Anorexia Nervosa: Causes and Treatment

Anorexia is a psychological disorder when one takes extreme measures to lose weight.

The warning signs and symptoms of anorexia nervosa include:

Physical signs:

• Low body mass index (<17.5 kg/m2)
• Bodyweight less than 85% of ideal body weight
• Body temperature less than 35°C
• Bradycardia (heartbeat less than 60 beats per minute)
• Hypotension (blood pressure of less than 90/50 mm Hg)
• Dry, scaly skin
• Brittle hair and hair loss
• Fine, soft hair on the body
• Bloating and swelling in the stomach
• Brittle nails
• Pressure sores
• Yellow tinge on the skin
• Cold and pale legs and hands
• Edema
• Impaired immune system
• Menstrual irregularities
• Difficulties concentrating
• Dizziness
• Fainting
• Muscle weakness

Emotional and behavioral signs include:

• Dramatic weight loss
• Refusal to eat certain foods
• Preoccupied with weight, food, calories, fat grams, and dieting
• Expresses a need to “burn off” calories
• Intense fear of gaining weight
• Maintains an excessive, rigid regimen
• Develops food rituals
• Becomes socially isolated and withdrawn
• Feels ineffective

Anorexia nervosa, commonly known as anorexia, is a psychological disorder in which an individual considers themselves as being overweight or controls the shape and size of a specific body part, even when they are extremely thin. In the more severe form of this disease, one may be petrified of gaining weight or may have a tremendous obsession over the shape of the body to the point that people are sick of eating and may take extreme measures to lose weight.

The exact cause of anorexia nervosa is unknown; however, some situations make anorexia more common in certain societies or areas. Factors associated with anorexia nervosa include:

Genetic and biological factors:

• Hormonal issues
• Family history of anorexia

Psychological factors:

• Feelings of inadequacy
• Obsessive-compulsive personality traits
• Trauma, stress, depression, and other psychiatric disorders

Environmental factors:

• Peer pressure
• Cultural beauty ideals
• Participation in activities such as ballet, gymnastics, modeling, and weight-restricted sports
• History of being teased about their size or weight

Emotional stress:

• Troubled relationships
• Joining a new school
• Death of a loved one

The physician may diagnose if a person has anorexia nervosa by:

• History taking.
• Conducting a complete physical examination to check for any visible signs of anorexia. These include checking vitals such as heart rate and blood pressure and examining the nails, skin, and abdomen.
• Conducting lab tests that include serum electrolytes, blood urea nitrogen, serum creatinine, liver function tests, complete blood count, thyroid-stimulating hormone, serum glucose, liver function tests, and serum albumin.
• Conducting imaging studies such as an X-ray or a magnetic resonance imaging (MRI).

Treatment of anorexia nervosa is difficult because people deny the fact that they have a problem. The treatment options of anorexia nervosa include:

• Psychotherapy: Different therapies work for different people. Reducing eating disorder behaviors is the first goal of treatment. Psychotherapy involves cognitive-behavioral therapy, acceptance and commitment therapy, and dialectical behavior therapy.
• Hospitalization: Hospitalization may be required in case of an emergency. Issues such as heart rhythm disturbance, dehydration, electrolyte imbalances, or a psychiatric emergency require hospitalization.
• Medication: Certain antidepressant medications such as selective serotonin reuptake inhibitors can be effective in controlling anxiety and depression.
• Nutrition counseling: A healthy approach to food and weight is instilled in the patients. It helps to restore normal eating patterns and teaches the importance of nutrition.
• Family support: Family support is of utmost importance. The family should help their loved ones to overcome their fears.