Anorexia Nervosa

What is anorexia nervosa?

A person with anorexia nervosa has an intense fear of gaining weight. They think about food a lot and limit the food she or he eats, even though she or he is too thin. Anorexia is more than just a problem with food. It's a way of using food or starving oneself to feel more in control of life and to ease tension, anger, and anxiety. Most people with anorexia are female. An anorexic:

  • Has a low body weight for her or his height
  • Resists keeping a normal body weight
  • Has an intense fear of gaining weight
  • Thinks she or he is fat even when very thin
  • Misses 3 menstrual periods in a row (for girls/women who have started having their periods)

Who becomes anorexic?

Anorexia mostly affects girls and women (85 - 95 percent of anorexics are female), it can also affect boys and men. People with different cultural backgrounds may develop eating disorders because it's hard to adapt to a new culture (a theory called "culture clash"). The stress of trying to live in two different cultures may cause some minorities to develop their eating disorders.

What causes anorexia?

There is no single known cause of anorexia. Eating disorders are real, treatable medical illnesses affecting both the body and the mind. Some of the following things may play a part:

  • Culture
  • Families
  • Life changes or stressful events
  • Personality traits
  • Genes, hormones, and chemicals in the brain may be factors in developing anorexia

What are signs of anorexia?

Someone with anorexia may look very thin. She or he may use extreme measures to lose weight by:

  • Inducing vomiting often
  • Taking medicines to urinate or have a bowel movement
  • Taking diet pills
  • Not eating or eating very little
  • Exercising a lot, even in bad weather or when hurt or tired
  • Weighing food and counting calories
  • Eating very small amounts of only certain foods
  • Moving food around the plate instead of eating it
  • Someone with anorexia may also have a distorted body image, shown by thinking she or he is fat, wearing baggy clothes, weighing her or himself many times a day, and fearing weight gain.
  • Anorexia can also cause someone to not act abnormally. She or he may talk about weight and food all the time, not eat in front of others, be moody or sad, or not want to go out with friends. People with anorexia may also have other psychiatric and physical illnesses, including:
    1. Depression
    2. Anxiety
    3. Obsessive behavior
    4. Substance abuse
    5. Issues with the heart and/or brain
    6. Problems with physical development

What happens to your body with anorexia?

With anorexia, the body doesn't get the energy from foods that it needs, so it slows down both growthwise and metabolically.

Can someone with anorexia get better?

Yes. Anorexia is a treatable disease. A health care team consisting of doctors, nutritionists, and psychotherapists will help the patient get better. Treatment consists of:

  • Help bring the person back to a normal weight
  • Treat any psychological issues related to anorexia
  • Help the person get rid of any actions or thoughts that cause the eating disorder
  • These three steps will prevent "relapse" (relapse means to get sick again, after feeling well for a while)

Is it safe for young people to take antidepressants for anorexia?

It may be safe for young people to be treated with antidepressants. However this decision is entirely the responsibility of your treating psychiatrist. At no time should you attempt self medication.It may be possible that antidepressants make children, adolescents, and young adults more likely to think about suicide or commit suicide.

Some forms of psychotherapy can help make the psychological reasons for anorexia better. It uses different ways of communicating to change a patient's thoughts or behavior. This kind of therapy can be useful for treating eating disorders in young patients who have not had anorexia for a long time. Individual counseling can help someone with anorexia. If the patient is young, counseling may involve the whole family. Support groups may also be a part of treatment. In support groups, patients, and families meet and share what they've been through.

What is outpatient care for anorexia treatment and how is it different from inpatient care?

With outpatient care, the patient receives treatment through visits with members of their health care team. Often this means going to a doctor's office. Outpatients usually live at home. Some patients may need "partial hospitalization." This means that the person goes to the hospital during the day for treatment, but sleeps at home at night. Sometimes, the patient goes to a hospital and stays there for treatment. This is called inpatient care. After leaving the hospital, the patient continues to get help from her health care team and becomes an outpatient.

Can women who had anorexia in the past still get pregnant?

It depends. When a woman has "active anorexia," meaning she currently has anorexia, she does not get her period and usually does not ovulate. This makes it hard to get pregnant. Women who have recovered from anorexia and are at a healthy weight have a better chance of getting pregnant. If you're having a hard time getting pregnant, see your doctor.

Can anorexia cause harm to a baby when the mother is pregnant?

Yes. Women who have anorexia while they are pregnant are more likely to lose the baby. If a woman with anorexia doesn't lose the baby, she is more likely to have the baby early, deliver by C-section, deliver a baby with a lower birth weight, and have depression after the baby is born.

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