Anorexia nervosa is a potentially life-threatening eating disorder. It is a serious psychological disorder characterized by either a significantly reduced appetite or complete aversion to eating.
A patient with anorexia nervosa, often just called "anorexia" (although the meaning is different), has a distorted body image and an exaggerated fear of becoming overweight or obese - so a deliberate effort is made to lose weight.
Contents of this article:
What is anorexia nervosa?
Anorexia should not be confused with anorexia nervosa.
- Anorexia is a general loss of appetite, or a loss of interest in food.
- Anorexia nervosa is a serious mental illness. Patients have not "lost" interest in food, they have intentionally restricted their food intake because of an irrational fear of being or becoming fat.
However, lay people often use the term "anorexia" when referring to the serious psychological disorder.
According to the National Library of Medicine1, anorexia nervosa is an eating disorder that makes the patient lose more weight than is considered healthy for his or her height and age.
A person with anorexia disorder may be underweight, but still has an intense fear of putting on weight. They may do too much exercise, diet, use laxatives and other methods to get leaner.
Anorexia nervosa typically begins during a person's teenage years or early adulthood. It is the third most common chronic illness among teenagers.
Many studies have found that the risk of suicide among patients with anorexia nervosa is high. A study published in PLoS ONE3 found that among eating disorders, anorexia nervosa has the highest rates of completed suicides, but not attempted suicides. However, S. Coren and P. L. Hewitt wrote in the American Journal of Public Health14 that "(our) findings suggest that the suicide rate is not elevated among individuals currently suffering from anorexia nervosa."
James Lock, MD, PhD, a professor of psychiatry and behavioral sciences at Stanford University Medical School says that anorexia nervosa kills approximately 1 in every 10 patients4 (all causes, not just suicide).
Causes of anorexia nervosa
Anorexia nervosa has no single cause. The National Health Service5, UK, says that the majority of experts believe the mental disorder is caused by a combination of biological, environmental and psychological factors.
Some individuals are thought to have personality traits which make them more susceptible to developing the disease.
Being underweight and not having a normal diet may have an effect on the brain which reinforces behaviors and obsessive thoughts related to anorexia nervosa. In other words, under-eating and being underweight can set off a cycle of further weight loss and under-eating.
The following risk factors have been associated with anorexia nervosa:
- Being overly obsessed with rules
- Having a tendency towards depression
- Being overly worried about one's weight and shape
- Being excessively worried, doubtful and/or scared about the future
- Being perfectionist
- Having a negative self image
- Having eating problems during early childhood or infancy
- Having had an anxiety disorder during childhood
- Holding specific cultural/social ideas regarding beauty and health
- Inhibition - the individual restrains or controls his or her behavior and expression
Many experts believe that some young females who in Western cultures are exposed to multiple messages through the media that being thin is beautiful, are more susceptible to developing anorexia nervosa. However, research carried out in the University of Granada, Spain, found the incidence of eating disorders was considerably higher among Muslim adolescents than their Christian peers.
Other environmental factors some experts believe may contribute include physical abuse, sexual abuse, issues with family relationships, being bullied, other school stress (e.g. exams), bereavement, and a stressful life event, such as the breakdown of a relationship or becoming unemployed.
According to NEDA6 (National Eating Disorders Association), studies are finding that in some people with eating disorders certain brain chemicals that control digestion, appetite and hunger may be unbalanced. Nobody is sure what the implications of this might be - further studies are underway to find out.
Experts believe susceptibility to eating disorders may be partly driven by a person's genes. In many cases, anorexia nervosa, bulimia nervosa and other eating disorders have been found to run in families.
Recent developments on anorexia nervosa from MNT news
Past research claims that negative emotions, such as feeling depressed or angry, can fuel anorexia nervosa. But a new study from Rutgers University in New Jersey finds the eating disorder can also be encouraged by "skewed" positive emotions, such as feeling pride after weight loss.
Though eating disorders such as anorexia and bulimia are typically associated with teenagers and young adults, researchers caution parents that children between 8 and 12 years old who are difficult eaters could have lurking psychological issues. The team adds that restrictive eating behaviors can surface before puberty.
New research published in Psychosomatic Medicine suggests that people with anorexia nervosa may have very different gut microbial communities than those found in healthy individuals.
On the next page we look at the symptoms of anorexia nervosa and how the condition is diagnosed. On the final page we discuss treatments for anorexia nervosa and possible complications caused by the condition.