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Anorexia Nervosa: Causes, Symptoms and Treatment

Anorexia nervosa is a serious eating disorder characterized by severe weight restriction, intense fear of gaining weight, and a distorted body image. Early medical treatment is essential.

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Things worth knowing about "Anorexia"

Anorexia nervosa is a serious eating disorder characterized by severe weight restriction, intense fear of gaining weight, and a distorted body image. Early medical treatment is essential.

What is Anorexia?

Anorexia, clinically known as anorexia nervosa, is a severe mental health condition classified as an eating disorder. People affected by anorexia severely restrict their food intake, have an intense fear of weight gain, and perceive their body in a distorted way. Despite being dangerously underweight, many individuals still see themselves as overweight. The condition most commonly affects adolescents and young adults, particularly females, but can occur at any age and in people of all genders.

Causes

The causes of anorexia are multifaceted, involving biological, psychological, and social factors:

Genetic predisposition: Anorexia tends to run in families, suggesting a hereditary component.
Psychological factors: Perfectionism, low self-esteem, anxiety disorders, and difficulties managing emotions are commonly associated.
Sociocultural influences: Societal beauty standards, social media pressure, and peer influence can play a significant role.
Biological factors: Alterations in brain neurotransmitter systems, particularly serotonin and dopamine, are linked to the disorder.
Traumatic experiences: Bullying, abuse, or other stressful life events may contribute to the onset of the condition.

Symptoms

Symptoms of anorexia can be divided into physical and psychological manifestations:

Physical Symptoms

Severe underweight (Body Mass Index below 17.5)
Absence of menstruation (amenorrhea)
Hair loss and brittle nails
Fine downy hair growth on the skin (lanugo)
Low blood pressure and a slow heart rate
Cold sensitivity and persistent fatigue
Electrolyte imbalances that can be life-threatening

Psychological and Behavioral Signs

Obsessive preoccupation with calories, food, and weight
Distorted body image
Social withdrawal and isolation
Ritualistic behaviors around eating (e.g., cutting food into tiny pieces)
Excessive exercise despite physical weakness
Denial of the illness

Diagnosis

Diagnosis is based on a thorough medical and psychiatric evaluation. The primary diagnostic frameworks are the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) and the ICD-11 (International Classification of Diseases). The diagnostic process typically includes:

Physical examination including weight and height measurement (BMI calculation)
Blood tests to assess nutritional deficiencies and organ function
Psychological interviews and validated questionnaires (e.g., EDE-Q)
Exclusion of medical conditions that may cause weight loss

Treatment

Treating anorexia requires a comprehensive, multidisciplinary approach tailored to each individual:

Medical Stabilization

In cases of severe underweight or life-threatening complications, inpatient treatment is required to stabilize the body, restore nutritional status, and prevent organ damage.

Psychotherapy

Cognitive Behavioral Therapy (CBT) is one of the most evidence-based treatments for anorexia. Other effective approaches include family-based therapy (especially for adolescents), psychodynamic therapy, and Acceptance and Commitment Therapy (ACT). The goal is to address and restructure dysfunctional thoughts and beliefs about food, weight, and body image.

Nutritional Therapy

Structured dietary counseling helps individuals gradually rebuild healthy eating behaviors and meet the nutritional needs of their body.

Medication

No medications are specifically approved for anorexia nervosa. However, antidepressants or other psychiatric medications may be prescribed to treat co-occurring mental health conditions such as depression or anxiety.

Long-term Care and Relapse Prevention

Anorexia has a high relapse rate. Ongoing therapeutic support, self-help groups, and a stable social environment are key components of sustainable recovery.

Prognosis

Anorexia nervosa carries one of the highest mortality rates among mental health disorders. However, with early intervention and appropriate treatment, the chances of recovery are significantly improved. Many individuals are able to lead healthy, fulfilling lives with the right support.

References

American Psychiatric Association (2013): Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th edition. American Psychiatric Publishing.
World Health Organization (2019): International Classification of Diseases, 11th Revision (ICD-11). WHO Press, Geneva.
Treasure J., Claudino A.M., Zucker N. (2010): Eating disorders. The Lancet, 375(9714), 583-593.

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