Anorexia nervosa is an eating disorder characterized by an unrealistic perception of ideal body weight, resulting in extreme food restrictions and exercise to shed calories. This obsession to attain a certain body shape interferes with the affected individual’s personal life and day-to-day tasks. Such behaviors continue regardless of weight changes and are accompanied by feelings of low self-worth. This article discusses anorexia nervosa, its causes and symptoms, and effective therapies and treatment options.

Anorexia nervosa symptoms
Physiological symptoms
Fatigue
Fatigue results from undereating, overexercising, and lack of nutrients in the body and can also occur due to induced purging and vomiting.

Skin dryness
Dehydration and malnutrition can lead to skin dryness and even discoloration.

Lanugo
Lanugo refers to the growth of tiny hair strands all over the body. Individuals with anorexia have low body temperatures due to a lack of food intake. These fine hair strands develop to regulate body temperature.

Arrhythmia
Starvation significantly alters the heart rhythm, as the body needs to slow down its processes for energy conservation. Sometimes, acute arrhythmia can result in heart failure and even death.

Amenorrhea or irregular periods
When the body does not receive adequate nutrition, its hormone levels decrease, causing a stoppage of menstruation (amenorrhea) or irregular periods.

Nausea, vomiting and bloating
Stomach issues like nausea, vomiting, abdominal pain, and bloating are common among patients with anorexia. This is because purging and extreme food restrictions can alter the body’s natural excretion process, leading to digestive issues.

Psychological and behavioral symptoms
Starving or loss of appetite
Individuals with anorexia typically starve themselves to achieve a certain unrealistic body weight. Such malnourishment deprives them of essential nutrients.

Irritability
Starvation can cause extreme changes to one’s temperament, leading to mood swings, irritability, and even depression.

Illusions of being overweight
People with anorexia often perceive themselves as overweight, even though they might be of ideal weight or even underweight. Such negative self-perception causes them to impose more strict food restrictions on themselves, worsening their symptoms.

Induced vomiting and purging
Patients with anorexia may induce purging or vomiting to empty their stomachs in an attempt to maintain body shape. Laxatives may be used for this purpose, causing extreme fatigue and digestive problems.

Over-exercising
Over-exercising is a common behavioral symptom among individuals with anorexia. Extreme physical activity to attain an idealistic body shape can have serious repercussions.

Causes of anorexia nervosa
Genetic factors
Studies have shown that mutations to chromosome 1, which governs appetite, anxiety levels, susceptibility to depression, etc., are responsible for the onset of anorexia nervosa. Family studies reveal that individuals having first-degree relatives with anorexia are 10 times more likely to develop the condition than those with no such close relations.

Extreme perfectionism
Individuals with perfectionist tendencies have idealistic standards in every sphere, including their bodies. Their constant attempts to attain this idealistic standard can culminate in eating disorders like anorexia.

Societal and familial pressures
Societal standards of ideal weight may influence people to over-exercise and restrict their food intake considerably, culminating in anorexia nervosa.

Childhood trauma
Studies have shown that individuals with childhood histories of trauma, particularly physical, sexual, or emotional abuse, are likely to have negative perceptions about their bodies, often contributing to eating disorders like anorexia.

Psychotherapies for anorexia
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is based on the view that changes in thoughts can influence behavioral changes. CBT is one of the most commonly recommended therapies for anorexia, involving slow but steady exposure to self-restricted foods and constant motivation to overcome one’s negative self-image and unrealistic weight perceptions.

Family-based therapy
Family-based therapy, or FBT, is an intervention particularly effective among children and adolescents. FBT integrates narrative, behavioral, and structural family therapies to analyze the root cause of the condition rather than placing blame on family members. It works with clients and their families to find solutions and perpetuate healthy eating habits.

Maudsley anorexia nervosa treatment for adults (MANTRA)
MANTRA combines individual, and group therapies, wherein the former helps understand specific problems contributing to the condition, setting individual goals, and monitoring progress, while the latter involves activities like collaborative problem-solving, disclosure of “shameful” acts in a safe environment, and practicing compassion toward oneself and others.

Special supportive clinical management
Special supportive clinical management (SSCM) is a therapeutic approach involving two main components – clinical management, focusing on the inclusion of self-restricted foods and subsequent increase in weight, and supportive therapy to address specific issues highlighted by the client. Clients learn to associate their unhealthy eating habits with their anorexia symptoms, which helps them manage their habits systematically.

Anorexia nervosa can result from a combination of genetic and environmental (sociocultural) factors triggering low self-worth and idealistic body perceptions. A systematic treatment plan and a loving family environment are essential for a steady recovery from this mental health condition.