Often anorexia begins with a harmless diet to get rid of some extra pounds. But the transition to anorexia can be fluid. If the weight continues to fall and the eating behavior gets out of control, professional help in the form of psychotherapy is usually necessary.
Especially girls and young women are at risk of suffering from anorexia - but men can also be affected. The disease can be life threatening. Early treatment significantly improves the chances of recovery.
What is anorexia?
Anorexia is one of the eating disorders along with bulimia (eating crushing addiction, bulimia nervosa) and binge eating disorder. These mental illnesses are characterized by a pathological handling of food intake.
Anorexia is defined as a body mass index (BMI) of less than 17.5 kg / m². Other criteria for diagnosing are self-induced weight loss, a body disorder in which feel the affected despite being underweight too thick and hormonal disorders as a result of malnutrition. If not all of these criteria are met, experts speak of atypical anorexia.
Binge eating in bulimia and binge eating disorder
In contrast to anorexia, bulimia does not focus on starvation, but on binging with subsequent deliberate vomiting. Common to both eating disorders is the morbid anxiety to increase, as well as the constant mental dealing with food.
Binge eating disorder is also characterized by binge eating. However, since there is no subsequent countermeasure such as vomiting, the patients are usually overweight.
Orthorexia: morbidly healthy diet
A newly emerged form of the eating disorder is the so-called Orthorexie: Here, the concerned compulsively pay attention to a healthy diet and strictly refuse in their eyes unhealthy food.
Long-term consequences can be malnutrition and social isolation. However, orthorexia is not yet a recognized disease.
Who has anorexia?
Anorexia is especially common among teenagers and young women. But even men can be anorexic. However, this is much less the case, as women are affected about ten times as often.
As a rule, the disease begins between the age of 10 and 25, but usually at puberty of 13 to 16 years. In Germany, about 1.4 percent of adults suffer from anorexia - the result of a representative study in 2013. However, frequency data vary greatly in this regard. In addition, especially in the case of eating disorders, the number of unreported cases is enormously high.
Slimming mania as a cause?
Various causes can lead to the development of anorexia. The genes seem to play a role, because in identical twins, both siblings are affected in up to 50 percent of the cases. Also, biological factors such as changes in neurotransmitters may be involved.
In addition, trauma in childhood, disturbed conflict handling in the family or overprotected education can contribute to the development of anorexia. Whether the spread of the slim ideal of beauty in media and society can promote or cause anorexia is controversial.
How do you recognize anorexia?
The transition from a diet to anorexia is often insidious. But when does one speak of anorexia? Alarm sign is the so-called body disorder (Body Dysmorphia): anorexics are found despite obvious underweight to fat and want to continue to lose weight.
Another characteristic of anorexia is the strict control of food intake, whereby "thicker" foods are usually avoided. Important is the difference to pure underweight: Often underweight are referred to as anorexic, although they have a normal eating behavior.
Anorexia: Possible symptoms
In addition to the main feature of "underweight self-induced weight loss" can show anorexia in various forms. Other possible symptoms include:
- long fasting periods
- excessive sport
- Abuse of medications such as laxatives, drainage tablets, thyroid medications or appetite suppressants
- intentional vomiting with or without previous bingeing
- strict control of body weight with very low target weight
- panic afraid of gaining weight
- Hiding weight loss - such as loose clothing or hidden weights when weighing
- very slow food or even thought-out "food rituals"
- constant mental work on the topics of weight and nutrition
Not infrequently, anorexics additionally suffer from mental symptoms or illnesses such as depressive mood, compulsive behavior, anxiety disorders or personality disorders. This can create a vicious circle that may worsen anorexia.
Episodes of Anorexia: Physical Symptoms
Since the body gets too little energy and nutrients in anorexia, it often comes to physical deficiency symptoms or in severe cases even permanent damage.
The short-term consequences of the reduced energy intake include, for example:
- Freezing, cold hands and feet
- a headache
- low blood pressure, slow heartbeat
- sleep disorders
- Concentration problems, reduced performance
In the case of long-term malnutrition energy and nutrient deficiencies can lead to the following physical changes:
- dry, flaky skin
- brittle nails
- hair loss
- fluffy hair all over (Lanugo hair)
- Exposing the period by lowering the sex hormone level
- reduced interest in sexuality (loss of libido)
- Potency disorders in men
- Cardiac arrhythmias (such as potassium deficiency in vomiting and misuse of laxatives or dehydration tablets)
- kidney damage
- Tooth damage (due to calcium deficiency or vomiting)
- Infectiousness due to weakening of the immune system
- Water retention due to lack of protein
- Loss of brain tissue with impaired concentration, memory impairment or change in nature (usually normalizes when reaching normal weight)
Increasing: acute treatment of anorexia
The treatment of anorexia is composed of the treatment of physical symptoms and psychotherapeutic support. Depending on the degree of underweight, the stabilization of the physical condition is paramount.
For this, the patients have to increase body weight depending on the BMI and possible deficiency symptoms such as electrolyte disturbances are compensated. In severe cases, inpatient admission to a clinic makes sense. If there is a lack of insight into the disease, force-feeding with a nasogastric tube may be necessary.
Psychotherapy: core element of the treatment
Psychotherapy - for example in the form of a so-called cognitive behavior therapy - is essential in the treatment of anorexia. Because in most cases, a cure of the disease is possible only with psychological support.
The patients learn how to accept their body and are gradually introduced to a normal eating behavior and life after anorexia. Often, a treatment contract is designed in which treatment goals - such as a certain weekly weight gain (usually 500 to 1, 000 grams) - are recorded.
Therapy: Medication only in concomitant diseases
In addition to psychotherapy, group or art therapies may be used. Especially with children and adolescents the inclusion of relatives - for example in the form of a family therapy - is very important.
On the other hand, medications that affect the psyche (known as psychotropic drugs) are only used in cases of anorexia, such as depression. The duration of treatment for anorexia depends on the success of treatment and varies for each patient.
Early treatment increases chances of recovery
Decisive for the prognosis of anorexia is the early onset of therapy. In addition, it is generally true that the more pronounced the weight loss is and the older the person affected at the onset of the disease, the more frequently relapses occur.
The cure rate of anorexia is given as about 50 to 70 percent. In contrast, there is a death rate of about 5 to 20 percent, in addition to the physical damage caused by extreme underweight suicide is a frequent cause of death in anorexic patients.
Help service on the Internet
Patients with anorexia nervosa are usually reluctant to see a doctor and do not know whom to contact. Here the Internet offers numerous information offers for those affected as well as advice for the parents. Also addresses of counseling centers and tests for initial assessment ("Am I anorexic?") Can be found online.
The following links provide further information and help with anorexia:
- Federal Center for Health Education
- Hungry online
- Patient Guideline Diagnosis and Treatment of Eating Disorders
- Anorexia - self-help with eating disorders
Pro Ana: Dangerous Exchange on the Internet
The Internet offers sufferers low-threshold and free exchange platforms - but also in the negative sense: "Pro Ana" is an anorexia movement that originated on the Internet at the beginning of the 21st century and whose goal is not the fight against the disease, but the further weight loss.
On blogs and in forums, the disease is idealized and personalized in the form of "Ana" (derived from anorexia). Anorexics give each other tips for losing weight and concealing the disease and motivate each other - for example, with pictures of themselves or by underweight models (so-called "thin inspiration").