The development of Anorexia Nervosa is considered the most deadly mental illness. It can affect people of all ages, genders, sexual orientations, races, and ethnicitys. People who have anorexia try to keep their weight as low as possible by not eating enough food or exercising too much, or both.
Anorexics tend to be perfectionists with obsessive, anxious, or depressive symptoms with their weight, diet, food, body image and exercise. They want to project the “perfect” image to the outside world. Their need to see the perfect number on the scale or eat the perfect diet can get extreme and become an eating disorder.
Perfectionism tendencies can look like: wanting to do everything in your power to avoid failure, constant seek of external approval, focusing on the achievement rather than the experience itself, feeling horrible and beating themselves up when they cannot reach their goals. There seems to be a lack of self-compassion for oneself, that makes it hard to be forgiving towards themselves when they make a mistake. Perfectionism can show itself in similar patterns with those who suffer from eating disorders; attempting to eat the perfect way (avoiding ‘bad foods’ and only eating ‘ good foods), having to follow a strict diet plan, obsessively counting calories to make sure they are not over or under their goal caloric intake and comparing one’s body/weight/shape/size and food/exercise habits to those who exhibit a good physique (models, fitness professionals or celebrities).
For many people with eating disorders, low self-esteem is a trigger in the development of eating disorders ( or a bad influence that can lead to a chaotic relationship with food and body). Individuals use anorexic coping skills to cope with stress, anxiety, and low self-esteem. Limiting food may gives them a sense of control over their life. Individuals with anorexia also have a distorted self-image of their body, (they may see themselves overweight even though they are skinny) and have an intense fear of gaining weight.
Obsessions and anxiety about food and weight creates monotonous eating rituals (and annoyance to be seen eating by others). Food rituals are compulsive ways in which a person interacts with their planned food; it produces a lot of anxiety when not followed. For instance, many people who have eating disorders tell themselves to eat very small bites of food at a time, and if they were to take big bites, they will feel extreme anxiety and feel like a failure. Some of the most common ritualistic eating behaviors include using abnormal condiment/seasoning combinations (e.g. carrots and mustard) to stimulate the senses, always talking about diets and labeling low calorie foods as healthy, choosing low calorie food options over desired ones and feeling superior when achieving it (e.g. only drinking sugar-free lattes), obsessive calorie counting, eating while doing a specific activity (e.g. needing to watch TV while eating) and never completely finishing a meal or snack; always leaving something on your plate.
Anorexia can lead to health problems caused by under-nutrition and low body weight. Consuming fewer calories than you need means that the body breaks down its own tissue to use for fuel. Typically, heart disease is the major cause of death in people with severe anorexia nervosa. The heart is a muscle that needs fuel to stay strong and function efficiently. When the body is starved of fuel, it shrinks and weakens. Anorexia nervosa is also associated with low bone mineral density (BMD), concerning for an increased risk of fractures, and decreased bone accrual in adolescents, concerning for suboptimal peak bone mass. Anorexia causes the male hormone testosterone to be low. Testosterone helps to keep muscles and bones strong. With weight loss, testosterone levels decrease and men will lose muscle mass. Even lifting weights, will not help to increase muscle mass in men with anorexia. They simply are not eating enough food to build muscle, and they also do not have enough of the hormone testosterone to help build muscle.
Disrupted eating behaviors negatively affect adequate nutrition absorption; thus, the brain does not get the nutrients it needs to function properly. This is especially concerning in adolescents, as brain development occurs through early adulthood – meaning that significant periods of growth could be disrupted. Research has found that eating disorders may cause: Parts of the brain undergo structural changes and abnormal activity during anorexic states, A shrinking in the overall size of the brain, including both gray and white matter, An adverse effect on the emotional centers of the brain may lead to depression, irritability, and isolation.
For the majority of people with an eating disorder, there comes a point when their lives become unmanageable and they make a decision to seek help. Recovering from an eating disorder will not be easy. Treatments for eating disorders are complex and multifaceted. Getting treatment can help them develop healthy and balanced eating habits. It can also help them see and cope with the underlying issues of their eating problems. Therapy may include nutritional counseling, weight restoration, medical stabilization, psychotherapy, and medication. If we never break an eating disorder rule, we can attempt to avoid the anxiety, fear, self-criticism and so many other painful thoughts and feelings that come from doing so.
The first step in treatment is talking to someone you can trust – it might be a member of your family, a friend, or your teacher, but most importantly it should be someone you feel comfortable with. A number of different talking therapies are available to treat anorexia. Therapy will be about helping yourself, how you can change a destructive pattern and see that you have the strength to break this negative cycle.
- Lloyd, S., Yiend, J., Schmidt, U., & Tchanturia, K. (2014, October 31). Perfectionism in anorexia nervosa: Novel performance based evidence. PloS one. Retrieved March 16, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216122/
- Mantilla, E. F., & Birgegård, A. (2015, August 25). The enemy within: The association between self-image and eating disorder symptoms in healthy, non help-seeking and clinical young women. Journal of eating disorders. Retrieved March 16, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549025/
- Medical complications of anorexia nervosa elsevier enhanced reader. (n.d.). Retrieved March 16, 2023, from https://www.researchgate.net/profile/Nicole-Sobotka/publication/342885141_Medical_Complications_of_Anorexia_Nervosa/links/61a90126092e735ae2d5b560/Medical-Complications-of-Anorexia-Nervosa.pdf
- Mehler, P. S., & Brown, C. (2015, March 31). Anorexia nervosa – medical complications – journal of eating disorders. SpringerLink. Retrieved March 16, 2023, from https://link.springer.com/article/10.1186/s40337-015-0040-8
- Levinson, C. A., Brosof, L. C., Ram, S. S., Pruitt, A., Russell, S., & Lenze, E. J. (2019, August). Obsessions are strongly related to eating disorder symptoms in anorexia nervosa and atypical anorexia nervosa. Eating behaviors. Retrieved March 16, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708491/
- Author links open overlay panelM.D. Joseph A. Silverman a b, a, b, This poorly understood disease has been studied in 27 girls and two boys. Metabolic aberrations included electrocardiographic abnormalities, WarrenM.P., PearsonH.A., MortonR., NelsonW.E., & BlissE.L. (2006, April 26). Anorexia nervosa: Clinical observations in a successful treatment plan. The Journal of Pediatrics. Retrieved March 16, 2023, from https://www.sciencedirect.com/science/article/abs/pii/S002234767480555X
- Resmark, G., Herpertz, S., Herpertz-Dahlmann, B., & Zeeck, A. (2019, January 29). Treatment of anorexia nervosa-new evidence-based guidelines. MDPI. Retrieved March 16, 2023, from https://www.mdpi.com/2077-0383/8/2/153
- The relationship between shame, perfectionism and anorexia nervosa: A … (n.d.). Retrieved March 16, 2023, from https://bpspsychub.onlinelibrary.wiley.com/doi/full/10.1111/papt.12425
- Perfectionism in Anorexia Nervosa: Novel Performance Based . Retrieved March 16, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216122/
- The relationship of self‐esteem and body … – Wiley Online Library. (n.d.). Retrieved March 16, 2023, from https://onlinelibrary.wiley.com/doi/abs/10.100
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Silan Eser is a clinical psychologist originally from Turkey, Istanbul. She has a bachelor of science in psychology from the University of London, Goldsmiths and Master of Science Degree in Clinical Psychology and Health Services from Goldmiths College.
After starting university, she found her passion in research in psychology, focusing on conspiracy theories and personality differences. She then established her own company, PsychCentre, a private mental health practice located in London. She diagnoses and treats mental, emotional and behavioral disorders. She currently resides in Istanbul, Turkey, where she is running her new company BetterMentalLife.