Anorexia is a severe mental abnormality accompanied by an eating disorder. It is motivated by the desire to lose weight, as well as prevent weight gain. As a result, pathological passion, accompanied by a powerful fear of obesity, leads to a loss of 30 to 60% of body weight.
Features
Many patients with anorexia nervosa cease to critically evaluate their behavior, they do not pay attention to obvious dystrophy. They begin hormonal disorders, but convincing the patient of the need for therapy is an extremely difficult task. Some may be aware of their own exhaustion, but they have such a deep fear of eating food that they are already unable to restore their appetite without external help.
If you do not conduct special treatment, anorexia nervosa in 10-20% of all cases leads to death. This condition is considered to be a disease of stereotypes. Most often, it develops among those who belong to the wealthy strata of the population. Statistics say that every year the number of anorexia patients increases. Anorexia nervosa in men is extremely rare. About 95% of all patients are girls and women. At the same time, about 80% of all patients are 12-26 years old, and only 20% belong to a more mature age category.
In the ICD, anorexia nervosa has the code F 50.0. Its key symptoms are amenorrhea, a pronounced fear of obesity, and serious weight loss.
Risk factors
Anorexia is always accompanied by an obsessive desire to lose weight. It is a kind of syndrome when a person has a complete lack of appetite. Risk factors for anorexia nervosa are:
- Biological predisposition to psychological disorders.
- Intrapersonal conflict, which can be complicated by family difficulties.
- Social values equating the ideal of beauty to thinness.
What causes the disease?
Several factors lead to the onset of the ailment. The causes of anorexia nervosa are divided into three categories - biological, psychological and social.
- Genetic predisposition. When adverse environmental conditions occur, people with certain genes begin to suffer from mental disorders.
- Biological. This category of factors includes overweight, early onset of the first menstruation, dysfunction of some neurotransmitters (dopamine, serotonin).
- Personal. The likelihood of getting anorexia is higher in those who belong to the perfectionist-obsessive type, suffers from low self-esteem, self-doubt.
- Family problems can also cause anorexia nervosa. The risk of getting sick rises among people in whose family someone is suffering from depression, alcoholism, bulimia, drug addiction.
- Age. Teenagers and youths are most susceptible to the desire to please the opposite sex, the desire to imitate idols.
- Cultural. People living in large cities are often more willing to comply with the generally accepted canons of attractiveness and success, which are expressed in the slimness of the figure.
- Stressful. It can be physical, psychological or sexual abuse. Anorexia can also cause traumatic events - the death of a loved one, a divorce.
- Mental. There are many disorders that are accompanied by malfunctions in eating behavior - for example, schizophrenia.
Signs
As a rule, anorexia nervosa begins with the patient having an obsession: supposedly being overweight is the cause of all his troubles (lack of external attractiveness, parting with a lover, lack of career growth). Then the patient begins depression, leading to severe self-restriction in nutrition. Most often, patients tend to hide their problem from others (they can give food to a pet, shift part of the dinner back to the pot, etc.).
Constant malnutrition leads to another symptom. A person sometimes “breaks down” and begins to eat everything. At the same time, he reproaches himself and invents ways to limit the assimilation of food. For example, provoke vomiting, use laxatives, enemas.
Against the background of those changes that occur in the body due to malnutrition, a person loses the ability to be critical of his condition. Even after he or she achieves the desired result in getting rid of extra pounds, it starts to seem unsatisfactory. Anorexia sufferers set new “goals.”
Mental disorders
From the psyche, the following signs of anorexia may be observed:
- Lack of criticality regarding signs of exhaustion.
- A constant feeling of my own "fullness", the desire to lose weight more and more.
- Change the way you eat (eat in small portions or when standing).
- Excessive passion for food topics - collecting various recipes, diets.
- Panic fear of gaining extra pounds.
- Depression, irritability, decreased activity.
- Reducing the number of social contacts, isolation. Too many sports training. Reluctance to attend events that involve eating (e.g. birthdays).
Pathological ideas
One of the most characteristic signs of anorexia is reasoning like: “My height is 167 and my weight is 44 kg. However, I want to weigh 35 kilograms. ” In the future, the numbers become even smaller. Any results become the desired achievement, and a set of even a few kilograms can be considered as the absence of self-control.
Often people suffering from anorexia prefer to wear baggy clothes so that their appearance does not cause unnecessary questions from others who do not share their ideas about the “standard of beauty”.
Anorexia nervosa in adolescents
As a rule, girls in the children's psychiatric ward become girls who, with a height of about 1.5 m, can weigh 30 kg. They look very exhausted. Weight loss can be up to 30-40%. Parents should pay attention to the following symptoms of anorexia nervosa in adolescents.
- Refusal of food on a regular basis.
- Fear of a child to gain weight even with his lack, the dependence of self-esteem on weight.
- Denial of the problem ("Leave me alone! Everything is fine with me!").
- The disappearance of menstruation in girls.
- Reduced emotional background.
If you have these symptoms, you need to see a doctor - it is possible that the child will be diagnosed with Anorexia Nervosa.
Physical impairment
Over time, constant malnutrition leads to severe metabolic disorders, diseases of the internal organs. Initially, these are hormonal changes that are caused by decreased production of thyroid hormones, sex hormones and increased levels of cortisol. The consequences of anorexia nervosa can be:
- persistent weakness;
- in women - menstrual irregularities;
- decreased sex drive.
Then there are violations in the work of various body systems:
- dizziness, fainting, feeling cold, arrhythmia (may cause sudden death);
- immunity decreases, susceptibility to infectious diseases becomes higher;
- from the gastrointestinal tract there is dyspepsia, pain, peptic ulcer, gastritis, constipation, nausea;
- dry skin occurs, hair falls out, nails peel off;
- from the musculoskeletal system osteoporosis, an increased risk of fractures, muscle atrophy may be observed;
- there is a tendency to urolithiasis, renal failure.
Some of the symptoms described are manageable with timely and adequate treatment, but most of the consequences may be irreversible.
What causes excessive enthusiasm for cleansing procedures?
Excessive passion for inducing vomiting by artificial means or taking laxatives is also fraught with consequences:
- difficulty swallowing food;
- esophageal ruptures;
- weakening of the walls of the rectum;
- prolapse of the rectum.
Women's Health and Anorexia
Often, the onset of pregnancy with this violation can be extremely difficult. However, after the treatment, the level of estrogen in the body is restored, and conception is quite possible.
However, even after the therapy, the woman may have difficulties with the hormonal background:
- difficulty conceiving;
- high risk of fetal malnutrition, the presence of congenital malformations in the unborn baby;
- high risk of complications during pregnancy and childbirth;
- high risk of relapse of anorexia nervosa with news of pregnancy;
- with complex forms of the disease, the restoration of reproductive health does not occur on its own, and even after therapy, the woman is not able to become pregnant.
Stages
During the disease, the following stages are distinguished.
- Dysmorphomanic. The patient has painful ideas that he is inferior. These thoughts are associated with imaginary completeness. The emotional state becomes anxious, depressed. The patient can stand in front of a mirror for a long time, considering the shape of his figure, constantly weighed. At this stage, for the first time, he makes attempts to limit himself in food, begins to search for an “ideal” diet.
- Anorectic. The patient begins to attempt starvation and for this reason loses up to 30% of body weight. Such "successes" are perceived with a sense of euphoria. There is a desire to lose weight even more. The patient begins to torment himself with very high physical exertion, and eats, on the contrary, even less. He is trying to convince himself and loved ones that he has no appetite. At this stage, he is not critical of exhaustion and underestimates the consequences of his actions. Starvation and lack of nutrients in the body lead to the first somatic symptoms: hypotension, fainting, dry skin, hair loss. Metabolism is impaired. Failures in the physiological functioning of organs are accompanied by tissue breakdown, which leads to even greater appetite suppression.
- Cachectic. At this stage, irreversible consequences occur that are caused by dystrophy of the internal organs. As a rule, this stage begins 1.5-2 years after the first symptoms of anorexia nervosa. The consequences at this stage are most deplorable: the patient loses about 50% of body weight. If there is no treatment, organ dystrophy leads to the death of the patient.
Diagnostics
For those who monitor their psychological health, the question of how to treat anorexia nervosa is unlikely to ever become relevant. Therefore, we can say that the best way to treat this disorder is to prevent its development.
In the event that a similar diagnosis has already been made, therapy can be carried out by doctors of several specializations. Who should I contact with anorexia nervosa? This may be a psychotherapist, psychiatrist, as well as an endocrinologist. Often, a nutritionist is also connected to the treatment. Treatment is carried out in a hospital or at home.
Hospitalization is needed in the following cases:
- A decrease in body mass index is one third below normal.
- Increasing loss of body weight.
- Disorders in the work of the heart.
- Hypotension.
- Severe depressive states.
- Suicidal tendency.
Therapy Features
The main goal of treatment is aimed primarily at restoring the former weight. It is advisable that the patient add about 1 kg per week. Also, therapy is carried out aimed at eliminating mental and physical complications. It is very important that the patient is aware of the importance of treatment and himself takes part in his fate. The following factors can complicate the treatment process:
- Communication with friends, relatives, coaches who are delighted with thinness.
- Lack of emotional support from loved ones.
- The inability to overcome the belief that excessive thinness is the only way to deal with excess weight. Therapy, as a rule, includes several multidirectional methods.
Lifestyle change
To overcome anorexia, the patient requires the following changes:
- Regular intake of healthy foods.
- Adequate daily diet formation, menu preparation with the help of a professional nutritionist.
- Getting rid of the addiction of constant weighing.
- The exclusion of serious physical exertion (only after the condition is normalized, the doctor can include physiotherapy exercises in the schedule).
- Psychological support from loved ones.
Power recovery
This component of treatment is one of the fundamental in the fight against the disease. In order for the weight to increase, a special diet is prescribed for the patient. Its principle is that every day the calorie content of the diet should increase. First, it is 1000-1600 kcal per day. Then it gradually increases to 2000-3500 kcal. The patient should take food 6-7 times a day in small portions.
At the initial stages, the patient may feel anxiety, depression. Over time, these symptoms disappear.
As a rule, intravenous nutrition is not used in the treatment of anorexia, because in the future such methods can lead to difficulties in normal nutrition. And also patients can perceive these methods as compulsory treatment. However, in some cases, such measures are justified. For example, if a patient categorically refuses food for a long time, he has abnormalities in the cardiovascular system, bleeding from the oral cavity, etc.
Nutritional supplements
Patients suffer from a serious lack of vitamins, minerals, various nutrients. Treatment of anorexia nervosa at home must necessarily be supervised by a doctor. Relatives should understand that improving the diet and taking vitamins is one of the fundamental factors for recovery. If the lack of nutrients is filled, the mental and physical condition becomes much better. If necessary, diet therapy is supplemented by the use of special additives, dietary supplements. It can be:
- multivitamin preparations;
- Omega 3, fish oil;
- coenzyme Q-10;
- probiotics.
Other recommendations
To improve the absorption of nutrients, the following measures must also be observed:
- drink enough fluid every day (about 6-8 glasses a day);
- include protein sources in the diet - meat and dairy products, eggs, protein shakes;
- quitting smoking and drinking alcohol;
- the exclusion of caffeinated drinks;
- restriction of products that contain refined sugar - sweets, soda, etc.
Methods of working with a psychologist
As a rule, psychotherapy for anorexia nervosa is carried out in one of three directions: it can be behavioral, cognitive or family therapy. Behavioral causes the patient to gain weight. Cognitive aims at transforming the distorted ideas of thinking that led to the disease. Family psychotherapy is usually most effective for patients under 18 years of age. In some cases, work with a psychologist may be supplemented by the use of pharmacological preparations - Chlorpromazine, Fluosketin, Cyproheptadine. However, drugs are prescribed only in cases where working with a psychotherapist is not enough.
Hypnosis
In some cases, hypnotherapy can be part of the treatment. Sessions allow the patient to regain confidence in his abilities, increase resistance to stress. Hypnosis allows you to restore the right attitude to your body. As a result, this approach allows you to return to proper nutrition and normal life in general.
Exodus
As a rule, after treatment, recovery is observed. The course of the disease is relapsing. Death can occur without treatment in 5-10% of cases as a result of irreversible changes in the work of internal organs.
Anorexia is a fairly serious mental disorder. If it is found, you must immediately consult a doctor. Timely treatment will help to avoid terrible consequences. All information is given for familiarization, before the use of any drugs and methods, a specialist consultation is necessary.