Anorexia nervosa (anorexia)

A healthy lifestyle and a conscious approach to food is in principle a good thing. However, when thoughts turn more and more to being slim, losing weight or compulsive weight control, anorexia is not far away. Often the disease develops unnoticed and insidiously. To get rid of it is difficult. The consequences can be fatal. We explain what is behind the term and clarify various causes, symptoms, treatment and therapy.

What is anorexia?
What are the causes of anorexia?
What are the symptoms of the disease?
How does the doctor recognize anorexia nervosa?
What treatment options and therapies are available?
How to find a way out of anorexia nervosa?
How to prevent the disease?

What is anorexia?

Anorexia nervosa (anorexia nervosa) is one of the psychological eating disorders and is a psychosomatic disease: Psychological processes are closely related to the physical suffering. In Germany is about one in 100 people at Anorexia nervosa diseased. Women are significantly more likely to be affected by the disease than men, although the proportion of male anorexics is increasing. girls and women between 14 and 24 years Are particularly prone to becoming "addicted" to starvation and weight loss.

Externally, an anorexic person is characterized by a extremely low body weight and a Disturbed eating behavior From. Although she eats almost nothing, she is constantly preoccupied with food intake, she knows the calorie content of numerous foods by heart or cooks for her family without eating herself. Doctors refer to this as a "restrictive subtype".

An even more pronounced form of the disease is exhibited by the "Purging type" on: He pursues various measures to lose even more weight, such as excessive sports. In winter, it deliberately exposes itself to great cold, lightly clothed, in order to burn calories by freezing. Some "purging types" take thyroid hormones to stimulate their metabolism or swallow dehydration tablets (Diuretics), to continue losing weight. Hunger is alleviated by chewing ice cubes or swallowing cotton balls.

To distinguish Anorexia nervosa from bulimia (Bulimia nervosa), a binge eating disorder. compulsive overeating followed by self-induced vomiting is another form of eating disorder, but it can develop into anorexia nervosa.

Anorexics often do not recognize anorexia because of a body schema disorder: an distorted self-perception ensures that they still feel too fat on severely underweight. enormous self-control and the obsessive control over one’s own body weight takes the diseased person in such a way that Outsiders have little access can provide. In addition, anorexia often occurs on the Internet, on so-called "Pro Ana" The "weight loss" is touted as a lifestyle to strive for, encouraging the disordered eater to lose more and more weight, to the point of acutely endangering their life.

In order to continue losing weight, many anorexics do an extreme amount of sport

Many anorexics cannot spend a day without excessive exercise. (c) Monet / Fotolia

What are the causes of anorexia?

The causes are many. Both social, societal and psychological as well as hereditary factors can be causal. Fashion trends, advertising, media influences (z.B. by model casting shows), influences from the social environment, such as bullying at school, are often reasons for dissatisfaction with one’s own body. Traumatic experiences such as violence, sexual abuse, or the death of a loved one can leave you feeling like you have lost control of your life. With compulsive weight control, sufferers then try to be self-determined at least in this area of life.

The Puberty is a time when many adolescents do not feel up to their current stage of life. The child’s body is developing into that of a young adult. Some teens do not feel ready for these changes. A self-induced rapid weight loss can be the result. By losing body fat, the subconscious Desire to maintain the childlike figure, be achieved.

Often, the family environment also influences the behavior of young eating disorders. For example, some parents high expectations to their offspring and exert a strong performance pressure on them. They are very possessive and try to mold the girl or boy according to their own ideas (meshing). In case of disappointment, they react with emotional coldness and shy away from the open confrontation with negative feelings such as fears or anger. As a result, affected adolescents may try to lose weight via severe weight loss and weight control more independence to attain.

Great ambition can also be an anorexia cause. Often affected people are particularly perfectionistic people who link their self-esteem to the achievement of certain performances. Through their own self-mortification, the feeling of power and strength arise. A feeling that drives addiction with every kilo lost. Sports or professions that require a low body weight can also exert great pressure and thus increase the risk of developing an eating disorder.

Studies also show that relatives of those affected (especially twins) have a significantly higher risk of developing anorexia. However, it has not yet been possible to identify precisely which gene is responsible for this.

What symptoms trigger the disease?

The eating disorder can cause numerous psychological and physical symptoms. Here is an overview of the most common effects:

  • Often Desired social isolation the affected person becomes conspicuous, caused by depression.
  • A typical feature in young women is frequent Absence of periods (Amenorrhea) – unless they take the contraceptive pill. Reason for infertility is the disturbed hormone balance. In most cases, pregnancy is not possible under these conditions. In men, potency and libido decline.
  • In adolescents it comes to Developmental disorders, such as stunted growth or lack of or delayed sexual maturity (Pubertas tarda).
  • The nutrient deficiency that follows from malnutrition leads to dry skin, brittle nails and hair loss.
  • The lack of nutrients can also lead to disturbances in bone metabolism. Brittle bones (Osteoporosis) and tooth loss are resulting dangers.
  • Cardiac arrhythmias (often due to a potassium deficiency), a slowed heartbeat or low blood pressure, which in the worst case can lead to sudden cardiac death.
  • The gastrointestinal tract becomes sluggish, constipation and cramps occur.
  • A low body temperature, because heat-insulating subcutaneous body fat is missing and metabolism has slowed down. As a result often grow downy hair (lanugo hair) to protect the body from cold.
  • Brain shrinkage, as well as Functional disorders of the kidneys and liver may occur.

The proportion of male anorexics is increasing

Anorexia also affects more and more young men. (c) Africa Studio / Fotolia

How does the doctor recognize anorexia??

Because anorexics often do not admit their illness, few seek medical help of their own accord. Relatives can at least try to persuade the patient to see a doctor with a lot of tact and sensitivity.

The first point of contact is usually the Family doctor. In a detailed diagnostic interview, he first checks the patient’s general condition and asks the following questions, for example:

  • How much do you weigh?
  • Feel that you are too fat?
  • Do you want to lose weight?
  • Do you have physical complaints?
  • Do you have cycle disorders? (in female patients)

Then the general practitioner measures body height and weight. These two values are put in relation to each other and the body mass index is determined. With a BMI below 17.5 kg/m² begins underweight, high-grade underweight is below 16 kg/m² (grade I) and acute life-threatening underweight is below 13 kg/m² (grade II) – in this case, affected persons should be treated immediately as inpatients. In children and adolescents who are in the process of growing, instead of using BMI, so-called BMI percentile tables Measured whether there is any underweight.

In addition, the doctor can check blood pressure and pulse, measure blood and liver values, check the body’s salt balance and test cardiac performance. All these examinations are important to see, for example, whether organic damage has already been caused by the Anorexia nervosa are developed.

It also makes sense to talk to a Specialist in psychiatry or psychotherapy. He can use special diagnostic questionnaires to make a psychopathological finding and diagnose whether a mental illness is present.

What treatment options and therapies are available?

Often the cure requires a inpatient anorexia therapy in a special clinic. Only rarely can a short treatment cure the affected person completely. In the meantime, however, there are also more and more clinics that offer outpatient therapy, which also has prospects of success. However, this must be done on a long-term basis.

In case of life-threatening underweight, natural rapid weight gain (often by means of force-feeding) is essential. However, the goal should always be to correct disturbed self-perception and the to treat psychological addiction. Weight gain should at best be in accordance with the patient’s will. Experts such as psychotherapists, psychologists, nutritionists and also physiotherapists can help with this, To get back to a healthy eating behavior. It is important that those affected no longer see their body as an adversary and develop a new body awareness.

Helpful is also a focal psychodynamic therapy, in which patients learn to better manage their emotions, process negative experiences and work on their social skills. In younger people with eating disorders, there may also be a systemic-family-therapeutic treatment make sense: Here, for example, the whole family learns to establish new family rules and to deal with conflicts more openly. This can have a positive effect on a disturbed parent-child relationship.

In some cases Antidepressants prescribed, as the eating disorder is often accompanied by depression or social anxiety.

In general, when dealing with anorexia, it is always important to keep in mind: The cure starts in the head! It is therefore all the more important to find out exactly what triggers the illness and to eliminate it.

Unresolved conflicts in the family can promote eating disorders

Unresolved conflicts in the family can promote eating disorders. (c) JackF / Fotolia

How to find a way out of anorexia nervosa?

It can take several months, even years, for those affected to overcome anorexia. About half of all anorexics can be permanently cured (after 5 years they are considered to have been successfully treated), but about 20 percent keep getting Relapses. In these cases, the risk of death is considerably increased. Overall, around 15 percent of all sufferers die as a result of anorexia complications or through suicide.

Many addicts, like other addicts, have to fight their addiction for the rest of their lives fight addictive cravings. They are often no longer able to eat without inhibitions. Regular sessions with psychotherapists and an open exchange in self-help groups can help to avoid a renewed slide into the eating disorder and to get the disease under control in the long term.

How to prevent the disease?

There Anorexia nervosa can have many causes, prevention is not always possible. However, the family environment can help to reduce the risk of anorexia nervosa. For example, parents should not demand too much performance from their offspring, but should model for them that Love not bound to perfection and outward appearances is.

An eating disorder often begins insidiously. At the beginning, there is a harmless diet, but this is carried out increasingly more radically. Mothers and fathers should therefore not single-handedly encourage their children to diet, should not put them under pressure, but should give them a joyful, uninhibited contact with food and balanced diet example. This is more effective and healthier than any diet. Children and adolescents who are actually very overweight should consult a doctor with their parents, and not start a radical weight loss cure on their own.

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