritability, and emotional numbing

Anxiety and avoidance

Social anxiety and shyness

Perfectionism

Compulsions

Medical Complications of Anorexia Nervosa: Treatment of Anorexia Nervosa

The earlier anorexia nervosa is detected and diagnosed, the better the chances of recovery. The first goal of treatment is to re-establish medical stability, restore a normal eating structure, and restore weight to a minimum healthy goal. Patients typically work with a team of specialized professionals, which might include a dietitian, family doctor, psychiatrist, and therapist to work towards these goals. At first , psychotherapy should address obstacles to accepting healthy weight, eating, and exercise goals. Once a plan is established, the therapist must focus on self-acceptance, quieting critical thoughts and understanding underlying anxieties. The goal is to increase the patient’s skills so that he or she can let go of inappropriate use of food and weight control behaviors to cope with stress and change.

Family-based treatment is the treatment of choice for most adolescents who first present with anorexia nervosa. In this treatment method, the family learns how to focus meal support and emotional support to assure gradual restoration of balanced eating and safe weight. Therapy focused on resolving family conflict, adolescent development, peer issues, boundaries, and role transitions is postponed until weight restoration and normal eating are established.

Treatment Goals of Anorexia

McCallum Place is an eating disorder treatment center specializing in treating anorexia offering a residential treatment program, partial hospital and transitional living programs. In these programs, individuals who suffer from anorexia nervosa will meet with an eating disorder specialist to receive individualized treatment designed to meet their specific needs. The primary goals at McCallum Place for bulimia are stabilization of symptoms, weight restoration and beginning to build the foundation for a strong recovery. Our protocols are designed to help patients restore weight to within one's ideal body weight range and to minimize relapse. Patients practice weight maintenance and flexible eating prior to discharge. When possible, a gradual step down is recommended to ease the transition back to independent living. We give individuals the power to manage the fears associated with new meal expectations and changes in body size. Our goal is to change the way each individual uses food and body image to express underlying emotional needs and concerns.