Anorexia Nervosa
Anorexia Nervosa is a severe, very distressing and often chronic mental illness. It can lead to very serious medical complications such as osteoporosis, malnutrition and alterations to heart rate and blood pressure. Anorexia, due to its long duration, can also disrupt the social and educational development of sufferers. It most often appears for the first time in adolescence.People with anorexia tend to be visible due to rapid or relentless weight loss. In order to maintain a low body weight, people with anorexia restrict the range and amount of food they eat, often limiting their choice to foods they consider ‘safe’. They may also attempt to prevent weight gain by employing other methods - purging and/or obsessive exercise. They may continue to feel overweight, no matter how thin they appear to others. Some sufferers, although able to accept that they are thin, are unable to escape the feeling that they are not ‘thin enough’ and continue to lose weight, despite physical and emotional complications.
From the outside, anorexia appears to be all about intense anxiety around food and weight. It is generally believed, however, that anorexia is strongly influenced by low self-esteem, feelings of inadequacy and worthlessness and the problems that these feelings cause in coping with the pressures of daily living. Other psychological illnesses, such as depression, anxiety and obsessional thinking may also be experienced with anorexia.
Personality/Psychological Factors
Low self esteem
People with eating disorders often have low self esteem (or a low opinion of themselves). They can appear on the surface to be competent or many even be high achievers. they may need external success as a way of estimating their own value but underneath they may be very fragile and find themselves unable to cope with even the merest hint of failure.
Need to seek the approval of others
Some people will go out of their way to please people and put the needs of and wishes of others before their own. “In addition, some will go to any lengths to avoid upsetting or displeasing anyone. As a result, feelings such as anger and depression may be turned inside, rather than shared.” p.8 (EDFV)
Difficulties experiencing and expressing need and feelings
For a variety of reasons, some people may have difficulty accepting or expressing their real feelings and food and eating can be a way of re-directing or deflecting some of these unwanted feelings.
Difficulties being assertive with others
People can feel that it is too difficult to make demands on others or to express their needs or wishes. This is often driven by a belief that they do not deserve to expect anything of others.
Social anxiety
People with very negative views about themselves, eg. who believe they are not thin enough, can become terrified of interacting with others in any social situation.
Perfectionism
Nothing is ever good enough! People “strive to do better and better at everything, setting higher and more unrealistic goals for themselves.”
Rigid thought patterns
Some people need things to be predictable and consistent. “Often people will blame themselves, or feel anxious or depressed, when life doesn’t follow their expectations.” p.9 (EDVF)
Over emphasis on body image
“Some people base their self-worth on their appearance and are unable to appreciate their other attributes, believing that their appearance is central to acceptance and love from others” p.9 (EDFV)
Fear of the responsibilities of adulthood
For some becoming an adult and taking on responsibility is overwhelming. They prefer to be ‘looked after’ by others.
Dangers of Anorexia
Sufferers of anorexia experience many physical side effects associated with starvation and malnutrition. These may include:
- Severe sensitivity to cold
- Loss of menstrual periods
- Imbalanced body chemicals
- Hormonal changes
- Dehydration
- Growth of down-like body hair
- Dry, rough skin
- Hair loss
- Brittle, thin and fragile nails
- Osteoporosis
- Bloating; abdomen distension; water retention
- Constipation
- Apathy
- Nervous irritability
- Mental confusion and concentration difficulties
- Hyperactivity and euphoria alternating with lethargy and depression
- Low blood pressure
- Slow pulse
- Irregular heart beat
- Heart attack
- Kidney failure
- Death
For information about a program offering free outpatient treatment for people with longstanding anorexia, please click here.
Professor Pierre Beumont (MBBS; RANZCP) kindly gave the Eating Disorders Foundation permission to include his article, “Anorexia Nervosa is a serious disease”.