Anorexia nervosa is a serious eating disorder that results in unhealthy, often dangerous weight loss. While it is most common among adolescent women, anorexia can affect women and men of all ages and is characterized by a refusal to maintain a healthy body weight, an intense fear of gaining weight, and a distorted body image.
For some people, restricting their food and weight can be a way of controlling areas of life that feel out of their control and their body image can come to define their entire sense of self worth. It can also be a way of expressing emotions that may feel too complex or frightening such as pain, stress or anxiety.
Fast facts on Anorexia:
- Anorexia Nervosa continues to have the highest mortality of all psychiatric conditions.
- Anorexia is not simply a woman’s disease. Men make up about 10% of the entire population that suffers from this eating disorder.
- The problem with this eating disorder might start at a very early age. Research has shown that girls as young as 6 are concerned about what their bodies look like.
- 80% of girls are afraid of becoming fat by the time they reach the age of 10.
- 1 person out of 10 with this eating disorder will ever seek out some form of treatment to help them with their issue.
- Men with same sex attractions are twice as likely to suffer from anorexic thinking patterns.
- Nearly 70% of girls who are 18 or younger say that their ideal body image is influenced by the pictures they see online, in magazines, or in celebrity images.
Major Types of Anorexia
There are two common types of anorexia, which are as follows:
Binge/Purge Type – The individual suffering from this type of eating disorder, will purge when he or she eats. This is typically a result of the overwhelming feelings of guilt a sufferer would experience in relation to eating; they compensate by vomiting, abusing laxatives, or excessively exercising.
Restrictive – In this form, the individual will fiercely limit the quantity of food consumed, characteristically ingesting a minimal amount that is well below their body’s caloric needs, effectively slowly starving him or herself.
Though two classifications of anorexia nervosa exist, both types exhibit similar symptoms, such as irrational fear of weight gain and abnormal eating patterns.
Dieting Vs. Anorexia
Though the restrictive eating patterns that characterize anorexia nervosa are similar to dieting behaviors, there are stark differences between the two. The effects of the extreme behaviors resulting from anorexia nervosa are far more devastating and consequential than dieting.
While someone may diet in an attempt to control weight, anorexia nervosa is often an attempt to gain control over one’s life and emotions, especially in the light of traumatic events or a chaotic environment.
While someone might diet in an attempt to lose weight as the primary goal, in anorexia they may diet because they perceive losing weight as a way to achieve happiness and self-mastery.
- Obvious, rapid, dramatic weight loss
- Soft, fine hair grows on face and body
- Obsession with calories and fat content
- Preoccupation with food, recipes, or cooking – may cook elaborate dinners for others but not eat themselves.
- Dieting despite being thin or dangerously under weight
- Fear of gaining weight or becoming overweight.
- Food purging : uses laxatives, diet pills, ipecac syrup, diuretics, may engage in self induced vomiting.
- May engage in frequent strenuous exercise.
- Perception: perceives self to be overweight despite being told by others they are too thin.
- Becomes intolerant to cold: frequently complains of being cold due to loss of insulating body fat.
- Solitude: may avoid friends and family; becomes withdrawn and secretive.
- Clothing: may wear baggy, loose-fitting clothes to cover weight-loss.
- Cheeks may become swollen due to enlargement of the salivary glands by excessive vomiting.
Helping someone with anorexia
While there are things you can to do help someone with an eating disorder, you can’t force the person to get better. And because of the defensiveness and denial involved in anorexia, you’ll need to tread lightly. Waving around articles about the dire effects of anorexia or declaring “You’ll die if you don’t eat!” probably won’t work. A better approach is to gently express your concerns and let the person know that you’re available to listen. If your loved one is willing to talk, listen without judgment, no matter how out of touch the person sounds.
Tips for helping a loved one
Think of yourself as an “outsider.” As someone not suffering from anorexia, there isn’t a lot you can do to “solve” your loved one’s anorexia. It is ultimately their choice to decide when they are ready.
Be a role model for healthy eating, exercising, and body image. Don’t make negative comments about your own body or anyone else’s.
Take care of yourself. Seek advice from a health professional, even if your friend or family member won’t. And you can bring others—from peers to parents—into the circle of support.
Don’t act like the food police. A person with anorexia needs compassion and support, not an authority figure standing over the table with a calorie counter.
Avoid threats, scare tactics, angry outbursts, and put-downs. Bear in mind that anorexia is often a symptom of extreme emotional distress and develops out of an attempt to manage emotional pain stress, and/or self-hate. Negative communication will only make it worse.
Understand this is not really about weight or food
The food and weight-related issues are in fact symptoms of something deeper: things like depression, loneliness, insecurity, pressure to be perfect, or feeling out of control. Things that no amount of dieting or weight loss can cure.
In order to overcome anorexia, you first need to understand that it meets a need in your life. For example, maybe you feel powerless in many parts of your life, but you can control what you eat. Saying “no” to food, getting the best of hunger, and controlling the number on the scale may make you feel strong and successful—at least for a short while. You may even come to enjoy your hunger pangs as reminders of a “special talent” that most people don’t possess.
Anorexia may also be a way of distracting yourself from difficult emotions. When you spend most of your time thinking about food, dieting, and weight loss, you don’t have to face other problems in your life or deal with complicated emotions.
Unfortunately, any boost you get from starving yourself or shedding pounds is extremely short-lived. Dieting and weight loss can’t repair the negative self-image at the heart of anorexia. The only way to do that is to identify the emotional need that self-starvation fulfills and find other ways to meet it.
Learn to tolerate your feelings
Identifying the underlying issues that drive your eating disorder is the first step toward recovery, but insight alone is not enough. Let’s say, for example, that following restrictive food rules makes you feel safe and powerful. When you take that coping mechanism away, you will be confronted with the feelings of fear and helplessness your anorexia helped you avoid.
Reconnecting with your feelings can be extremely uncomfortable. It’s why you may feel worse at the beginning of your recovery. But the answer isn’t to return to the destructive eating habits you previously used to distract yourself; it’s to learn how to accept and tolerate all of your feelings—even the negative ones.
Using mindfulness to cope with difficult emotions
When you start to feel overwhelmed by negativity, discomfort, or the urge to restrict food, take a moment to stop whatever you’re doing and investigate what’s going on inside.
Identify the emotion you’re feeling. Is it guilt? Shame? Helplessness? Loneliness? Anxiety? Disappointment? Fear? Insecurity?
Accept the experience you’re having. Avoidance and resistance only make negative emotions stronger. Instead, try to accept what you’re feeling without judging yourself.
Dig deeper. Where do you feel the emotion in your body? What kinds of thoughts are going through your head?
Distance yourself. Realize that you are NOT your feelings. Emotions are passing events, like clouds moving across the sky. They don’t define who you are.
Once you learn how to accept and tolerate your feelings, they’ll no longer seem so scary. You’ll realize that you’re still in control and that negative emotions are only temporary. Once you stop fighting them, they’ll quickly pass.
Challenge damaging mindsets
People with anorexia are often perfectionists and overachievers. They’re the “good” daughters and sons who do what they’re told, try to excel in everything they do, and focus on pleasing others. But while they may appear to have it all together, inside they feel helpless, inadequate, and worthless.
If that sounds familiar to you, here’s the good news: these feelings don’t reflect reality. They’re fueled by irrational, self-sabotaging ways of thinking that you can learn to overcome.
Damaging mindsets that fuel anorexia
All-or-nothing thinking. Through this harshly critical lens, if you’re not perfect, you’re a total failure. You have a hard time seeing shades of gray, at least when it comes to yourself.
Emotional reasoning. You believe if you feel a certain way, it must be true. “I feel fat” means “I am fat.” “I feel hopeless” means you’ll never get better.
Musts, must-nots, and have-tos. You hold yourself to a rigid set of rules (“I must not eat more than x number of calories,” “I have to get straight A’s,” “I must always be in control.” etc.) and beat yourself up if you break them.
Labeling. You call yourself names based on mistakes and perceived shortcomings. “I’m unhappy with how I look” becomes “I’m disgusting.” Slipping up becomes “I’m a “failure.”
Catastrophizing. You jump to the worst-case scenario. If you backslide in recovery, for example, you assume that there’s no hope you’ll ever get better.
Put your thoughts on the witness stand
Once you identify the destructive thoughts patterns that you default to, you can start to challenge them with questions such as:
“What’s the evidence that this thought is true? Not true?”
“What would I tell a friend who had this thought?”
“Is there another way of looking at the situation or an alternate explanation?”
“How might I look at this situation if I didn’t have anorexia?”
As you cross-examine your negative thoughts, you may be surprised at how quickly they crumble. In the process, you’ll develop a more balanced perspective.
Develop a healthier relationship with food
Even though anorexia isn’t fundamentally about food, over time you’ve developed harmful food habits that can be tough to break. Developing a healthier relationship with food entails:
- Getting back to a healthy weight
- Starting to eat more food
- Changing how you think about yourself and food
- Letting go of rigid food rules
While following rigid rules may help you feel in control, it’s a temporary illusion. The truth is that these rules are controlling you, not the other way around. In order to get better, you’ll need to let go. This is a big change that will feel scary at first, but day by day, it will get easier.
Get back in touch with your body. If you have anorexia, you’ve learned to ignore your body’s hunger and fullness signals. You may not even recognize them anymore. The goal is to get back in touch with these internal cues, so you can eat based on your physiological needs.
Allow yourself to eat all foods. Instead of putting certain food off limits, eat whatever you want, but pay attention to how you feel physically after eating different foods. Ideally, what you eat should leave you feeling satisfied and energized.
Get rid of your scale. Instead of focusing on weight as a measurement of self-worth, focus on how you feel. Make health and vitality your goal, not a number on the scale.
The role of meal plans
If you need to gain weight, a nutritionist or dietitian can help you develop a healthy meal plan that includes enough calories to get you back to a normal weight. While you can do this on your own, you’re probably out of touch with what a normal meal or serving size looks like.
Getting past your fear of gaining weight
Getting back to a normal weight is no easy task. The thought of gaining weight is probably extremely frightening, and you may be tempted to resist.
But this fear is a symptom of your anorexia. Reading about anorexia or talking to other people who have lived with it can help. It also helps to be honest about your feelings and fears. The better your family and treatment team understand what you’re going through, the better support you’ll receive.
You can do a self test quiz : Eating disorder Quiz.
This is not to diagnose – but to inform.
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