Anorexia nervosa is a body dysmorphic disorder (a distorted attitude towards body shape, weight and food) where the sufferer refuses to eat due to an irrational fear of gaining weight.

Anorexia nervosa causes may be social or emotional trauma or repeated exposure to skewed thinking around body image. It is an eating disorder that typically affects young women, although cases of anorexia in young men are increasingly reported. It typically presents around puberty, that is, at approximately at 16 years in girls and usually earlier in boys. 

In extreme cases, hospitalisation may be necessary to prevent or treat starvation.

What are its symptoms?

Some of the signs and symptoms of anorexia include:

  • An irrational fear of weight gain and preoccupation with diet
  • Weight loss, leading to being 15% under the optimal weight for age and height
  • A halted menstrual cycle in females known as amenorrhoea
  • Use of self-starvation, extreme amounts of exercise, appetite suppressants, laxatives or vomiting to achieve weight loss
  • Symptoms of malnutrition, including loss of potassium in the blood known as hypokalemia, which may result in heart arrhythmia, muscle weakness, cramps and constipation
  • Brittle, dry hair and a yellow tinge to the skin
  • The prominent growth of downy-soft hair on the face and body called lanugo

The other most common clinically recognised eating disorder is bulimia. Here sufferers engage in binging, or overeating, followed by purging through the use of vomiting or laxatives. It is possible to suffer from both disorders simultaneously.

How is it diagnosed?

Psychological evaluation by a doctor and psychologist is required to determine whether a person suffers from anorexia nervosa. This will include a physical and a psychological evaluation. Depression is often a factor in anorexia. 

Eating Disorders South Africa sets out diagnostic criteria in the following order:

  • Continuous restriction of kilojoule intake, resulting in dramatic weight loss. A person who weighs 15% below their body mass index (BMI) may be considered at risk. 
  • Obsession with weight loss and actions that ensures no weight gain regardless of how underweight they are already.
  • Where self-esteem is directly linked to body weight and shape, with a belief that weight loss is a sign of self-discipline.
  • Denial that their behaviour is negatively impacting their health, when evidence is to the contrary.

What are your treatment options?

There is no cure for anorexia but treatment is available and can result in full recovery for some, particularly if treatment is ongoing.

Anorexia nervosa treatment is a combination of psychological and medical therapies. Medical professionals will need to establish if the person requires medical assistance. Usually, this will involve ensuring they receive electrolyte replacements via a saline drip. In extreme cases, a feed tube may be used to help the patient reach a healthy minimum weight.

In addition to one-on-one therapy with a psychologist, sufferers are advised to join support groups ,to hear other people’s anorexia stories and how they are fighting to become well again. Family therapy is sometimes required, as family dynamics may be the source of the problem.

Conversely, it is important to avoid groups that might share anorexia tips, most often online through anorexia tumblrs (Tumblr is a popular microblogging platform and social networking website), thereby enabling continued harmful behaviours.

Can it be prevented?

There is no medically recognised way to prevent anorexia, however, scientists are currently gathering data from subjects worldwide in a research project called the Anorexia Nervosa Genetics Initiative (ANGI) to establish whether or not genetics determine the likelihood of anorexia nervosa. 

Since anorexia is believed to be linked to psychological states, parents should work to instill a healthy body image and self-esteem in their children from a young age to prevent the feelings of inadequacy that may drive unhealthy behaviour.

It is important to detect any changes in behaviour early on and to address the root cause of these through open discussion with a trained psychologist or counsellor. 

For more info
Recoveryspace.org (for local support groups)

Therapistdirectory.co.za (a resource to find local therapists who specialise in the treatment of eating disorders)

The accuracy of this information was checked and approved by physician Dr Thomas Blake in May 2015