Anorexia Nervosa

Overview

Anorexia nervosa is a potentially life-threatening eating disorder characterized by an individual's refusal to maintain a normal body weight, an intense fear of gaining weight, and significant disturbances in the perception of their own body shape and weight. This condition is not just a problem related to nutrition; it is a complex psychological presentation usually associated with deep emotional difficulties and a search for control.

In a healthy body, hunger signals from the brain trigger food intake to meet the person's energy needs. Nutrients provide the fuel necessary for organ function, cell repair, and hormonal balance. In the case of anorexia nervosa, this natural process may be suppressed by the individual's ideal of "being thin" in their mind. The person begins to ignore the feeling of hunger, and because the body does not receive the energy it needs, it may enter a "saving mode," slowing down the metabolism.

This disorder can lay the groundwork for serious damage in all systems of the body (heart, digestion, bone structure, and reproductive system). The main focus of treatment is to return eating habits to a healthy level, manage medical complications, and address the psychological traumas or issues such as low self-esteem underlying the eating disorder. Early intervention can significantly increase the chances of physical and mental recovery.

Symptoms of anorexia nervosa

Symptoms of anorexia include both physical changes and behavioral disturbances in the person's relationship with food and their body. Symptoms usually start gradually and can intensify over time.

• Extreme weight loss: Dropping far below the weight appropriate for the person's age and height and continuing to feel "overweight" despite being thin is the most prominent sign.
• Rigid changes in eating habits: Skipping meals, extreme obsession with calorie counting, cutting food into very small pieces, or avoiding eating in front of others may be seen.
• Disturbed body perception: Constantly checking oneself in the mirror, focusing on specific body areas (such as the abdomen, thighs), and perceiving even the slightest weight gain as a disaster may occur.
• Physical weakness and fatigue: Due to malnutrition, muscle loss, constant feelings of exhaustion, dizziness, and fainting spells may be triggered.
• Hormonal irregularities: Stopping or irregularity of the menstrual cycle in women (amenorrhea) and loss of sexual desire in men might be noticed.
• Skin and hair changes: Dryness in the skin, hair loss, and the formation of fine, downy hair called "lanugo," which the body produces to maintain heat, can be observed.

When to see a doctor

If eating has become a source of anxiety for you, if the thought of losing weight occupies your entire day, or if people around you have started to worry about your weight, it may be recommended to consult a psychiatrist or a nutritionist.

When to seek emergency help

In cases of severe heart rhythm disturbances, chest pain, uncontrollable vomiting, extreme dehydration, or suicidal thoughts, emergency services (911 or local emergency number) should be called without losing time. These situations can be a sign that the body is reaching a point of failure.

Causes of anorexia nervosa

Anorexia is not due to a single cause; it usually emerges through a combination of genetic predisposition, biological factors, and environmental pressures.

• Biological and genetic factors: It is thought that some people are genetically more predisposed to eating disorders. Additionally, an imbalance of chemicals in the brain (neurotransmitters) that regulate feelings of hunger and fullness may trigger this process.
• Psychological characteristics: In individuals with perfectionism, obsessive personality traits, and high anxiety levels, weight control can be seen as a method of "success" or "feeling safe."
• Social and cultural pressures: The perception of "extreme thinness" idealized in the media and social networks can lead to body dissatisfaction, especially in young people, triggering eating disorders.

Treatment of anorexia nervosa

Treatment is a multidisciplinary process tailored to the patient's physical condition and needs, carried out by a team consisting of a doctor, dietitian, and psychologist.

Medical monitoring and nutritional rehabilitation

Eliminating the life threat and stabilizing body functions is the first step of treatment:

• Weight restoration: Under the supervision of a dietitian, a slow and controlled increase in calories is planned to prevent the body from going into shock.
• Medical follow-up: Heart rate, electrolyte balance, and organ functions are regularly monitored. In severe cases, treatment may be carried out in a hospital.

Psychological treatment methods

Different therapy methods are applied to resolve the mental causes of the eating disorder:

• Cognitive behavioral therapy (CBT): The aim is for the person to recognize faulty thought patterns regarding food, weight, and body shape and replace them with healthy ones.
• Family-based therapy (Maudsley approach): Especially in adolescents, the family is included in the nutrition process in a healthy way to support the patient.
• Group therapies: Sharing with individuals experiencing similar difficulties can increase the motivation for recovery by reducing the feeling of isolation.

Medication therapy

While there is no medication that directly cures anorexia, antidepressants or anti-anxiety medications may be prescribed under a doctor's supervision to manage accompanying depression, anxiety, or sleep disorders.

Risks of anorexia nervosa

Untreated anorexia carries a risk of leaving permanent damage in almost every organ of the body and has one of the highest mortality rates among psychiatric conditions.

• Heart problems: Weakening of the heart muscle, low blood pressure, and rhythm disturbances that can lead to sudden arrests may develop.
• Bone loss (Osteoporosis): Due to nutrient deficiency and hormonal drops, bone fragility may increase; this can lead to permanent disabilities in the future.
• Kidney failure: Fluid and electrolyte imbalance can disrupt the kidney's filtering function, creating a life-threatening risk.
• Anemia: Production of blood cells may decrease as a result of malnutrition, which can cause organs to be deprived of oxygen.

Preparing for your appointment

Asking for help is the biggest step on the path to recovery. Being prepared before going to a specialist can make you feel more secure.

What you can do:

• Note your feelings: Write down feelings such as fear or guilt that you experience when you eat or think about your weight.
• Record physical changes: Mention conditions such as feeling cold, hair loss, fatigue, or cessation of menstruation.

Questions to ask your doctor:

• What is the greatest harm this condition has caused to my body?
• How long will it take for me to reach my ideal weight?
• How can I explain this situation to my family?
• What awaits me in the recovery process?

What to expect from your doctor:

• How much food do you eat during the day?
• How do you feel when you think you have gained weight?
• Do you try to make yourself vomit or do you exercise excessively?