Anorexia

Anorexia wreaks havoc on physical and mental well-being, resulting in damaging and potentially life-threatening issues. Education is crucial for early intervention, enabling you to recognise symptoms and encouraging a supportive atmosphere for seeking help. We delve into anorexia, exploring signs and symptoms and dispelling common myths, offering valuable insights on how you can seek assistance.

DSM-V criteria for anorexia:

According to the DSM-V, the diagnostic criteria for anorexia include:

• Restriction of energy intake relative to requirements
• Intense fear of gaining weight or becoming fat
• Disturbance in the way one’s body weight or shape is experienced (i.e: persistent lack of recognition of the seriousness of the situation)

It’s important to note that the severity of anorexia is classified into three subtypes based on body mass index (BMI) and the presence or absence of specific behaviours:

• Mild: BMI greater than or equal to 17 kg/m²
• Moderate: BMI 16–16.99 kg/m²
• Severe: BMI 15–15.99 kg/m²
• Extreme: BMI less than 15 kg/m²

What are the signs of anorexia?

Anorexia extends beyond undereating. Emotional factors play a crucial role, highlighting the complex nature of this eating disorder that requires comprehensive understanding and compassionate support for those affected. Below, we take a look at some of the main signs of anorexia in three different categories: physical, psychological and behavioural.

Physical signs of anorexia:

• Significant weight loss: Anorexia often leads to severe weight loss, which can result in malnutrition and various physical complications, such as muscle wasting and weakness.
• Brittle nails: Malnutrition can affect the health of nails, leading to brittleness and increased susceptibility to breakage.
• Dry skin: Inadequate nutrition and dehydration can contribute to dry and flaky skin.
• Development of fine body hair (Lanugo): The body may grow fine hair, known as lanugo, due to insufficient insulation caused by extreme weight loss.
• Fatigue: Lack of essential nutrients can result in fatigue and overall weakness, impacting the person’s ability to engage in daily activities.
• Weakness: Muscular weakness is common in people with anorexia due to the body’s inability to maintain muscle mass without proper nutrition.
• Dizziness: Low-calorie intake and dehydration can lead to dizziness and lightheadedness.
• Irregular menstruation (Amenorrhea): Women with anorexia may experience disruptions in their menstrual cycle, including irregular periods or the absence of menstruation altogether.

Psychological signs of anorexia

• Intense fear of weight gain: The fear of gaining weight is often irrational and disproportionate, driving the restrictive eating behaviours seen in anorexia.
• Distorted body image: people with anorexia may perceive their bodies inaccurately, seeing themselves as overweight even when severely underweight.
• Preoccupation with food, dieting and body size: Constant thoughts and concerns about food, calories, dieting and body size dominate a person’s mental space.
• Changes in eating habits: Restrictive eating habits may involve avoiding specific foods or entire food groups, extreme calorie counting and rigid adherence to self-imposed dietary rules.
• Denial of the severity of weight loss: Many people with anorexia may downplay or deny the seriousness of their low body weight, making it challenging to recognise the need for intervention.

Behavioural signs of anorexia

• Restrictive eating habits: Anorexia is characterised by severe restrictions in food intake, often leading to inadequate nutrition and weight loss.
• Excessive exercise: Some people with anorexia engage in compulsive and intense exercise as a way to burn calories and control weight.
• Social withdrawal: people with anorexia may withdraw from social activities, particularly those involving food, to hide their eating habits and body size.

What causes anorexia?

Anorexia is a complex psychiatric disorder with multiple contributing factors, and its exact cause is not fully understood. It will likely result from genetic, biological, psychological and environmental factors. Here are some key factors that may contribute to the development of anorexia:

Genetics

There is evidence to suggest a genetic predisposition to anorexia. People with a family history of eating disorders may be at a higher risk. A recent 2022 study stated that ‘genetic factors predispose for approximately 33-84% to anorexia nervosa’.

Neurobiology

With state-of-the-art technology and emerging research, scientists are now able to study the brains of people with eating disorders, such as anorexia. Researchers have identified differences in the brains of those with eating disorders compared to those without.

They include differences in:

• Neurochemistry
• Grey matter volume
• Cortical thickness
• White matter volume
• Integrity and structural connectivity
• Functional and effective connectivity

This new research is valuable as it enables researchers to develop models for understanding brain function and food avoidance in people with eating disorders. By identifying specific neural patterns, scientists can enhance treatment strategies, leading to more effective interventions and support for those struggling with conditions like anorexia.

Psychological factors

Psychological factors, such as low self-esteem, perfectionism and obsessive-compulsive personality disorder (OCD), can contribute to the development of anorexia. Some people may use restrictive eating as a way to cope with stress, anxiety, or traumatic experiences.

Environmental factors

Societal pressures and cultural influences, including the media’s portrayal of an idealised body image, can contribute to the development of body dissatisfaction and drive people to pursue extreme weight loss. Peer pressure and societal expectations regarding beauty standards may also play a role.

Life events

Traumatic events, major life changes, or stressful situations could be the cause of anorexia in some people. Studies have shown that 23.1% of those with anorexia also met the criteria for PTSD.

Debunking common anorexia myths

FAQ’s