Weight Loss Disorders Anorexia Nervosa & Bulimia

Some people battling anorexia may use control over food and weight to compensate for other areas of life that are more difficult to control. A person’s body image can also play a significant role in overall self-esteem, so a person with anorexia may seek to change their body in an attempt to feel better emotionally. Sometimes, overwhelming feelings of anxiety or the inability to express emotions can lead a person to cope using anorexic behavior.

Dieting and exercise can become extreme over time. Girls and women may engage in restrictive eating or excessive exercise in an attempt to conform to cultural expectations. Boys and men may engage in excessive exercise to build muscle, also attempting to conform to cultural expectations. While traditionally, adolescent girls and young women have been the predominant group afflicted by eating disorders, boys and men can also experience these issues. Older women are also experiencing more issues with eating disorders.

Anorexia Nervosa Definition

People suffering from anorexia nervosa do not maintain weight within a normal range. Weight loss that amounts to a weight that is 85 percent of normal weight or failure to grow and gain weight that results in a weight less than 85 percent of normal weight meets the criteria of anorexia nervosa. A person with anorexia typically displays a strong fear of gaining weight or of becoming overweight.

Someone experiencing anorexia also usually has a body image distortion, which means that the person sees themselves as much heavier than they really are. Issues of self-worth and self-esteem become intricately intertwined with body image and weight for a person with anorexia. People with anorexia may resist gaining weight because they feel that they have a higher value to others at a lower weight. People with anorexia may experience amenorrhea, which is the absence of menstruation for at least three consecutive cycles.

Anorexia Nervosa Subtypes

Two subtypes of anorexia nervosa exist that present physical and psychological issues for patients.

• Restricting anorexia involves excessive dieting. A person experiencing this type of anorexia typically restricts food consumption severely. This type of anorexic person may only eat foods from certain food groups or may count calories obsessively. It’s common for a person with restricting anorexia to skip meals and have obsessive or compulsive rules about how and when to eat. This type of anorexia often involves compulsive exercise.
• The binging and purging form of anorexia involves periods of restrictive eating and periods of binge eating followed by purging with laxatives and vomiting. Purging can also involve using diuretics and enemas. This form of eating disorder can also be called bulimia nervosa. A person with this disorder may maintain a normal weight, or their weight could be higher or lower than normal. The person typically vacillates between the two extremes of disordered eating. Non-purging bulimia is another variation that involves binging without traditional purging behavior. This disorder may involve excessive exercising or fasting between binging.

Physical Warning Signs

Knowing common signs and symptoms of anorexia can make it possible to intervene at the first sign of unusual behavior. Friends or family who recognize common symptoms can encourage and get help for the person engaging in compulsive overeating or dieting. Physical signs can include some or all of the following:

• Significant weight loss or a drastic change in weight
• Menstrual disturbance for women and libido disturbance for men
• Dizziness and fainting
• Poor circulation leading to coldness
• Constipation and bloating
• Fatigue and sleep problems
• Lethargy
• Pale skin and circles under eyes
• Downy hair covering the skin

Psychological Warning Signs

Common behaviors can also produce psychological abnormalities and disturbances. A person experiencing anorexic symptoms may display some or all of these warning signs:

• Obsessiveness with food and weight
• Anxiety and irritability around food
• Strong fear of gaining weight
• Inability to maintain a healthy weight
• Depression
• Inability to focus and concentrate
• Extreme thinking
• Inaccurate and distorted body image
• Low self-esteem
• Perfectionism
• Hypersensitivity to discussions regarding food, weight, and exercise
• Negative opinion of body image

Behavioral Warning Signs

People pursuing thinness at all costs often exhibit alarming emotional issues and behavior. You may notice any combination of the following behaviors:

• Restrictive dieting may include counting calories, planning menus, avoiding specific foods, eating at specific times, and creating compulsive eating environments.
• Binge eating may involve consuming large amounts of food in a short time. Some people hoard food and eat in secret to avoid questions about their activity. If large amounts of food disappear, this could indicate binge behavior.
• Purging activities will eliminate calories from binging. Purging may include misusing laxatives, diuretics, and enemas. Purging may also involve vomiting and extreme exercising to work off calories. Some people misuse appetite suppressants between binging to control appetite.
• Obsessive behavior may involve checking the body for fat content, looking in the mirror repeatedly, and stepping on the scale numerous times each day.
• Private eating may be preferred to avoid eating with other people. Some people begin spending large amounts of time alone instead of spending time with family and friends.
• Compulsive exercise is common for people experiencing eating disorders. Compulsive exercise could involve exercising at odd times of the night, exercising even when sick, exercising outdoors in bad weather, and becoming distraught if it’s not possible to exercise.
• Significant dietary changes may indicate a problem. If someone suddenly stops eating favorite foods and undergoes major shifts in food choices, this could be a warning sign.
• Ritualistic behavior regarding food preparation and eating is a common sign of anorexia nervosa. A person may only eat sitting at one spot at the table, eating from one specific plate, using one specific fork. Slow and deliberate eating is another common symptom.
• Food obsession often accompanies anorexia nervosa. A person may spend hours reading cookbooks, copying recipes, and even cooking for others.
• Self-injurious behavior such as cutting and substance abuse often accompanies anorexia. Suicide attempts are also not unusual.

Health Risks

A person struggling with anorexia can experience serious health risks. The health risks include the following issues:

• Iron deficiency
• Weakened immune system
• Constipation and/or diarrhea
• Amenorrhea (menstruation interruption)
• Infertility
• Kidney failure
• Osteoporosis
• Heart issues
• Death

Treatment Plans

Upon recognizing disordered eating, prompt treatment can be effective for recovery. Treatment options should include psychological therapy to help the person reach a healthy weight and learn normal eating and exercising behaviors. Typically, treatment involves outpatient care to monitor psychosomatic delusions and assist with psychological and emotional issues. Therapy may include behavioral and cognitive therapies, individual therapy, family therapy, and supportive clinical management. The recovery process also involves physical monitoring of weight and other health issues. Some patients also require antidepressant drug therapy for recovery.

Outlook for Recovery

Many professionals exist who specialize in eating disorders. Whether a person has been suffering from anorexia for many years or only months, recovery is possible. A team of professionals who will provide care and support is essential for overcoming this eating disorder. The patient must also have strong motivation to recover and be willing to work toward wellness.

Seeking Help

Prompt assistance is important to intervene in this eating disorder. Early intervention is a key to successful recovery. Seek help with a primary care physician first, who can provide a referral to a specialist if necessary.