Anorexia causes and consequences. Symptoms of neurological anorexia

Nowadays, there are very high demands on the appearance of boys and girls. Women, of course, pay particular attention to their appearance. They are very demanding of their appearance, sometimes they want the almost impossible. The standard of modern beauty is an ideal, slim, fit, sexy figure. This idea is imposed on us by television programs, videos on the Internet, and photographs in magazines.

Images of thin models impose on many women the idea that thinness and beauty are equivalent concepts. Women who are unhappy with their figure are willing to go to great lengths to achieve the desired result. But some of them get too carried away with this idea and go too far. Therefore, when losing weight, you need to understand that there is such a disease as, which in its symptoms is practically no different from the behavior of an ordinary woman who is simply losing weight.

Very few women are naturally deprived of an ideal body, such is nature. For this reason, many representatives of the fairer sex are trying to get rid of extra pounds, folds, and centimeters. They are ready to use various tools in this fight, which are not always harmless. Teas and diet pills, fasting, exhausting physical activity can be used, all this can have a very disastrous result. In this article we will tell you in detail how to distinguish normal weight loss from anorexia, as well as the reasons for which this disease occurs and what symptoms it manifests.

What is anorexia?

Anorexia is a disease in which normal eating behavior is disrupted, which is expressed in too much attention to one’s weight and in the desire to almost completely limit oneself from eating food. Women who suffer from anorexia are so afraid of gaining excess weight that they are ready to drive themselves to the point of exhaustion.

Alas, this disease mainly occurs in young girls, and sometimes in teenagers. This is explained by the fact that they are the ones who are most susceptible to environmental influences. Girls with anorexia so deplete their body with various diets, or even refusing food, that their weight drops fifteen to twenty percent below what it should be. In some cases, weight may decrease even more. But even under such circumstances that the girl’s weight is greatly reduced and her general well-being suffers, the girl, looking at herself in the mirror, sees herself still very fat. She continues to make every effort to get rid of the “extra weight” that she needs, on the contrary.

This disease is very, very dangerous for young girls, as their body is not yet fully formed and continues to grow and develop. As a result of trying to lose weight, others see not a healthy, beautiful girl, but a ghost with bruises under her eyes, pale skin and many concomitant diseases. When the body intensively grows and develops, various functional systems of the body are formed - endocrine, nervous, musculoskeletal, cardiovascular; it needs many nutrients, vitamins, and minerals. A teenager, instead of giving all this to the body in the right quantities, torments it with starvation, this brings irreparable harm to the young, developing body.

Anorexic symptoms

Most often, girls and women who develop anorexia refuse to admit that they have this disease. It is very important for close friends to detect the signs of anorexia in a timely manner. If this does not happen, then the obsession with getting rid of excess weight will bring very disastrous results - the girl’s health is under great threat, and in some cases, her life. The most important and first sign of anorexia in a woman is a significant obvious weight loss, sometimes in a very short period of time. But, unfortunately, this symptom becomes visible only when the exhaustion of the body approaches a dangerously critical level. It may simply seem to many that the girl decided to get rid of excess weight in a very harmless way.

Another manifestation of anorexia is a significant reduction in the portion of food that a woman eats and loss of appetite. These signs should never be ignored. Some girls may refuse to eat at all, while finding many different excuses, which sometimes look very plausible - she’s tired, her stomach hurts, she’s eaten recently. But despite this, a person who suffers from anorexia can happily talk about different diets, food, weight loss methods, and calories. In addition, women with anorexia can spend a long time in the kitchen, while preparing a wide variety of dishes. They themselves do not want to use them.

It may seem to many that anorexics are not interested in food at all. But this is not really true - they think about food almost all the time. But as soon as it comes to putting these thoughts into practice, this desire instantly disappears somewhere. The patient's general condition worsens as the disease progresses. This manifests itself in various symptoms of disrupted functioning of many systems in the body.

The condition of nails and hair is deteriorating. Hair becomes dull, loses its shine, and splits severely. And no hair balms, even the best ones, help improve the condition of your hair. This process is due to the fact that the body does not have enough minerals and vitamins that are needed to maintain hair in excellent condition. The same applies to nails, they become brittle and thin, sometimes peeling.
Very high fatigue. The patient develops severe weakness and gets tired easily. The girl is just waking up and is already starting to feel tired. This happens not because of strong physical activity, but because the body does not receive the necessary energy, and it begins to take it from its internal resources, which are limited. If the cases of the disease are severe, the girl may become very drowsy, she may begin to faint regularly.
Disappearance of menstruation or. The mechanism by which this symptom occurs is not entirely clear; it is most likely influenced by the lack of nutrients that the body needs. For this reason, hormonal levels fail. Amenorrhea is a serious disorder, which indicates that the girl needs urgent medical help.
The condition of the skin changes. In patients with anorexia, the face becomes pale and blue circles appear under the eyes. The reason for this is iron deficiency anemia, which is mandatory for this disorder. Anorexia very often causes kidney problems. The skin of the sick girl's legs and arms acquires a characteristic bluish tint. It occurs due to poor microcirculation of the skin. For this reason, a woman is often cold; her body can often be covered with a layer of short and thin hair. The body thus tries to maintain heat and protect itself from hyperemia.
Various diseases develop. The body lacks essential minerals, vitamins, proteins, carbohydrates, fats, and nutrients. This is a kind of stress for the body, and it is very difficult to predict exactly how it will react to this. Many women experience problems with the gastrointestinal tract, develop osteoporosis, and disrupt the functioning of the endocrine and nervous systems.

Causes of anorexia

Many people are interested in the reasons for this disease. An important fact is that there are several types of anorexia: mental, nervous and primary. Primary anorexia in women occurs due to various physiological and organic pathologies. This may be neurological disorders, malignant tumors, hormonal dysfunction and other diseases. Mental anorexia occurs due to various psychiatric pathologies. These could be delusions, depression, schizophrenia, catatonic stupor. But when most people use the term “anorexia,” they still mean anorexia nervosa. There are many reasons why anorexia nervosa occurs. These include family characteristics, problems communicating with others, and personal difficulties. Basically, the wide range of problems that cause anorexia include:

Dysfunctional family. Such a family has an unhealthy mental climate. All family members become irritated with each other or hide their emotions greatly. One family member or several of its members most often have various types of addiction - drug addiction, alcoholism, gambling addiction, and so on. Everyone thinks exclusively for themselves and does not take into account each other's needs. A child in such a family is left to his own devices, or is under the authoritarian control of his parents. In such conditions, most often one of the family members, usually a teenage girl, suffers from anorexia.
Too low self-esteem and impaired perception of one's own body. All girls with anorexia consider themselves fat and ugly. Even if a girl has very little weight, and her bones stick out, it still seems to her that she is very fat and has a lot of extra pounds. But, most likely, this opinion is not the result of anorexia; the real reason is that in life such girls consider themselves passive, uninteresting, weak, stupid and ugly. They want to achieve at least something in life, that is, to have a beautiful figure, in their opinion.
Negative atmosphere around eating. The source of such a reason lies, as a rule, in early childhood. Many parents consider it necessary to feed their baby, despite his reluctance to eat. They forcefully begin to push food into the child, and the child, in turn, develops a gag reflex and develops a negative attitude towards eating food. For this reason, anorexia can occur already in early childhood, and sometimes it can hide and make itself felt in adolescence or adulthood, if there is the influence of additional factors.
Unmet need for acceptance and love. In this case, the disease occurs because the girl strives to please other people. Very often this can happen to those girls who suffered from excess weight. When they begin to lose weight, they begin to notice how other people begin to show sympathy and be drawn to them. This fact reinforces the positive result of losing weight in a person, and they quickly continue in the same spirit. Very soon the disease begins to become pathological.
Perfectionism. Obsessiveness and fixation in behavior. With long-term weight loss, this trait has very serious consequences. Even if it begins as a completely normal and healthy process, then a very high desire for perfection can provoke a girl to become fixated on this idea, on the idea of losing weight. She will constantly seem not beautiful enough for herself. And in order to appear beautiful to yourself and others, you need to eat less and less (according to people with anorexia).
Fighting some obstacles. Some doctors believe that the basis of the disease anorexia is the girl’s desire to overcome some difficulties; the difficulties are their own constant appetite. By refusing to eat, the girl believes that she has overcome this difficulty and it brings her pleasure. This process brings the girl victory over herself and has an important meaning in her life. This is why it is so difficult for girls suffering from anorexia to give up such pathological behavior.

Girls, if your figure does not suit you in some way, and you are planning to get rid of extra pounds with the help of some effective diet, then before that, think carefully about whether it is worth it? Are you ready to risk your own health for the sake of invented beauty?

If you still decide to improve and correct your body and overcome extra pounds, then do it wisely, do not forget about the limits in such a struggle. Assess the current situation soberly, because the line between anorexia and ordinary harmless weight loss is very, very thin. It is very easy to cross, so if your friends or relatives have any doubts about your health, it is better to once again seek advice from a specialist. If nature has not blessed you with an ideal figure, then this is not a reason to fall into despair.

You need to know that you can be attractive, charming, beautiful and attract attention without an ideal appearance. Much more important than a flat stomach is charisma and self-confidence! Be healthy and love yourself for who you are!

This is a disease to which a person dooms himself; in fact, he himself organizes it. Anorexia nervosa (under this name it is included in the international classification of diseases) is a meaningful and deliberate refusal to eat, purposeful weight loss beyond all reasonable limits. This is an obsession, a behavioral disorder, so the characteristic “nervous” is very appropriate here.

Anorexia nervosa common in young girls during puberty (rarely in boys: nothing is impossible in this world), with age the likelihood of developing anorexia disappears. The disease manifests itself as an obsessive phobia of being overweight, forcing you to sharply reduce your diet and preventing you from taking a sober look at yourself from the outside. The number of people with anorexia has increased significantly over the past quarter century. This was greatly facilitated by the introduction into the immature teenage souls of the cult of slender fashion models, forcing thousands and thousands of unlucky followers from the pages of fashion magazines to adapt the phenotypic characteristics of thousands and thousands of unlucky followers to their appearance.

Causes of anorexia

Don't expect any specifics here, because... There are more than one or two theories trying to explain the reasons that provoke a mental disorder in the form of anorexia. The vulnerable soul of a teenager keeps many secrets. During this period, serious physiological and psychological changes occur in the body; there is such a phenomenon as a disharmonious teenage crisis, i.e. exaggeration of one’s problems and experiences. Thus, the seeds of potential anorexia are planted in fertile soil. And here it is more appropriate to talk not about the causes, but about the factors that can provoke the development of the disease:

hereditary factors. Scientists have found that there is a special gene that induces a tendency towards anorexia. In the presence of other unfavorable factors (psycho-emotional overload, unbalanced diet), carriers of this gene are more likely to develop anorexia nervosa. Of no small importance is the presence in the family of people who suffered from anorexia, depressive disorders or alcoholism;
physiological factors(excess weight, early onset of menstruation);
personal factors(low self-esteem, self-doubt, feelings of inferiority, perfectionism). Anorexics are characterized by such character traits as excessive punctuality and accuracy;
sociocultural factors. Anorexia is more common in developed countries, where the primary needs of the population are fully satisfied, and the desire to comply with fashion trends and aesthetic trends comes to the fore.

Stages and symptoms of anorexia

In its development, anorexia goes through 4 stages.
initial stage lasts from 2 to 4 years. It lays the foundations of those overvalued and delusional (this is a psychiatric, not an abusive term) ideas that will later lead to such disastrous consequences for the body. The patient is dissatisfied with his own appearance, and this is due to actual changes in it, which is characteristic of puberty. The positive opinions of others have virtually no weight for a potential anorexic. A careless remark, on the contrary, can give rise to a mental disorder.

The beginning of the next stage - anorectic- can be identified by the patient’s active desire to correct his own imaginary shortcomings, which leads to a significant loss of body weight (up to 50%), the development of somatohormonal abnormalities, and a decrease or cessation of menstruation.

A variety of methods are used to lose weight: exhausting exercise in the gym, limiting the amount of food consumed, taking laxatives and diuretics, enemas, artificially induced vomiting, smoking, and excessive coffee consumption.

Behavioral disorders that arise at the initial stage of anorexia begin to produce results in physiological terms: inflammatory processes develop throughout the gastrointestinal tract, prolapse of the gastrointestinal organs occurs, pain in the stomach becomes frequent, and persistent constipation appears. Some time after eating, attacks of suffocation, tachycardia, dizziness, and hyperhidrosis are observed. What is characteristic is that even against the background of a sharp reduction in the supply of nutrients to the body, at the anorectic stage the patient does not lose physical activity and performance.

Anorectic is followed by cachectic stage anorexia, in which somatohormonal disorders predominate. Menstruation stops completely, no traces remain of the subcutaneous fatty tissue, dystrophic changes in the skin, cardiac and skeletal muscles develop, the heartbeat slows down, blood pressure drops, body temperature decreases, due to a decrease in peripheral blood circulation, the skin turns blue and loses elasticity, the patient constantly feels cold, nails become brittle, hair and teeth fall out, anemia develops.

Even in the phase of extreme exhaustion, patients continue to refuse proper nutrition, being unable to adequately look at themselves (literally and figuratively). Mobility is lost, and the patient spends more and more time in bed. Due to water-electrolyte imbalance, convulsions are possible. This condition, without any assumptions, should be recognized as life-threatening and forced inpatient treatment should begin.

Anorexics constantly consider themselves fat. The last stage of anorexia is reduction stage. In essence - the return of the disease, its relapse. After therapeutic measures, weight gain is observed, which entails a new surge of delusional ideas in the patient regarding his appearance. His previous activity returns again, as well as the desire to prevent weight gain using all the “old” methods - taking laxatives, forced vomiting, etc. It is for this reason that anorectics, after leaving the cachectic stage, must remain under constant supervision. Relapses are possible within two years.

Treatment of anorexia

As a rule, treatment of anorexia begins at the junction of the anorectic and cachectic stages (of course, ideally it should begin much earlier and with an emphasis on the psychological component, but the patient in the preliminary stages of the disease simply does not fall into the hands of a doctor). In the cachectic stage, treatment sets itself three main goals: to prevent irreversible dystrophy and restore body weight, to prevent massive fluid losses, and to restore electrolytic balance in the blood.
The treatment regimen is bed. The diet is increased gradually, splitting food into small portions: a sharp increase in calories overloads the digestive tract. After eating, the patient should not be allowed to burp.

To increase appetite, insulin is administered daily. Sometimes a 40% glucose solution is added intravenously to insulin. Over time, appetite increases, which makes it possible to increase the caloric content of the diet.

Gradually the patient is transferred from bed to normal mode. The psychological component of treatment consists of taking tranquilizers, psychotherapy sessions and (sometimes) hypnosis.

Anorexia in men has its own characteristics:

Anorexia in men is often associated with various mental disorders - schizophrenia, neuroses.
Men don't talk about their desire to lose weight. They are more secretive, unlike women who constantly discuss ways to lose weight.
Men are more purposeful, they firmly adhere to their promise to refuse certain foods. They are less likely to have eating disorders.
A large percentage of sick men refuse food for ideological reasons. They are supporters of body cleansing, raw foodism, veganism, sun-eating or other nutritional systems.
Anorexia affects not only young men who strive to meet the standards of beauty, but also men over 40 who are interested in methods of cleansing the body and various spiritual practices. You can often hear phrases from them that “food is an obstacle to mental development”, “refusing food prolongs life and purifies the spirit.”
The character of patients is dominated by asthenic and schizoid traits, in contrast to women, who are characterized by hysterical traits.
Delusional ideas about imaginary fatness sometimes serve as a distraction for a man. At the same time, he tends not to notice real physical defects, which sometimes disfigure his appearance.

Factors that provoke anorexia in men

Growing up in a single-parent family in an overprotective atmosphere from the mother's side. The boy is afraid that as he gains weight, he will grow up and lose the love of his family. By remaining thin, he tries to avoid the responsibilities and hardships of adult life. Such men continue to live with their parents into adulthood.
Critical statements from others regarding excess weight. This can cause psychological trauma.
Participation in certain sports, requiring strict control over body weight - sports dancing, ballet, running, jumping, figure skating.
Professions related to show business– singers, actors, models. People employed in these professions sometimes pay excessive attention to their appearance, which causes thoughts about their own imperfections and excess weight.
Self-punishment. Boys and men work themselves to the point of exhaustion, reducing the feeling of guilt for undiagnosed aggression towards the father or forbidden sexual desire.
Schizophrenia in one of the parents, the tendency to which is inherited. There is a high risk of anorexia nervosa in young men whose parents suffered from anorexia, phobia, anxious depression, and psychosis.
Homosexuality. In specialized publications, a cult of lean male bodies is created, which encourages young men to refuse food.

Manifestations of anorexia in men and women have many similarities. In 70% of patients, the onset of the disease occurs at the age of 10-14 years. If parents failed to notice and stop them, then the symptoms slowly increase.

Painful attention to one's appearance.
The tendency to eat normally once and then starve for weeks.
Tendency to hide food. To convince relatives that the patient is “eating normally,” he may hide or throw away his portion of food.
Decreased sexual interest and potency, which is analogous to female amenorrhea (lack of menstruation).
Traditional methods of losing weight include refusing to eat, excessive exercise and vomiting, enemas, and colon therapy. However, morbid attachment to vomiting is less common than in women.
Unmotivated aggression. Rude attitude towards close people, especially parents.
Refusal to be photographed. Patients argue that their “fullness” is more noticeable in photographs.
Hypochondria. A man is overly concerned about his health and suspects that he has serious illnesses. Natural sensations (especially the feeling of fullness in the stomach) seem painful to him.
Changes in appearance appear after a few months - weight loss (up to 50% of body weight), dry skin, hair loss.
The tendency to alcoholism is an attempt to cope with emotions and drown out thoughts about food and losing weight.

At first, losing weight causes euphoria. There is a lightness and a feeling of victory when the appetite has been curbed, which causes deep satisfaction in the patient. Over time, appetite disappears and the body's resources are depleted. Vigor is replaced by irritability and chronic fatigue. The way of thinking changes, delusional ideas are formed that cannot be corrected. The body becomes painfully thin, but the man continues to perceive himself as fat. Brain malnutrition affects the ability to think clearly and process information. Long-term abstinence from food leads to organic brain damage.

Men with anorexia do not perceive their condition as a problem. They do their best to justify fasting by cleansing the body and the desire for enlightenment. Their relatives often seek medical help. If this does not happen in time, then the man ends up in a hospital with cachexia (extreme exhaustion) or in a psychiatric hospital with an exacerbation of mental illness.

Treatment of anorexia in men includes psychotherapy, medication and reflexology. Taken together, these measures lead to recovery in over 80% of patients.

1. Psychotherapy- an obligatory component of treatment. It allows you to correct the patient’s thinking and helps eliminate psychological trauma that led to an eating disorder. For anorexia in men, the following have proven effective:

psychoanalysis;
behavioral therapy;
family psychotherapy with the patient's relatives.

2. Drug treatment. Medicines can only be prescribed by a doctor, and the dosage depends on the severity of the symptoms of the disease.

Neuroleptics Clozapine and Olanzapine are used for the first 6 months of treatment. They promote weight gain and reduce delusions regarding obesity. The dose of the drug is determined individually. After achieving a therapeutic effect, it is gradually reduced. If an exacerbation occurs, the dose is increased to the initial dose.
Atypical antipsychotics Risperidone and Risset eliminate the negative manifestations of the disease, but do not reduce performance or interfere with work and study. Take medications constantly or only when symptoms of the disease occur. Treatment with atypical drugs can last from 6 months to one and a half years.
Vitamin preparations. B vitamins normalize the functioning of the nervous system, helping to eradicate the root cause of the disease. Vitamins A and E improve the production of hormones, promote the restoration of the skin and its appendages, as well as the mucous membranes of internal organs.

3. Reflexology(acupuncture). During sessions, reflex points are affected, which stimulates appetite and restores impaired metabolism.

4. Trainings on organizing healthy nutrition. Special training programs will help the patient create a menu in such a way that the body receives all the nutrients and does not experience discomfort.

5. Intravenous nutrition or feeding through a tube. These methods are used in cases of extreme exhaustion in patients who categorically refuse to eat.

Anorexia in a child, what to do?

Anorexia in children is a more common problem than is commonly believed. 30% of girls 9-11 years old limit themselves in food and adhere to a diet in order to lose weight. Every 10th person has a high risk of developing anorexia (in boys this figure is 4-6 times lower). However, in childhood the psyche is more susceptible to influence and early stages Parents can help their child avoid developing the disease while remaining slim.

Causes of anorexia in a child

Parents feed the child, forcing him to eat too large portions. As a result, an aversion to food is formed.
Monotonous diet, which creates a negative attitude towards food.
Past severe infectious diseases - diphtheria, hepatitis, tuberculosis.
Psycho-emotional stress - sudden acclimatization, death of a loved one, parental divorce.
The abundance of unhealthy and sweet foods in the diet disrupts digestion and metabolism.
Excessive care and control on the part of parents. Often found in single-parent families, where a child is raised without a father by his mother and grandmother.
Dissatisfaction with one's appearance, which is often based on parental criticism and peer ridicule.
Hereditary predisposition to mental illness.

What are the signs of anorexia in a child?

Eating disorders – refusal to eat or a certain set of foods (potatoes, cereals, meat, sweets).
Physical signs include weight loss, dry skin, sunken eyes, dark circles under the eyes.
Behavioral changes – sleep disturbances, irritability, frequent tantrums, decreased academic performance.

What to do if you notice signs of anorexia in a child?

Make eating an enjoyable experience. Create comfort in the kitchen. While your child is eating, find a few minutes to sit next to him and ask him how the day went, what was the most pleasant event today.
Start eating healthy as a family. For example, instead of pies, cook baked apples with cottage cheese; instead of frying potatoes or fish, bake them in foil. Focus not on the fact that this will make you lose weight, but that proper nutrition is the basis of beauty, health and vigor. Being slim is just a pleasant consequence of a healthy lifestyle.
Follow family rituals related to food. Bake meat according to your grandmother's recipe, marinate fish, as is customary in your family. Share these secrets with your child. Rituals make the child feel like he is part of a group and give him a sense of security.
Go shopping together. Make a rule: everyone buys a new, preferably “healthy” product. It could be yogurt, an exotic fruit, a new type of cheese. Then you can try it at home and decide whose choice is better. This way you instill in your child the idea that healthy food brings pleasure.
Don't insist on your own. Give your child a choice, strive for a compromise. This applies to all aspects of life. A child who is overly controlled in everything takes control of what is left to him - his food. Avoid categorical demands. If you think it's cold outside, don't shout at your daughter to put on a hat, but offer your child an acceptable choice: a headband, a hat, or a hood. The same applies to food. Ask what the child will like, offering a choice of 2-3 acceptable dishes. If your daughter flatly refuses dinner, move lunch to a later time.
Involve your child in the cooking process. Watch cooking shows together, choose recipes on the Internet that you would like to try. There are a huge number of tasty and healthy low-calorie dishes that do not increase the risk of gaining weight.
Encourage dancing and sports. Regular physical training increases appetite and promotes the production of endorphins - “happiness hormones”. It is advisable that the child exercise for his own pleasure, since professional activities aimed at winning competitions can provoke a desire to lose weight and cause anorexia and bulimia.
Consult a cosmetologist or fitness trainer if the child is dissatisfied with his appearance and weight. Children often ignore the advice of their parents, but listen to the opinions of unfamiliar experts. Such specialists will help you create a proper nutrition program that improves skin condition and prevents excess weight gain.
Listen carefully to your child. Avoid categorical judgments and do not deny the problem: “Don’t talk nonsense. Your weight is normal." Give reasons for your reasons. Together, calculate the ideal weight formula, find the minimum and maximum values for this age. Promise to help fight for beauty ideals and stick to your word. It is better to prepare a diet soup for your child than for a rebellious daughter to fundamentally skip a meal consisting of a high-calorie roast.
Find areas where your child can self-actualize. He should feel successful, useful and indispensable. To generate interest in various activities, attend a variety of events with your child: exhibitions, dance group competitions and sports competitions. Encourage him to try his hand at a wide variety of sections and clubs. Give sincere praise for every small achievement. Then the teenager will take root in the idea that success and positive emotions can be associated not only with physical attractiveness. And new acquaintances and vivid impressions will distract you from thoughts about the imperfection of your body.
Help your child receive complete and comprehensive information. If your child wants to stick to a diet, then find detailed instructions on this topic. Be sure to familiarize yourself with the contraindications and read about the dangers and consequences of this diet. For example, it has been proven that supporters of protein diets are at risk of cancer. The more your child knows, the better protected he will be. Thus, due to a lack of understanding of the full danger of the problem, many girls stubbornly search the Internet for advice on “how to get anorexia?” In their minds, this is not a serious mental illness, but an easy path to beauty.

Remember that if over the course of 1-2 months you have not been able to correct your child’s eating behavior, then seek advice from a psychologist.

How to avoid relapse of anorexia?

Relapses of anorexia after treatment occur in 32% of patients. The most dangerous are the first six months, when patients are highly tempted to give up food and return to old habits and the same way of thinking. There is also a risk that in an attempt to suppress their appetite, such people will become addicted to alcohol or drug use. That is why relatives should pay maximum attention and try to fill their lives with new impressions.

How to avoid relapse of anorexia?

Scientists agree that anorexia is a chronic disease characterized by periods of calm and relapses. This food addiction is compared to diabetes mellitus: a person must constantly monitor his condition, follow preventive measures, and begin drug treatment when the first signs of the disease appear. This is the only way to stop the return of anorexia in time and prevent a relapse.

Anorexia nervosa is a severe mental disorder that is accompanied by an eating disorder motivated by the goals of losing weight or preventing excess weight. As a result, such a pathological desire to lose weight, accompanied by an all-consuming fear, leads to a loss of 30 to 60% of body weight. Many patients lose their criticality towards their condition, they do not notice obvious dystrophy, their metabolism is disrupted, diseases of various systems and organs arise, but it can be extremely difficult to convince them of the need for treatment from a specialist. Some patients are aware of their exhaustion, but their fear of eating food is so deep that they can no longer restore their appetite on their own.

In this article we will introduce you to the causes, risk factors, manifestations, consequences, methods of identifying and treating anorexia nervosa. This information will help you notice alarming symptoms of the disease in yourself or your loved ones, and you will make the right decision about the need to see a specialist.

Without treatment, anorexia nervosa leads to death in about 10-20% of patients. This condition is rightly called the disease of stereotypes, and more often it develops among the affluent segments of the population. According to statistics, the number of such patients has been increasing in recent years; almost 95% of patients are women. Approximately 80% of all anorexics are girls and young women 12-26 years old, and only 20% are men and women of more mature age (up to the period).

Causes and risk factors

Girls who are insecure and suffer from low self-esteem are more susceptible to anorexia nervosa.

The causes of anorexia nervosa are conventionally divided into biological, psychological and social. The following factors can lead to the occurrence of such a disease:

genetic – the disease manifests itself under unfavorable conditions in carriers of certain genes (HTR2A, BDNF), which form a certain type of personality and contribute to the development of mental disorders;
biological - obesity and early onset, dysfunction of neurotransmitters regulating eating behavior (serotonin, norepinephrine and dopamine) can deepen pathological disorders in anorexia;
personal – the likelihood of developing a mental disorder increases among those belonging to the perfectionistic-obsessive personality type, suffering from feelings of inferiority and the need to meet certain standards and requirements, low self-esteem and uncertainty;
family - the risk of anorexia increases among people in whose family someone suffers from the same disease, obesity, bulimia nervosa, depression, alcoholism and drug addiction;
age - persons of adolescence and adolescence are most susceptible to desires to please the opposite sex or to imitate idols and stereotypes;
cultural - living in industrialized cities increases the desire to meet the canons of beauty and success, expressed in a slim figure;
stressful - physical, psychological, sexual violence or traumatic events (death of a close friend or relative, divorce, etc.) can contribute to the development of eating disorders;
mental – a number of mental illnesses (for example, schizophrenia) may be accompanied by eating disorders.

Symptoms

Usually the disease begins with the patient having a delusional and obsessive thought that excess weight is the cause of all his troubles (unattractiveness, separation from a loved one, lack of demand in the profession, etc.). Next, the patient develops depression, which leads to severe and constantly progressive restriction of food. As a rule, patients try to carefully hide this from others (they throw away food secretly, give it to a pet, put part of their portion back into the pan, etc.).

Constant malnutrition and starvation leads to the appearance of another pathological deviation - at times he “breaks down” and begins to absorb large amounts of food. At the same time, he reproaches himself and comes up with ways to limit its absorption. To do this, the patient can artificially induce vomiting, take laxatives and perform enemas.

Against the background of changes occurring in the body due to malnutrition and metabolic disorders, patients with anorexia nervosa lose their criticality towards their condition. Even after they achieve the desired result in losing weight, it begins to seem unsatisfactory to them, and they set themselves new “tasks.”

As a rule, after about 1.5-2 years the patient loses 20% or more of his body weight and the physical consequences of anorexia nervosa appear - physiological deviations in the functioning of various systems and organs.

Mental disorders

Long-term malnutrition leads to a number of changes in the behavior and mental state of the patient:

the patient’s denial of mental disorders and lack of criticality towards signs of exhaustion;
a constant feeling of fullness and a desire to lose weight more and more;
changes in eating habits (eating in small portions, eating while standing);
sudden passion for topics about food: collecting recipes, reading books on cooking, organizing delicious meals for relatives without the participation of the patient himself, excessive enthusiasm for diets;
panic fear of extra pounds;
the emergence of unreasonable grievances and anger;
sleep disorders;
depressive state: sadness, irritability, periods of euphoria followed by decreased activity;
change in activity in the social environment and family: excessive sports training outside the home, reluctance to attend events that include meals (birthdays, corporate parties, etc.), limited communication with relatives and friends.

One of the characteristic signs of anorexia nervosa is the following reasoning from the patient: “My height is 168, and my weight is now 45 kilograms, but I want to weigh 35 kilograms.” Subsequently the numbers become smaller.

Any results in weight loss are regarded by the patient as a desired achievement, and gaining even a few kilograms is perceived as insufficient self-control and dissatisfaction with oneself. Even patients who are aware of their dystrophy often wear baggy clothes, hiding their thinness from others. In this way, they try to avoid having to explain themselves and enter into discussion with those who do not support their aspirations for far-fetched “ideal” standards.

One of the most dangerous manifestations of anorexia nervosa is the self-prescription of various hormonal drugs for weight loss. Such cases are very difficult to treat, and even forced treatment may be ineffective.

Mental disorders that occur with anorexia nervosa can cause suicide.

Physical disorders

Over time, prolonged malnutrition and starvation leads to severe metabolic disorders and the development of diseases of various systems and organs.

Initially, the patient experiences hormonal changes caused by decreased production of thyroid hormones, estrogens and increased cortisol levels. They are manifested by the following symptoms:

constant weakness (up to hungry fainting);
violations menstrual cycle(scanty periods, pain, delays and absence of menstruation, inability to conceive);
decreased libido;
muscle spasms;
bradycardia;
tendency to.

Subsequently, the following disturbances in the functioning of body systems occur:

cardiovascular system - fainting, feeling cold, the occurrence of arrhythmias, which can cause;
blood - signs, a decrease in the level of leukocytes, leading to increased susceptibility to infections;
digestive system - functional dyspepsia, cramping pain in the stomach, peptic ulcer, chronic constipation, nausea, edema (bloating) of the abdominal cavity;
skin and hair - dryness and swelling, yellow skin tone, dullness and hair loss, the appearance of vellus hair on the face and body, brittleness and splitting of nails;
skeletal system and muscles - tendency to fractures and their long-term healing, tooth decay, swelling of joints, muscle atrophy;
urinary system – tendency to,.

Some of the physical problems described above can be remedied by treating anorexia nervosa and restoring normal weight and nutrition, but some of them are irreversible.

Excessive enthusiasm for attempting to induce artificial vomiting and performing cleansing enemas can cause the following disorders:

problems swallowing food and liquids;
esophageal ruptures;
weakening of the rectal wall;
rectal prolapse.

Pregnancy and anorexia nervosa

Getting pregnant with anorexia is often difficult, but after treatment and weight gain, estrogen levels can be restored and conception occurs. Even after therapy, a woman may experience the following problems in the future related to the disorder: hormonal levels:

difficulty in conceiving;
increased risk of fetal malnutrition and the appearance of congenital malformations in the unborn child;
increased risk of complications during pregnancy and childbirth;
increased risk of relapse of anorexia due to stress that occurs in response to the news of pregnancy.

In severe forms of anorexia nervosa, even after treatment, the menstrual cycle does not return, and the woman cannot become pregnant on her own.

Stages of the disease

The initial stage of anorexia nervosa is characterized by the patient’s constant bad mood, her tendency to frequently weigh herself and measure body volume, and the desire to follow a strict diet.

The following stages are distinguished during anorexia nervosa:

Dysmorphomanic. The patient often has painful thoughts about his own inferiority associated with imaginary completeness. The mood becomes depressed and anxious. The patient can look at his reflection in the mirror for a long time, often weighs himself, measures the size of his waist, hips, etc. At this stage, he begins to make his first attempts to limit himself in food or searches for and follows an “ideal” diet.
Anorectic. The patient is already attempting persistent fasting and loses about 20-30% of his body weight. Such “successes” are perceived with euphoria and are accompanied by a desire to lose even more weight. The patient begins to exhaust himself with excessive physical exertion, eats even less and tries in every possible way to convince himself and those around him that he has no appetite. At this stage, he can no longer be critical of his exhaustion and underestimates its excessive degree. Fasting and lack of nutrients lead to the first signs of changes in physical condition: hypotension, bradycardia, fainting and weakness, menstrual irregularities and libido, dry skin, hair loss. Disturbances in metabolism and physiological functioning of organs are accompanied by active tissue breakdown and lead to even greater suppression of appetite.
Cachectic. At this stage, irreversible disorders occur caused by organ dystrophy. As a rule, this period begins 1.5-2 years after the first manifestations of anorexia nervosa, when the patient loses approximately 50% of his body weight. If left untreated, degenerative processes lead to the fading of the functions of all organs and the death of the patient.

Diagnostics

Many people with anorexia nervosa think that they are not sick or that they are able to control their illness on their own. That is why they rarely go to the doctor on their own. In such cases, the task of their relatives is to help their loved one understand the problem and resort to the services of a specialist.

Typically, to make a diagnosis, the doctor asks the patient several questions from a test developed in the UK:

do you consider yourself fat;
whether you keep your weight under control and what you eat;
have you lost more than 5 kilograms recently;
whether thoughts about food are dominant;
Do you believe that you are fat if others say that you are thin?

Even two “yes” answers indicate the presence of eating disorders.

To confirm the diagnosis and determine the severity of anorexia nervosa, the patient is prescribed the following types of studies:

calculation of body mass index (for example, the norm for women over 20 years old is 19-25, the risk threshold is 17.5);
blood tests to detect anemia and electrolyte imbalances;
blood tests to determine kidney and liver function;
and sex hormones.

If necessary, examination of a patient with anorexia nervosa can be supplemented (to identify osteoporosis), ultrasound of various organs and (to identify diseases of internal organs).

Treatment

Treatment of anorexia nervosa is carried out by doctors of several specializations and can be carried out on an outpatient basis or in a hospital setting. The need for hospitalization of the patient is determined by the severity of the clinical picture. It is indicated in the following cases:

decrease in body mass index by 30% below normal;
progressive weight loss during outpatient therapy;
heart rhythm disturbances;
hypotension;
hypokalemia;
severe forms of depression;
suicidal tendencies.

The main goal of treatment for anorexia nervosa is to restore weight and eating habits. An increase in body weight of 0.4-1 kg per week is desirable. In addition, therapy is aimed at eliminating mental and physical complications.

The most successful treatment tactics for such a disease is a combination of psychotherapy, family and conservative therapy. It is extremely important that the patient himself participates in this process and understands its necessity.

Even after treatment, some patients remain prone to repeated relapses of the disease and need constant psychological support (especially during stressful periods of life). The following factors can complicate the recovery process and increase the risk of relapse:

communication with friends, sports coaches and relatives who admire thinness and promote weight loss;
lack of psychological support from close friends and family;
the impossibility of overcoming the patient’s conviction that excessive thinness is the only way to combat obesity.

The treatment plan for anorexia nervosa is drawn up depending on the characteristics of the disease and the personality of the patient. Complex therapy includes several techniques.

Lifestyle change

A patient with anorexia nervosa needs the following changes:

regular and healthy eating;
correct formation of the diet and menu preparation with the help of a nutritionist;
getting rid of the habit of constantly weighing yourself;
exclusion of exhausting physical activity for weight loss (only after the patient’s condition has normalized, the doctor can include physical therapy exercises in the treatment plan);
increasing social activity;
psychological support from friends and relatives.

Restoring normal nutrition and weight gain

This part of the treatment plan for anorexia nervosa is fundamental, as normalizing nutrition and weight helps restore both physical and mental health. In addition, these factors increase the effectiveness of psychotherapy.

To increase weight, the patient is prescribed a diet, the principle of which is aimed at gradually increasing the calorie content of the daily diet. Initially, it is recommended to consume 1000-1600 calories per day, and then the diet gradually expands to 2000-3500. Food should be taken 6-7 times a day in small portions.

In the early stages, the patient may experience anxiety, depression, and signs of fluid retention in the body that occur in response to increased body weight. Over time, as you gain weight, these symptoms decrease and disappear.

Parenteral and intravenous nutrition are not usually used to treat anorexia nervosa, as such methods may make it difficult to restore normal nutrition in the future and many patients perceive such methods as punishment and coercive treatment. However, in some difficult cases (categorical and prolonged refusal to eat, heart rhythm disturbances, bleeding from the mouth, etc.), such methods can be used temporarily to initially improve the patient’s condition.

Nutrition and supplements

People with anorexia nervosa suffer from a lack of vitamins, minerals and nutrients. Their replenishment significantly improves the mental and physical condition of patients and therefore food should be nutritious and fortified.

If necessary, diet therapy is often supplemented by taking nutritional supplements. The following dietary supplements can be used for this:

multivitamins (A, C, E) and supplements based on magnesium, zinc, calcium, copper, phosphorus and selenium;
Omega-3, fish oil, eating fish (especially halibut and salmon);
coenzyme Q10;
5-hydroxytryptophan;
probiotics based on lactobacilli and acidophilus;
creatine

Improve the absorption of nutrients and general state may follow the following recommendations:

sufficient intake of drinking water (up to 6-8 glasses per day);
inclusion of high-quality sources of proteins in the diet: eggs, meat, dairy products, protein and vegetable shakes;
quitting smoking and drinking alcohol;
eliminating or significantly reducing the amount of caffeine-containing products;
limiting refined sugars: sweets, sweet water, etc.

Cognitive behavioral therapy

This method of treating patients with anorexia nervosa is the most effective. Using this technique, the patient learns to replace distorted thoughts and negative judgments with real and positive ways to solve problems.

Cognitive behavioral therapy consists of the fact that over the course of several months or six months the patient himself creates his own menu and includes in it foods that he had previously refused in every possible way. It tracks your diet and records unhealthy thoughts and reactions associated with food. In addition, he notes relapses that occur in the form of vomiting, taking laxatives and excessive physical exertion.

The patient periodically discusses these recordings with a cognitive psychotherapist and as a result may become aware of false and negative judgments about his weight. After such acceptance, the list of foods in the diet expands, and awareness of previously present problems allows him to get rid of ingrained false judgments. Subsequently, they are replaced with correct and realistic ones.

Family therapy

Family psychotherapy plays an important role in the complex treatment of anorexia nervosa. The patient needs to feel the support and understanding of friends and relatives.

The participation of parents, relatives and friends helps the patient cope with emerging difficulties. The doctor teaches them to develop the right tactics for dealing with him. In addition, family therapy is aimed at eliminating feelings of guilt and anxiety that arise among the patient’s loved ones and relatives.

Maudsley method

This tactic is a form of family therapy and can be used in the early stages of anorexia nervosa. The Maudsley method consists in the fact that in the first stages the patient’s parents take charge of menu planning and control the consumption of prepared dishes. Gradually, as correct judgments about nutrition are restored, the patient begins to make decisions about when and how much to eat. Treatment results are discussed weekly with a psychotherapist, who gives additional recommendations and evaluates the effectiveness of this technique.

Hypnotherapy

The use of hypnosis can be part of a comprehensive treatment for anorexia nervosa. Such sessions allow the patient to regain self-confidence, increase resistance to stressful situations, and restore the correct perception of their appearance and weight. As a result, hypnotherapy can help you return to normal eating habits.

Drug therapy

Taking medications to treat anorexia nervosa is recommended only if it is impossible to eliminate existing problems using psychotherapeutic techniques and diet therapy. For this, the patient may be prescribed:

antidepressants (Fluoxetine, Cyproheptadine, Chlorpromazine, etc.) – for the treatment of severe forms of depression, relief from anxiety and obsessive-compulsive disorders;
atypical antipsychotics (Azenapine, Ziprasidone, Clozapine, Sertindole, etc.) - used to reduce increased levels of anxiety.

In addition, drug treatment is complemented by symptomatic treatment of emerging complications of anorexia nervosa (gastritis, peptic ulcer, arrhythmias, etc.). When mental illnesses causing eating disorders are identified, treatment is prescribed.

Forecasts

The recovery process for a patient with anorexia nervosa can take about 4-7 years. Even after recovery, there is still a possibility of relapse of the disease.

According to various statistics, approximately 50-70% of patients fully recover from the disease, but 25% of patients fail to achieve such results. Sometimes, after treatment, uncontrolled overeating occurs, leading to weight gain and a number of other psychological problems.

The likelihood of death with anorexia nervosa depends on the stage of the disease, mental and physiological characteristics of the patient’s body. Death can be caused by natural causes (i.e., complications and diseases that arise) or may occur due to suicide.

Which doctor to contact

If you are extremely concerned about your weight, open or hidden from others, refusal to eat and sudden weight loss, you should consult a psychotherapist. When anorexia nervosa is detected, a nutritionist and a therapist are involved in the patient’s treatment process.

Anorexia nervosa (lat. anorexia nervosa) is one of the most dangerous and, at the same time, one of the most common. This disease, classified as a mental disorder, is characterized by the need to refuse food and an obsession with one's own weight.

It is generally believed that anorexia mainly affects women, although in fact this is not the case. Experts note that men, albeit to a lesser extent, are still prone to anorexia. Another thing is that they are much less likely to seek treatment. According to Mayo Clinic researchers, anorexia is not related to food. In fact, people with anorexia, in their attempts to give up food, strive to cope by keeping one of the few areas of life completely accessible to this under control.

We have collected basic information about the causes, consequences and treatments for anorexia that is important to know.

Causes of anorexia

As with many mental illnesses, the exact causes of anorexia are almost impossible to determine. However, numerous scientific studies have helped to narrow the “search area”, so that there are currently three main triggers of anorexia - metabolism, genetic predisposition and psychological problems.

“People have long blamed families and the media for causing anorexia, but eating disorders are biological diseases,” Walter Kaye, a leading US expert on eating disorders and a fellow at the University of California, tells Scientific American Mind. of California). Like a genetic variant, the characteristics of metabolic function do not depend on the person, being individual characteristics of the organism.

As for psychology, Live Science notes that experts were able to record the characteristics of the psychotype most prone to anorexia nervosa. Traits of such a person include: perfectionism, a need to be loved, an increased need for attention, a lack of self-esteem, and high family expectations.

Signs of anorexia

The most obvious sign of anorexia is refusing to eat or limiting the amount of food for a long period. People suffering from anorexia often refuse to eat in the company of other people, fearing that their “weakness” will be noticed. They may lie about how much they ate and avoid attending social events that involve food consumption. In addition, they often become moody, depressed, obsessive about their weight (and the weight of others), and indifferent to things they once liked.

However, people with anorexia do not necessarily refuse food. They can eat extremely little, intensely burning calories in the gym, or get rid of the food they eat. Despite the fact that immediate elimination of food is considered the main symptom, bulimia itself often becomes the first symptom of anorexia.

Anorexia and bulimia: what is the difference

Both anorexia and bulimia are eating disorders. Although some of their symptoms overlap, the concepts are not interchangeable. Thus, anorexia inevitably leads to serious weight loss, while patients with bulimia can maintain a normal weight through excessive food consumption and “purging”, which results in getting rid of not all of what they eat, but only part of it.

Why is anorexia dangerous?

Because food is our body's fuel, dietary restrictions can lead to drastic health changes. Weight loss remains the most noticeable, but not the most important one. According to the Mayo Clinic, regular malnutrition leads to constipation, low blood pressure, osteoporosis, swelling in the arms and legs, abnormal blood counts, menstrual irregularities, dehydration, and insomnia.

Often, anorexia is driven by dissatisfaction with one's own appearance, but in fact, as the disease progresses, the person looks worse and worse. A lack of vitamins and minerals in the diet leads to hair becoming brittle or, and skin. But these are small changes compared to what is happening inside.

Treatment of anorexia

The American Journal of Psychiatry reports that eating disorders kill more people worldwide than any other mental illness. Since anorexia affects the body as a whole, the first step in its treatment should be symptomatic relief. Experts say that at the first stage of recovery it is useful to take vitamins and carefully monitor your diet in terms of the ratio of proteins, fats and carbohydrates on your plate. Of course, all this should be done under the supervision of a specialist.

Once the symptoms have been resolved, actions are usually taken to address the underlying causes of the disease. Therapy or hospitalization are the most common methods of treatment. However, doctors note that treatment options are determined by the duration and severity of the disease. But in any case, it is better, in order to prevent irreversible consequences, if help is received at the initial or middle stages of anorexia.