Anorexia Nervosa: Eating Disorder

Anorexia Nervosa: Eating Disorder

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What is Anorexia Nervosa?

Anorexia nervosa is an eating disorder that primarily affects women. It is characterized by a gradual and increasing reduction in caloric intake, often accompanied by excessive and compulsive exercise, leading to progressive loss of body weight.

Weight loss is relentlessly pursued by patients with little or no concern for the damage it does to their health. They also have an intense fear of gaining weight and an unwillingness to maintain healthy body weight (typically between 18.5 and 25 BMI points).

Causes of anorexia nervosa

The causes of anorexia nervosa (AN) are not clear, but most experts believe that it is a combination of several factors.

Psychological factors

People who develop anxiety disorders or obsessive-compulsive traits in childhood are at higher risk of developing anorexia nervosa.

Thus, many people with AN share other personality traits and behaviors that may make them susceptible to developing the disorder, including:

  • Difficulty managing stress
  • Excessive worry, anxiety, or doubt about the future
  • Perfectionism, they are very strict and demanding
  • Hyper-control over the expression of emotions

Environmental Factors

There appears to be an association between anorexia nervosa and cultures/environments in which thinness is considered a value. Puberty appears to be a critical factor in the development of AN. The presence of major hormonal changes as well as stress, anxiety, and low self-esteem during puberty constitute an explosive mixture capable of triggering the disorder in susceptible individuals.

Western culture and society seem to play a fundamental role. Girls, and to a lesser extent boys, are heavily exposed to a variety of media messages that constantly reinforce the idea that being thin is beautiful and successful.

Genetic and physiological factors

There is an increased risk of anorexia nervosa in first-degree biological relatives of those with the disease.

Alterations in brain function or hormone levels may contribute to the development of anorexia nervosa, although it is unclear whether these changes in people with anorexia nervosa may be the cause of the disorder or a consequence of malnutrition.

These alterations may impact the area of the brain that regulates hunger, or they may cause food-related anxiety and guilt, feelings that are exacerbated when meals are skipped or after strenuous physical activity.

Signs and symptoms of AN

The signs and symptoms of anorexia nervosa can be divided into physical symptoms and behavioral symptoms.

Most of the symptoms presented by people with anorexia are related to severe malnutrition. These include:

  • Amenorrhea (absence of a menstrual period for at least 3 consecutive cycles)
  • Hypothermia (<35 °C) with cold intolerance
  • Bradycardia (heart rate <60 beats/minute)
  • Hypotension (pressure <70 mmHg).
  • Dryness of the skin, which tends to be covered with a kind of fine hair and yellowish color (due to an increase in beta-carotene).
  • Generalized skin itching.
  • Abdominal pain and constipation.

Among the most common psychological symptoms that can make one suspect anorexia nervosa are:

  • Altered perception of body weight and self-image
  • Change in eating habits in a more restrictive manner associated with the fear of gaining weight
  • Withdrawal from social relationships
  • Increased physical activity

Treatment of Anorexia Nervosa

The treatment of anorexia nervosa is a complex process involving many health professionals. One of the key roles in the team is undoubtedly the psychotherapist. Psychotherapy is considered one of the pillars of anorexia nervosa treatment.

The main characteristic of anorexia nervosa is the restriction of calories. This restriction leads to a significantly low body weight (with a serious risk to physical health). Another characteristic of anorexia is the intense fear of gaining weight. Food restriction and fear of weight gain lead to progressive weight loss. Therefore, it becomes central to the treatment of anorexia to confront the fear of gaining weight and to aim for the recovery of healthy body weight.


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