Eating disorders in adolescents are a major concern for parents, and while the physical symptoms of body image disturbances are evident, eating disorders are fundamentally psychological problems. Anorexia nervosa, especially common among young women, is rarely seen in men. Studies indicate that about one in every thousand teenage girls suffers from this disorder, where the individual, due to a fear of gaining weight, refuses to eat and may face severe health problems or even death.
What is Anorexia Nervosa?
Anorexia nervosa is a psychological disorder characterized by abnormally low body weight and poses a life-threatening condition. Individuals suffering from this disorder are obsessively preoccupied with staying thin and typically weigh far below the normal range for their age and height. This disorder is most commonly observed in girls aged 12 to 20. Despite eating very little, individuals with anorexia nervosa are often very active and sleep little. They refuse to eat and may start by following very low-calorie diets, initially controlling their appetite, but eventually losing it entirely, leading to severe weight loss.
Symptoms of Anorexia Nervosa
People with anorexia nervosa develop unique eating behaviors to lose weight. The disorder is often identified when physical symptoms become apparent. They have an intense fear of gaining weight and follow extremely restrictive diets, despite being underweight. Common behaviors include:
- Removing carbohydrates entirely from their diet.
- Avoiding meals by hiding during mealtime, making excuses to leave the table, constantly thinking about food, collecting recipes, cooking for others, and refusing to eat in front of others.
- Engaging in peculiar and secret eating rituals.
- Persistent weight loss without any underlying illness.
- Frequently weighing themselves, wearing loose clothing to hide thinness, never believing they are thin enough, and being constantly concerned about their weight.
- Vomiting after meals, using diet pills, diuretics, or laxatives to purge what they’ve eaten.
- Exercising excessively as a form of self-punishment and spending prolonged periods in the bathroom.
Causes of Anorexia Nervosa
Anorexia nervosa does not have a single cause. It is a disorder commonly seen during adolescence, possibly emerging from difficulties young individuals face in adjusting to the changes of puberty. A combination of environmental, psychological, and biological factors contributes to the progression of the disorder. If left untreated, it can lead to fatal consequences.
Biological Causes
Individuals with anorexia nervosa often have sensitive, determined, and perfectionistic personalities. While there is no definitive evidence of a genetic predisposition, having a family history of anorexia increases the risk.
Psychological Causes
Improper eating behaviors during infancy and childhood can pose risks for developing anorexia in later stages of life. The disorder is more common in shy, depressive, submissive individuals, or those with obsessive-compulsive personality traits. Anorexia nervosa is also more frequently observed in individuals with a lack of a strong emotional bond with their parents and in women with a history of sexual abuse.
Environmental Factors
The emphasis on thinness in the fashion world particularly impacts adolescents negatively. In the pursuit of a slender body, young individuals often begin dieting and develop an obsession with being thin. Professions such as dancers, ballerinas, models, and jockeys face constant pressure to maintain a certain weight due to career demands, increasing their risk of developing eating disorders.
Diagnosis of Anorexia Nervosa
The diagnosis of anorexia nervosa requires attention to the presence of other illnesses that might cause significant weight loss. Besides weight loss, patients often exhibit psychiatric symptoms such as mood swings, loss of sexual desire, low self-esteem, introversion, obsession, social phobia, and depression. Sensitivity to cold, low blood pressure, constipation, slow gastric emptying, and bradycardia (slow heart rate) are also indicative of anorexia nervosa. Potassium deficiency due to vomiting or diuretic use can lead to heart arrhythmias. Additionally, a decrease in leukocytes in the blood, anemia, menstrual irregularities, cessation of menstruation, reduced bone density, and osteoporosis due to low estrogen levels may occur. Binge eating followed by vomiting can result in gastric dilation or rupture. A comprehensive evaluation of the patient’s clinical and psychological symptoms is necessary to diagnose anorexia nervosa.
Treatment Methods for Anorexia Nervosa
Treating anorexia nervosa requires a multidisciplinary approach involving a team of professionals, including psychiatrists, dietitians, psychologists, orthopedic specialists, endocrinologists, physiotherapists, and nurses. The involvement of the patient’s family in the treatment process is crucial for success. It is essential to clearly explain the physical and mental effects of reaching a healthy body weight. Convincing the patient and helping them understand the impacts of their illness are vital steps. If the patient has lost more than 30% of their ideal body weight, hospitalization is usually recommended, and weight gain is closely monitored. Psychotherapy sessions, including family therapy, can help individuals regain their sense of identity and self-esteem. Once the patient reaches a healthy weight, they may be discharged from the hospital. However, due to the high risk of relapse, continuous follow-up is necessary.