Anorexia nervosa is one of the most prominent eating disorders, notorious for its wide-reaching prevalence and severe and devastating impact on individuals’ lives. This issue casts a sombre shadow on a global scale, affecting countless individuals, predominantly young women, and reshaping their lives profoundly. In the 2021/22 period alone, the UK witnessed 5,428 people were hospitalised with a primary diagnosis of anorexia. Nevertheless, by delving into the intricacies of anorexia nervosa, exploring its symptoms, causes, and well-established treatment and recovery options, those needing professional assistance and support can find the means to conquer anorexia and embark on a path to renewal.
What is anorexia nervosa?
Anorexia nervosa is a serious mental health condition characterised by an intense fear of gaining weight, causing individuals to restrict their food intake drastically. This disorder transcends beyond mere dieting, manifesting in a persistent chase for thinness, even when the individual is significantly underweight.
Central to anorexia is a distorted body image; individuals perceive themselves as overweight, whatever the reality. This skewed perception fuels a vicious cycle of further food restriction, excessive exercise and an obsessive focus on perceived flaws.
While anorexia nervosa has historically been more prevalent in young women, it is important to acknowledge that it affects people of all ages and genders. One study found that anorexia often goes undiagnosed and untreated due to perceived stigma and limited male-focused anorexia recovery services.
Anorexia symptoms and behaviours
Identifying anorexia can sometimes be challenging, as the symptoms and behaviours associated with the disorder can vary significantly among individuals. However, understanding the diverse manifestations of anorexia symptoms is pivotal in identifying the disorder in its early stages and initiating appropriate intervention.
Physical anorexia symptoms
- Severe weight loss: Individuals may lose weight rapidly or maintain a significantly low body weight for their age and height.
- Distorted body image: Individuals often perceive themselves as overweight, even underweight.
- Menstrual irregularities: Women with anorexia might experience missed periods or the absence of menstruation altogether.
- Physical weakness and fatigue: The insufficient intake of nutrients often results in a lack of energy and physical weakness.
- Digestive issues: People with anorexia can develop digestive problems, including constipation and abdominal pain.
- Hair loss and brittle nails: Due to malnutrition, individuals may experience hair loss and have brittle nails.
- Cold intolerance: An inability to tolerate cold temperatures is a common symptom stemming from the loss of insulating body fat.
Behavioural anorexia symptoms
- Preoccupation with dieting: Individuals often become obsessed with dieting, showcasing rigid eating habits and avoiding meals.
- Excessive exercise: Despite being underweight, some people with anorexia engage in intense workout routines.
- Wearing loose or baggy clothing: To hide weight loss, individuals may start wearing clothes that conceal their body shape.
- Isolation: People with anorexia may isolate themselves from friends and family to avoid discussing their appearance or eating habits.
Psychological anorexia symptoms
- Depression and anxiety: Individuals with anorexia often experience co-occurring mental health issues such as depression and anxiety.
- Fixation of perceived flaws: A strong focus on perceived body flaws, constantly checking the mirror and expressing dissatisfaction with their appearance is common.
- Irritability: Anorexia may cause individuals to become easily irritable, having difficulty concentrating due to the physical stress the body is enduring.
Denial: Many individuals with anorexia fail to recognise or admit how underweight they are, exhibiting a disconnect between their actual and perceived body image.
Causes of anorexia
Anorexia nervosa is a complex disorder arising from genetic, biological, environmental and psychological influences. Understanding the root causes of anorexia nervosa can help formulate a comprehensive treatment plan that addresses the complex interplay of factors contributing to the disorder.
Genetic and biological factors
- Family history
- Chemical imbalances
- Biological changes during adolescence
- Chronic illnesses
Societal pressures and body ideals
- Media influence
- Peer pressure
- Ballet and fashion industry
- Traumatic events
- Low self-esteem
- Mental health disorders
How is anorexia diagnosed?
Diagnosing anorexia nervosa involves a comprehensive assessment that encompasses both physical evaluations and psychological analyses to determine the presence of characteristic anorexia symptoms. It is important to approach the diagnosis with sensitivity and empathy, bearing in mind the intense fear and anxiety that individuals with anorexia nervosa often experience. The diagnostic process usually involves:
Meeting DSM-5 criteria
The foremost step in the diagnostic process is verifying whether the individual meets the DSM-5 criteria for anorexia nervosa. The primary elements of this criteria include:
- Restricted energy intake which leads to a significantly low body weight in the context of age, sex, developmental trajectory and physical health.
- Intense fear of gaining weight or becoming fat, even though underweight.
- Disturbance in self-perceived weight or shape, wherein the individual is unable to perceive the seriousness of their current low body weight or is exceedingly influenced by their body weight or shape in self-evaluation.
A detailed physical examination is generally conducted to assess overall health and pinpoint any complications from severe weight loss. This could include routine evaluations like checking the vitals, assessing the body mass index (BMI) and looking for signs of malnutrition.
In conjunction with physical assessments, a thorough psychological evaluation is essential to understand the person’s eating habits, attitudes toward weight and shape and any coexisting psychological issues like anxiety or depression.
Laboratory tests may also be employed to rule out other underlying medical conditions and gauge the eating disorder’s impact on bodily functions. These tests often encompass complete blood count, liver, kidney and thyroid function tests.
The crucial facets of anorexia treatment
Anorexia treatment is a comprehensive process that seeks to address the disorder’s physical manifestations and the underlying psychological components that fuel the condition. The most important facets of anorexia treatment include:
One-on-one therapy sessions are a fundamental component of anorexia treatment. Cognitive behavioural therapy (CBT) is key within anorexia treatment. CBT focuses on helping individuals understand the distorted thought patterns that drive their disordered eating and working to develop healthier perspectives on body image and self-worth. At UKAT London clinic, we also integrate Dialectical Behaviour Therapy (DBT) into the treatment regime, further fortifying the recovery process, helping individuals to regulate emotions more effectively and reduce self-harming behaviours often associated with anorexia, establishing a more harmonious pathway to recovery.
Given the often central role of family dynamics in developing and maintaining anorexia nervosa, family therapy can be a vital component of anorexia treatment. It involves working with family members to foster understanding and develop strategies to support the individual’s anorexia recovery.
Group therapy provides a platform for individuals to connect with others who share similar experiences. It can foster community and understanding, helping individuals feel less isolated in their struggles.
Nutritional counselling is a cornerstone of anorexia treatment. UKAT London Clinic has expert nutritionists and dietitians who work with our clients to develop balanced meal plans to restore a healthy weight and correct any nutritional deficiencies.
While no medications are specifically approved for the treatment of anorexia, in some cases, psychiatrists may prescribe medications to address co-occurring mental health issues such as depression or anxiety that often accompany the disorder.
Recovery from anorexia is a gradual process, and post-treatment support is essential. At UKAT London Clinic, this involves ongoing therapy and support groups to maintain anorexia recovery and prevent relapse.
What does a successful recovery from anorexia look like?
Anorexia recovery is a multi-faceted journey that involves attaining a healthier body weight and a deep-seated change in how individuals relate to food, body image and themselves. At UKAT London Clinic, we firmly believe that recovery is possible and achievable for anyone, no matter the severity of their condition.
A successful recovery encompasses both physical and psychological healing. Physically, individuals work towards restoring their nutritional health, which includes regular monitoring and adjustments to ensure the body receives the appropriate nourishment.
On the psychological front, recovery is marked by a steady transformation in the individual’s self-perception and attitudes towards body image. The therapeutic process helps individuals unearth and address the underlying issues that fuelled the disorder, paving the way for a healthier relationship with oneself. Here, progress is marked by an increased acceptance of one’s body, reduced obsessive behaviours related to diet and exercise and the development of coping strategies to manage stress and anxiety more effectively.
At UKAT London Clinic, we tailor each recovery plan to the individual, considering their unique needs and circumstances. Recovery is a continuous journey; it involves building resilience and learning to navigate life’s challenges in healthier ways. It is a journey laden with self-discovery, learning and growth. Despite the challenges that may arise, with UKAT’s commitment and support system, individuals can forge a path to a happier, healthier future free from the constraints of anorexia.