What is Anorexia Nervosa?
Anorexia Nervosa is a health problem in which sufferers are obsessed with having a thin body and are very afraid if they look fat. Because of the fear, their bodies are always considered to be still not thin or still fat even though in reality it is not like that.
The age of sixteen to seventeen years is considered a vulnerable age for this disorder to begin to appear, and the majority of people with anorexia come from young women and women.
To keep their bodies as thin as possible, people with anorexia will try hard to limit the portion of food to a minimum and exercise excessively. Some of them will even try to regurgitate the food that has been consumed.
Symptoms of anorexia nervosa and other related psychological problems
Those who suffer from anorexia can be recognized by the following symptoms:
- Significant weight loss and looking very thin.
- Always pay attention to the shape of the body in front of the mirror.
- Weighing the body almost all the time.
- Frequent vomiting of food that has been eaten.
- Likes to lie when asked if they have eaten.
- Take into account the amount of calories, fat, and sugar in the food.
- Frequently exercising excessively.
- Experiencing health problems as a result of anorexia itself, such as fatigue, dehydration, low blood pressure, dizziness, hair loss, and dry skin.
- Likes to take laxatives and appetite suppressants.
Causes of anorexia nervosa
The exact cause of anorexia nervosa is still unclear. Most specialists believe that the disorder stems from a combination of factors, such as psychological, environmental, as well as genetic or biological factors.
Diagnosis of anorexia nervosa
In diagnosing anorexia nervosa, the doctor will usually ask about the patient's weight and diet to determine if he has an eating disorder. It is important for the patient to answer these questions honestly. Doctors don't mean to judge the patient, but just want to determine the exact condition.
Support people with anorexia to want to get help
If you have family or friends who are anorexic, approach it gently and then persuade them to seek medical attention. Persuading people with anorexia to want treatment is not easy. Usually they will assume that what they have done is the right thing and will refuse to admit that they are actually in trouble.
That's why patience and continuous support play a very important role in the recovery of anorexic sufferers. Never criticize or pressure them as this will only make the situation worse. Convey that your persuasion and support is solely out of concern for their health.
Anorexia treatment at a glance
Most cases of anorexia are treated on an outpatient basis and a few other cases, for example cases of severe anorexia, are treated with hospital care. In addition to making sufferers aware that the lifestyle they are living is wrong, this treatment aims so that they can safely regain their ideal weight.
Things that cover the treatment of anorexia include psychological therapy and advice related to food and nutrition. In order for treatment to be carried out properly, doctors must adjust to the physical, psychological, and social conditions of the person with anorexia. Treatment of anorexia can not be done instantly. To fully recover, it can take several years.
Complications that may occur
Anorexia can cause other health problems that are quite serious if not treated successfully in the long term. Some of the complications of anorexia nervosa are:
- Irregular heartbeat
- Heart failure
- Menstruation is not smooth
- Anemia
- Kidney failure
- Infertility
- Osteoporosis
- Constipation
- Death due to malnutrition or suicide
Symptoms of Anorexia Nervosa
Since people with anorexia are so obsessed with losing their weight as low as possible, the main symptom of this condition is a drastic drop in weight that is below a healthy limit.
In an effort to fulfill their obsession with being very thin, people with anorexia will do various things, including limiting food portions, vomiting back food that has been eaten, and lying when asked if they have eaten.
People with anorexia generally always wear loose-fitting clothes and routinely measure, weigh, or observe their bodies in front of the mirror. In addition, they will often exercise excessively and take appetite suppressants or laxatives.
From these symptoms, it is clear that anorexia is not only a physical health problem, but also a psychological problem.
Dissatisfaction with body weight makes people with anorexia lack self-confidence. They feel that their self-esteem is affected by their weight. As a result, this lack of self-confidence makes them isolate themselves and are no longer interested in socializing with other people. Because of that, not a few people with anorexia end up having problems in their relationships with other people, especially in family, friends, education, and work.
Health problems that arise
Health problems felt by people with anorexia are caused by a lack of food intake, especially in the long term. Some of these health problems are:
- Headache and dizziness
- Bloated
- Constipation
- Fatigue
- Hands and feet that look discolored due to poor circulation
- Fever
- Hair loss
- Dry skin
- Problems with physical growth and puberty in children and adolescents
- Insomnia
- Irregular heartbeat
- Dehydration
- Low blood pressure
- Growth of fine hair all over the body
- Nails that break easily
- Stomach ache
- Menstrual disorders in women.
Causes of Anorexia Nervosa
The exact cause of anorexia is still unclear. Most specialists believe the disorder arises from a combination of factors, such as psychological, environmental, and genetic or biological factors.
Psychologically, fear and worry about being fat has created an obsession and a strong urge in anorexics to lose weight. In addition, people with anorexia are also more emotionally closed and easily stressed.
Environmental influences on anorexia nervosa
The mindset that is formed due to environmental influences can trigger anorexia, an example is advertising in the mass media. In this day and age, a thin body is considered an absolute requirement of beauty. This thought was then strengthened and disseminated by advertising, so that not a few people were affected, especially teenagers.
The reason why people with anorexia are mostly teenagers is the many body changes, hormonal changes and times of stress or anxiety. At this time, teenagers' self-confidence is so low that they are often indecisive and easily influenced. In addition to the effects of hormones, the ridicule and pressure experienced by a teenager at school can also trigger anorexia.
Meanwhile, anorexia nervosa can also arise due to job demands and disappointing events, such as a breakup.
Anorexia due to genetic and biological factors
Someone who has a family history of eating disorders, depression, or drug addicts, is believed to have a greater risk of developing anorexia.
In addition to heredity or genetics, anorexia is thought to occur due to changes in hormone levels and brain function as well. These changes may affect the part of the brain that controls appetite or trigger feelings of guilt and worry from overeating.
Diagnosis of Anorexia Nervosa
In diagnosing anorexia, the doctor will first ask about the patient's diet and weight, for example how much he is concerned about his weight and whether he often vomits back the food he has consumed.
After that the doctor will also collect data about the patient's weight, especially if the patient has experienced significant weight loss.
To determine a healthy weight, the doctor will calculate the body mass index or body mass index (BMI). BMI is a weight calculation that refers to the ratio of a person's weight and height. The benefit of calculating BMI is to find out whether a person is overweight, underweight or at a healthy weight.
The formula used in calculating BMI is body weight in kilograms divided by body height in meters squared (m²). For example, if the patient's weight is 66 kilograms and his height is 1.65 meters, then the calculation is 66/1.65×1.65 = 24.24 kg/m²
The normal BMI for Asian adults is 18.5-22.9 (kg/m2), while the normal BMI for children and adolescents depends on their age. In adults, anorexia can be suspected if the BMI is below 17.5.
There is no specific test in the diagnosis of anorexia
Doctors may not need to perform special tests to diagnose anorexia nervosa, but usually the doctor will perform a simple examination to determine if the patient has complications due to anorexia. Things that need to be checked by a doctor are:
- Blood pressure
- Pulse
- Hands and feet
- Body temperature
Doctors will also usually ask the patient to perform simple physical movements to see the strength of the patient's muscles. Simple physical movements in question are such as squatting, standing, and shifting when sitting.
A person is prone to heart problems if he has anorexia. One of these heart problems is an irregular heartbeat. Usually to determine this, the doctor performs an electrocardiogram examination.
Anorexia Nervosa Treatment
Sometimes treatment must be done by force if the condition of anorexia has entered a dangerous stage and threatens the life of the sufferer. In cases like this, the family should immediately take the sufferer to the hospital so that it can be treated quickly.
Treatment of anorexia nervosa is usually done by combining psychological therapy with supervised weight recovery. It is very important to initiate treatment as early as possible, especially if the patient has lost a large amount of weight. In addition, prompt treatment can reduce the risk of complications.
Handling anorexia through psychological aspects
A number of psychological treatments can be applied to treat anorexia. Usually treatment will last from half to a year or even longer, depending on the condition of the sufferer or the severity of the anorexia. Below are described a number of therapies that are performed as part of treatment.
Analytical cognitive therapy by tracing the patient's past
This therapy is based on the theory which states that mental health problems including anorexia are caused by unhealthy thought patterns and behaviors that have been formed since the patient was a child or teenager. This therapy involves a three-step process.
The first stage is reformulation. In the reformulation stage, the therapist will usually find out what the patient's past experiences might be the reason why these unhealthy patterns can develop.
The second stage is introduction. A therapist will help the patient see and understand how these unhealthy patterns contribute to anorexia.
The third or final stage is revision. At this stage, a number of changes that can stop these unhealthy patterns are identified, assessed, and then implemented.
Changing negative thought patterns with behavior therapy
A person's behavior is usually the fruit of his mindset. Vice versa, behavior can shape the mindset as well. There are many unrealistic things that are believed to be true by anorexics. For example they feel their self-esteem depends on their weight. They are very afraid of being ridiculed or not appreciated by others because they are considered fat.
Therefore, through cognitive behavioral therapy, the therapist will try to help the patient change negative thoughts about food and appearance into a positive and realistic thought pattern, so that the patient's deviant behavior is expected to disappear.
Interpersonal therapy that examines the environment of the sufferer
This therapy is based on the theory of the relationship between the environment and anorexia, where the environment and people around have a very strong influence in shaping the psychological state of the sufferer. The theory concludes that low self-confidence and anxiety experienced by sufferers arise from their interactions with the people around them.
During this therapy, the therapist will try to examine the negative things related to the patient's interpersonal relationship and find out how to overcome these negative things.
The role of the family as part of anorexia treatment
The role of the family is very important for the recovery of people with anorexia because usually the family is the party most affected by anorexia itself. In addition to having to try to understand the condition that is being experienced by the sufferer, the family can also work with the doctor in helping speed up the healing process.
Gain weight regularly and safely
As part of the treatment plan, the doctor will include suggestions on how to increase the patient's weight safely. Doctors will also continue to monitor the patient's physical health. For pediatric and adolescent patients, their height will be checked periodically to ensure they are growing normally.
Gaining weight normally should be done gradually. As a first step, the therapist will usually ask the patient to try to eat regularly, even in small portions. This therapy is considered successful after the patient's diet returns to normal with adequate nutritional intake, including vitamins and minerals. It is hoped that through this therapy, patients can gain weight again by half to one kilogram per week.
Treatment of anorexia by using drugs
If anorexia is treated only by taking drugs, usually the results will not be effective. The use of new drugs will feel effective when combined with other therapies. Medications are also used to treat psychological problems associated with anorexia, such as depression and obsessive compulsive disorder. These drugs include olanzapine and selective serotonin reuptake inhibitors (SSRIs).
SSRIs are a type of antidepressant. This medication can help relieve depression and anxiety associated with anorexia. Usually the doctor will give this drug if the patient's weight has returned to normal. Giving SSRIs to patients with below normal weight is feared to cause bad side effects.
While olanzapine are drugs given to people with anorexia who do not respond to other treatment methods. This medication can help relieve anxiety related to diet or weight.
Treatment of anorexia can not be done instantly. To fully recover, sufferers can take several years because along with treatment, some of them still experience eating disorders.
Complications of Anorexia Nervosa
Several health problems or even death can occur if anorexia is not treated immediately. Complications arise due to lack of nutrients needed by the body, in this case from food intake.
Apart from anorexia nervosa, there is a similar condition known as bulimia nervosa. Some people with advanced anorexia develop bulimia. People with bulimia usually eat as much as possible before they excrete it again by vomiting or taking laxatives.
Examples of complications that can arise from anorexia include anemia, low blood pressure, irregular heartbeat, and even heart failure. People with anorexia are also at risk of suffering from damage to the liver and kidneys.
In children and adolescents, anorexia can hinder physical development. In adults, especially women, this condition can cause osteoporosis, menstrual disorders, and infertility. Whereas in adult men, anorexia can cause impotence and erectile dysfunction.
Anorexia during pregnancy
A pregnant woman who has anorexia can be at risk of having a miscarriage, giving birth to a premature baby, giving birth to a low birth weight baby, and sometimes the delivery process must be assisted by a cesarean section. Pregnant women who suffer from anorexia will usually continue to be monitored by a doctor, both during pregnancy, and after giving birth.
Not only pregnant women who can become anorexic, ex-anorexic women who are pregnant also still need to get supervision, and get support during their pregnancy.
Video Credit: Medical Centric