What Is Anorexia?
Does Thin Equal Power?
The primary concern of people with anorexia or bulimia is fear of gaining weight. An intense fear of fatness. The problem is really not loss of appetite but self-starvation. Features may be major behavioral, psychological, and physiological problems, in other words, anorexia affects every system in the body. It affects a person sexually, emotionally, physically, spiritually, mentally. Anorexia affects every part of a person from the top to the bottom, beginning with the brain!
Anorexics avoid food and meals, gradually eliminating foods from their diets. They live a life that is controlled over weight loss by way of other techniques such as exercise (a form of bulimia), purging, abuse of laxatives, diuretics, etc. They end up with a decreased heart rate and blood pressure and a decreased metabolic rate.
Many anorexics recover quickly while others have a fluctuating pattern of weight gain and relapse. Others may experience a chronically deteriorating course of illness over many years. An anorexic woman in her 40s or 50s, or even 60s can frighten the strongest of us. The mortality rate is the highest of any DSM diagnoses and the most common causes of death are cardiac arrest, electrolyte imbalance or suicide.
The following lists are compiled from the Diagnostic and Statistical Manual of Mental Disorders, revision IV
Summary of Diagnostic Criteria for Anorexia Nervosa, DSM IV.
- Refusal to maintain minimal body weight at or above a minimally normal weight
- Intense fear of weight gain, even though underweight (< 85% of normal weight)
- Body-image disturbance, including denial of the seriousness of the current low body weight
- Amenorrhea of 3 consecutive cycles
- Restricting type: During current episode person does not engage in binge eating or purging.
- Binge eating/purging type: During episode person engages in binge eating and purging
DSM-V, scheduled to be published in 2013, should contain additional findings in regards to anorexia but amenorrhea has been widely questioned.
The medical complications of anorexia are astounding.
|Medical Findings Associated with Anorexia Nervosa|
|Increased lanugo hair (fine body hair)||Acrocyanosis (decrease in the amount of oxygen delivered to the extremities)|
|Decreased subcutaneous fat||Dry skin (often scaly)|
|Decreased core body temperature||Heart rate below 60 BPM|
|ECG abnormalities||Congestive heart failure|
|Constipation||Crampy abdominal pain|
|Acute pancreatitis||Peripheral edema|
Anorexia occurs more frequently in specialized populations. A study at UCLA using the Eating Disorders Inventory, 716 female students were interviewed to obtain data on how often anorexia appears in different groups. Dancers, art students, healthcare students, athletes of all kinds particularly gymnasts and runners, are just a few of the at-risk groups.
Most people are amazed when they learn about the intensity of the patient's dysfunctional belief system and values they've developed in regards to their weight. Anorexia may be seen as a coping skill. Cognitive distortions are common when a person drops below a certain weight range and exhibits severe cognitive disturbance. The anorexic (and her parents) will likely say that she's "fine," she makes a 4.0 in college, completely ignoring the face that she is having difficulty with maturity (separating from parents, having a boyfriend, sexuality) feelings of ineffectiveness, helplessness, and poor self-esteem.
Relationships with people close to the anorexic become extremely disturbed. The anorectic becomes preoccupied with food and weight as a distraction from overwhelming feelings of anxiety, fear, and depression, triggered by these events. Then, the habit of food restriction and rituals become so entrenched that this set of behaviors can become split off from their goal of losing weight. They begin to maintain themselves as functionally autonomous behaviors. They serve to maintain the condition.
Causes of Anorexia
Studies have shown that 58% to 76% of variances in anorexia can be genetic. Researchers have found that families share genetic susceptibilities to major depression, substance abuse, anxiety disorders and personality disorders. Similarly, there is growing evidence to suggest that AN (anorexia nervosa) (and BN-bulimia nervosa) likely share the same genetic risk factors.
Researchers have found a connection to the modern values for females to be thin. Many anorexics are literally dying to be thin. Family dynamics play a role in eating disorders that mirror dysfunctional roles, conflicts, or interactional patterns within a family. Severe depression is a risk factor for anorexia as well as anxiety disorders, substance abuse, and personality disorders.
What is the anorexic thinking?
Anorexics spend 70-85% of each day thinking about food. One of the purposes of an eating disorder is to serve as a distraction. As long as they are thinking about food, they won't be thinking about anything else in their lives, such the fight they had with their mother this morning, or about how overwhelmed they feel about the amount of homework they have, or how homesick they are.
Anorexics are literally afraid of food. They're terrified of allowing themselves to eat. If they gain one pound, they visualize gaining 100 pounds. They fear that they will be considered a failure, that they have given up, and that they have lost "control." Loss of control means being fat and weight gain. Anorexics come to believe that all food is fattening!
The truth is that self-starvation cannot be maintained for years. The body's instincts take over. This is one reason why many anorexics will develop binge eating and bulimia.