Anorexia causes and consequences. Symptoms of anorexia nervosa

Nowadays, there are very high requirements for the appearance of guys and girls. In particular, women pay attention to their appearance, of course. They are very demanding on their appearance, sometimes they want the almost impossible. The standard of current beauty is the ideal, slender, toned, sexy figure. This idea is imposed on us by TV programs, videos on the Internet, 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 ready 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, it is necessary to understand that there is such a disease as, which, in its symptomatology, practically does not differ 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 weaker sex are trying to get rid of extra pounds, folds, centimeters. They are ready to use various tools in this struggle, which are not always harmless. Teas and diet pills can be used, fasting, exhausting physical activity, all this can have a very deplorable result. In this article, we will tell you in detail how to distinguish ordinary weight loss from anorexia, as well as the reasons why this disease occurs and what symptoms it manifests.

What is anorexia?

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

Alas, this disease mainly occurs in young girls, and sometimes in adolescents. This is due to the fact that they are the most affected by the environment. Girls with anorexia so deplete their body with various diets, or generally refuse food, that their weight drops fifteen to twenty percent lower than it should be. In some cases, the weight may drop 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 as still very fat. She continues to make every effort to get rid of the "extra weight" that she needs, on the contrary,.

This disease for young girls is very, very dangerous, because their body is not yet fully formed, 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, with pale skin and many concomitant diseases. When the body grows and develops intensively, various functional systems of the body are formed - endocrine, nervous, musculoskeletal, cardiovascular, it needs a lot of nutrients, vitamins, minerals. A teenager, instead of giving it all to the body in the right quantities, torments him with starvation, this brings irreparable harm to a young, developing organism.

Symptoms of anorexia

Most often, girls and women who have anorexia refuse to flatly admit that they have this disease. It is very important that close friends detect 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 the presence of anorexia in a woman is a significant apparent 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 dangerous critical level. It may simply seem to many that the girl decided to lose weight in a very harmless way.

Another manifestation of anorexia is a significant decrease in the portion of food that a woman eats, 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 - they are tired, their stomach hurts, they recently ate. But, despite this, a person who suffers from anorexia can talk with pleasure about different diets, about food, about weight loss methods, about calories. In addition, women with anorexia can stay in the kitchen for a long time, while preparing a wide variety of dishes. They don't want to use them.

It may seem to many that anorexic women are not interested in food at all. But this is not so in reality - they think about food almost all the time. But as soon as it comes to the realization of these thoughts in life, this desire instantly disappears somewhere. The general condition of the patient worsens as the disease progresses. This is manifested in various symptoms of impaired functioning of many systems in the body.

The condition of the nails and hair is deteriorating. Hair becomes dull, loses its shine, severely split. And no hair balms, even the best ones, help to improve the condition of the hair. This process is due to the fact that the body lacks the minerals and vitamins that are needed to maintain the hair in excellent condition. The same applies to nails, they become brittle and thin, sometimes exfoliate.
Very high fatigue. The patient develops severe weakness, she quickly fatigues. The girl just wakes up and already begins to feel tired. This happens not because of a strong physical robot, 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 are severe, the girl may become very drowsy, she may begin to faint regularly.
Loss of menses or. The mechanism of this symptom is not clearer, most likely it is affected by the lack of nutrients that the body needs. For this reason, hormonal levels fail. Amenorrhea is a serious disorder that indicates that the girl needs urgent medical attention.
Changes in the condition of the skin. In patients with anorexia, the face becomes pale, blue circles appear under the eyes. The reason for this is iron deficiency anemia, which is mandatory for this disorder. Anorexia is a very common cause of kidney problems. The skin of the legs and arms of a sick girl acquires a characteristic bluish tint. It occurs due to poor microcirculation of the skin. For this reason, a woman is often cold, often her body can be covered with a layer of short and thin hair. The body thus tries to keep warm and protect itself from hyperemia.
Various diseases develop. The body lacks the necessary minerals, vitamins, proteins, carbohydrates, fats, 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 have problems with the gastrointestinal tract, osteoporosis develops, and the work of the endocrine and nervous systems is disrupted.

Causes of anorexia

Many are interested in what causes 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. It can be neurological disorders, malignant tumors, hormonal dysfunction and other diseases. Mental anorexia occurs due to various psychiatric pathologies. It can be crazy ideas, depression, schizophrenia, catatonic stupor. But most people under the concept of "anorexia" mean anorexia nervosa. There are many reasons why anorexia nervosa occurs. These include family characteristics, problems in communicating with others, personal difficulties. Basically, a wide range of problems for which anorexia occurs include:

dysfunctional family. In such a family, an unhealthy mental climate. All family members get irritated with each other or strongly hide their emotions. One family member or several of its members most often have various kinds of addiction - drug addiction, alcoholism, gambling and so on. Everyone thinks exclusively for themselves and does not take into account the needs of each other. A child in such a family is left to himself, or is under the authoritarian control of his parents. In such conditions, most often one of the family members, mostly a teenage girl, suffers from anorexia.
Too low self-esteem and impaired perception of one's own body. All anorexic girls consider themselves fat and ugly ugly. Even if a girl has a very small weight, and her bones stick out, it still seems to her that she is very fat, has a lot of extra pounds. But, most likely, such an opinion is not the result of anorexia, the true 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 deep childhood. Many parents consider it necessary to feed their baby, despite his reluctance to eat. They forcibly begin to push food into the child, and the latter, in turn, has a gag reflex, a negative attitude towards eating food arises. 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 an influence of additional factors.
Unsatisfied need for acceptance and love. In this case, the disease occurs for the reason that 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 for themselves how other people began to show sympathy and reach out to them. This fact reinforces the positive result of losing weight in a person, and they rapidly continue in the same spirit. Very soon the disease begins to have a pathological character.
Perfectionism. Obsession and fixation in behavior. With prolonged weight loss, this feature has very serious consequences. Even if it starts as a completely normal and healthy process, then a very high desire for perfection can provoke a girl to get hung up on this idea, on the idea of losing weight. She will always seem not beautiful enough for herself. And in order to seem beautiful for yourself and others, you need to eat less and less (according to people with anorexia).
Fight with some obstacles. Some of the doctors believe that at the heart of anorexia is the desire of the girl to overcome some difficulties, their own constant appetite acts as difficulties. Refusing food, the girl believes that she has coped with this difficulty, it brings her pleasure. This process brings the girl victory over herself and has an important meaning in her life. Therefore, it is so difficult for girls suffering from anorexia to give up such pathological behavior.

Girls, if your figure does not suit you in any way, and you plan to get rid of extra pounds with the help of some effective diet, then before that, think carefully, is it 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. Evaluate the current situation soberly, because the line between anorexia and the usual harmless weight loss is very, very thin. It is very easy to go over it, so if your friends or relatives have any doubts about your health, it is better to seek the advice of a specialist once again. If nature has not rewarded 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 attention-grabbing without a perfect appearance. Much more important than a flat stomach is charisma and self-confidence! Stay healthy and love yourself just the way you are!

This is a disease that a person dooms himself to on his own, 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 comes to naught. The disease is manifested by an obsessive phobia of being overweight, forcing you to drastically reduce your diet and preventing you from taking a sober look at yourself from the outside. The number of patients with anorexia has increased significantly over the past quarter century. This was facilitated by the introduction of the cult of slender photo models into immature teenage souls, forcing from the pages of fashion magazines to customize the phenotypic features of thousands and thousands of unlucky followers to fit their exterior.

Causes of anorexia

Do not expect any specifics here, because. there are not one or two theories trying to explain the reasons that provoke a mental failure 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, such a phenomenon as a disharmonic teenage crisis takes place, i.e. exaggeration of their problems and experiences. Thus, the seeds of potential anorexia fall into fertile ground. 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 to anorexia. In the presence of other adverse factors (psycho-emotional overload, unbalanced diet), carriers of this gene are more likely to develop anorexia nervosa. Of considerable importance is the presence in the family of persons suffering from anorexia, depressive disorders or alcoholism;
physiological factors(overweight, 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, 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

Anorexia goes through 4 stages in its development.
initial stage lasts from 2 to 4 years. It lays the foundations of those overvalued and delusional (this is a psychiatric, not abusive term) ideas, which in the future will 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 opinion of others for a potential anorexic has almost no weight. A careless remark, on the contrary, can start a mental disorder.

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

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

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

Anorexic is followed by cachectic stage anorexia, in which somatohormonal disorders prevail. Menstruation completely stops, no traces of subcutaneous fat remain, dystrophic changes in the skin, cardiac and skeletal muscles develop, heart rate slows down, pressure drops, body temperature decreases, due to a decrease in peripheral 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 good nutrition, being unable to adequately look at themselves (literally and figuratively). Mobility is lost, the patient spends more and more time in bed. Due to violations of the water-electrolyte balance, convulsions are possible. This condition, without any assumptions, should be recognized as life-threatening and forced inpatient treatment should be started.

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

Treatment of anorexia

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

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

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

Anorexia in men has its own characteristics:

Anorexia in men is often associated with various mental disorders - schizophrenia, neuroses.
Men do not talk about their desire to lose weight. They are more secretive, unlike women who are constantly discussing ways to lose weight.
Men are more purposeful, they firmly adhere to the word given to themselves to refuse certain products. They are less likely to have food breakdowns.
A large percentage of sick men refuse food for ideological reasons. They are supporters of cleansing the body, raw food, veganism, sun-eating or other nutrition systems.
Anorexia affects not only young men who strive to meet the standards of beauty, but also men over 40, who are fond of cleansing the body and various spiritual practices. You can often hear phrases from them that “food is a hindrance to spiritual development”, “refusal of food prolongs life and purifies the spirit”.
Asthenic and schizoid features predominate in the character of patients, in contrast to women, who are characterized by hysterical features.
Crazy ideas about imaginary fullness sometimes serve as a distraction for a man. At the same time, he tends to ignore real physical flaws, sometimes disfiguring his appearance.

Factors that provoke anorexia in men

Growing up in an incomplete family in an atmosphere of excessive guardianship from the mother's side. The boy is afraid that with weight gain he will grow up and lose the love of his relatives. By staying thin, he tries to avoid the responsibilities and hardships of adulthood. 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 tight control over body weight - sports dancing, ballet, running, jumping, figure skating.
Professions related to show business- Singers, actors, fashion models. People engaged in these professions sometimes pay excessive attention to their appearance, which causes thoughts about their own imperfection and excess weight.
Self-punishment. Boys and men wear themselves out by reducing their feelings of guilt for unrevealed aggression towards their father or forbidden sexual desire.
Schizophrenia in one of the parents, the tendency to which is inherited. The risk of anorexia nervosa is high in young men whose parents suffered from anorexia, phobia, anxiety depression, 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 are very similar. 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.
Tendency to eat normally once and then starve for weeks.
Tendency to hide food. To reassure 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 (absence of menstruation).
Ways to lose weight are traditional - refusal to eat, excessive exercise and vomiting, enemas, colon therapy. However, painful attachment to vomiting is less common than in women.
Unmotivated aggression. Rude attitude towards close people, especially to parents.
Refusal to be photographed. Patients argue it by the fact that in the photographs their "completeness" is more noticeable.
Hypochondria. A man is overly worried about his health, he suspects that he has serious illnesses. Natural sensations (especially the feeling of filling 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 weight loss.

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

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

Treatment of anorexia in men includes psychotherapy, drug treatment, and reflexology. Together, these measures lead to recovery of more than 80% of patients.

1. Psychotherapy is an essential part of the treatment. It allows you to correct the thinking of the patient and helps to eliminate the psychological trauma that led to the eating disorder. With anorexia in men have proven their effectiveness:

psychoanalysis;
behavioral therapy;
family psychotherapy with relatives of the patient.

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

Antipsychotics Clozapine, Olanzapine are used for the first 6 months of treatment. They promote weight gain and reduce delusions about fullness. The dose of the drug is determined individually. After reaching the therapeutic effect, it is gradually reduced. If an exacerbation occurs, then the dose is increased to the initial one.
Atypical antipsychotics Risperidone, Risset eliminate the negative manifestations of the disease, but do not reduce performance, do not interfere with work and study. Take drugs 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, contribute to 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 the organization of a healthy diet. Special training programs will help the patient to create a menu in such a way that all the nutrients enter the body and there is no discomfort.

5. Intravenous nutrition or the introduction of food through a tube. These methods are applied at an extreme degree of exhaustion in patients who categorically refuse food.

Anorexia in a child, what to do?

Anorexia in a child is a more common problem than is commonly believed. 30% of girls aged 9-11 limit themselves in food and follow a diet in order to lose weight. Every 10th has a high risk of developing anorexia (in boys, this figure is 4-6 times lower). However, in childhood, the psyche is better influenced by early stages Parents can help their child avoid developing the disease while staying lean.

Causes of anorexia in a child

Parents feed the child, forcing them to eat too large portions. The result is an aversion to food.
Monotonous nutrition, which forms a negative attitude towards food.
Past severe infectious diseases - diphtheria, hepatitis, tuberculosis.
Psycho-emotional stresses - sharp acclimatization, death of a loved one, divorce of parents.
The abundance of harmful and sweet foods in the diet disrupts digestion and metabolism.
Excessive guardianship and control by parents. It often occurs in single-parent families where a child is brought up without a father by his mother and grandmother.
Dissatisfaction with their appearance, which is often based on criticism from parents and ridicule from peers.
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 - weight loss, dry skin, sunken eyes, bruising under the eyes.
Behavioral changes - sleep disturbances, irritability, frequent tantrums, poor 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 the child is eating, take a few minutes to sit next to him, ask 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 is losing weight, but that proper nutrition is the basis of beauty, health and vigor. Slimness is just a pleasant consequence of a healthy lifestyle.
Observe family rituals related to food. Bake meat according to your grandmother's recipe, pickle fish, as is customary in your family. Share these secrets with your child. Rituals make the child aware of being part of the group and give 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 kind of cheese. Then at home you can try it and decide whose choice is better. Thus, you instill in the child the idea that healthy food brings pleasure.
Don't insist on yours. 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 for him - his food. Avoid categorical requirements. If you think it's cold outside, then don't yell for your daughter to put on a hat, but offer the child an acceptable choice: headband, hat, or hood. The same applies to food. Ask what the child will be, offering a choice of 2-3 acceptable dishes. If the daughter flatly refuses dinner, reschedule lunch for 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 plenty of tasty and healthy low-calorie meals that do not increase the risk of gaining weight.
Encourage dancing and sports. Regular physical training increases appetite and contributes to the production of endorphins - “happiness hormones”. It is desirable that the child engages in for his own pleasure, as professional activities aimed at winning competitions can provoke the desire for weight loss and cause anorexia and bulimia.
Consult a beautician or fitness trainer if the child is dissatisfied with their appearance and weight. Children often ignore the advice of their parents, but listen to the opinions of unfamiliar experts. Such specialists will help to create a proper nutrition program that improves skin condition and prevents weight gain.
Listen carefully to the child. Avoid categorical judgments and do not deny problems: “Don't talk nonsense. You are of normal weight. Argument your arguments. Together, calculate the formula for the ideal weight, find the minimum and maximum values \u200b\u200bfor this age. Promise to help in the fight for the ideals of beauty and stick to your word. It is better to cook a diet soup for your child than a rebellious daughter fundamentally skips a meal consisting of a high-calorie roast.
Find areas where your child can fulfill himself. He should feel successful, useful and irreplaceable. To generate interest in various activities, attend a variety of events with your child: exhibitions, dance group competitions and sports. Encourage him to try his hand at a wide variety of sections and circles. Genuinely praise every small accomplishment. Then the idea will take root in a teenager that success and positive emotions can be associated not only with physical attractiveness. And new acquaintances and vivid impressions will distract from thoughts about the imperfection of your body.
Help your child to get complete and versatile information. If a child wants to stick to a diet, then find detailed instructions on this topic. Be sure to read the contraindications together, read about the dangers and consequences of this diet. For example, it has been proven that supporters of protein diets are at risk of getting cancer. The more your child knows, the better he will be protected. So, from a misunderstanding of the danger of the problem, many girls are persistently looking for advice on the Internet “how to get anorexia?”. In their view, this is not a serious mental illness, but an easy path to beauty.

Remember that if within 1-2 months you have not been able to correct the child's eating behavior, then seek the advice of 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 refuse food and return to old habits and the old way of thinking. There is also a risk that in an attempt to stifle their appetite, such people will become addicted to alcohol or drug use. That is why relatives should pay maximum attention, try to fill their life 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 with diabetes mellitus: a person must constantly monitor his condition, follow preventive measures, and start medication when the first signs of the disease appear. Only in this way is it possible 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 to their condition, they do not notice obvious dystrophy, their metabolism is disturbed, diseases of various systems and organs occur, but it can be extremely difficult to convince them of the need for treatment by a specialist. Some of the patients are aware of their exhaustion, but their fear of eating is so deep that they cannot restore their appetite on their own.

In this article, we will introduce you to the causes, risk factors, manifestations, consequences, ways to identify and treat anorexia nervosa. This information will help you notice the alarming symptoms of the disease in yourself or your loved ones, and you will make the right decision about the need to contact 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 wealthy segments of the population. According to statistics in recent years, the number of such patients has been increasing, almost 95% of patients are women. Approximately 80% of all anorexics are girls and young women aged 12-26, and only 20% are men and women of more mature age (up to the period).

Causes and risk factors

Anorexia nervosa is more prone to self-doubt, girls suffering from low self-esteem.

The causes of anorexia nervosa are conditionally divided into biological, psychological and social. The following factors can lead to the occurrence of such an ailment:

genetic - the disease manifests itself under adverse 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, dysfunctions 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 perfectionist-obsessive personality type, suffering from feelings of inferiority and the need to comply with some standards and requirements, low self-esteem and insecurity;
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 youth are most susceptible to aspirations to please the opposite sex or to imitate idols and stereotypes;
cultural - living in industrialized cities strengthens the desire to comply with the canons of beauty and success, expressed in the harmony of the figure;
stressful - physical, psychological, sexual abuse 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) can be accompanied by eating disorders.

Symptoms

Usually, the disease begins with the fact that the patient has a delusional and obsessive thought that being overweight is the cause of all his troubles (unattractiveness, separation from a loved one, lack of demand in the profession, etc.). Further, the patient develops depression, which leads to a strong and constantly progressive restriction of oneself in food. As a rule, patients try to carefully hide this from others (throw away food secretly, give it to a pet, transfer part of their portion back to the pan, etc.).

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

Against the background of changes occurring in the body due to malnutrition and metabolic disorders, patients with anorexia nervosa lose their criticality to 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 body weight and he has the physical consequences of anorexia nervosa - physiological abnormalities in the work of various systems and organs.

Psychiatric disorders

Prolonged malnutrition leads to a number of changes in the behavior and mental state of the patient:

denial by the patient of mental disorders and lack of criticality to 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 standing up);
sudden preoccupation with topics about food: collecting recipes, reading books on cookery, organizing gourmet meals for relatives without the participation of the patient himself, excessive enthusiasm for diets;
panic fear of extra pounds;
the emergence of unreasonable resentment and anger;
sleep disorders;
depressive state: sadness, irritability, periods of euphoria, followed by reduced activity;
change in activity in the social environment and family: excessive sports training outside the home, unwillingness to attend events that include meals (birthdays, corporate parties, etc.), limiting communication with relatives and friends.

One of the characteristic signs of anorexia nervosa is the following reasoning of 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 that hide thinness from others. In this way, they try to avoid having to explain themselves and engage in 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 compulsory 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 reduced production of thyroid hormones, estrogen, and increased cortisol levels. They show the following symptoms:

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

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

cardiovascular system - fainting, a feeling of 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, convulsive 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 delamination of nails;
skeletal system and muscles - susceptibility to fractures and their long healing, tooth decay, swelling of the joints, muscle atrophy;
urinary system - a tendency to,.

Some of the physical disorders described above can be corrected with treatment of anorexia nervosa and restoration of normal weight and nutrition, but some of them are irreversible.

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

trouble swallowing food and liquids;
rupture of the esophagus;
weakening of the rectal wall;
rectal prolapse.

Pregnancy and anorexia nervosa

Pregnancy with anorexia is often difficult, but after treatment and weight gain, estrogen levels can be restored and conception occurs. Even after the therapy in the future, a woman may experience the following problems associated with a violation hormonal background:

difficulty with the onset of conception;
increased risk of fetal malnutrition and the appearance of congenital malformations in the unborn child;
increased risk of complications during pregnancy and childbirth;
an increased risk of anorexia recurrence against the background of a stressful state that occurs in response to the news of pregnancy.

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

Stages of the disease

The initial stage of anorexia nervosa is characterized by the constant bad mood of the patient, her tendency to frequent weighing and measuring body volumes, and the desire to follow a strict diet.

During anorexia nervosa, the following stages are distinguished:

dysmorphomaniac. The patient often has painful thoughts about his own inferiority, associated with imaginary fullness. The mood becomes depressed, anxious. The patient can look at his reflection in the mirror for a long time, often weigh himself, measure the waist, hips, etc. At this stage, he begins to make the first attempts to limit himself in food or seeks and follows an "ideal" diet.
Anorexic. The patient is already attempting persistent starvation and has lost about 20-30% of body weight. Such “successes” are perceived with euphoria and are accompanied by the desire to lose weight even more. 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. Starvation and lack of nutrients lead to the appearance of the first signs of changes in the physical condition: hypotension, bradycardia, fainting and weakness, menstrual irregularities and libido, dry skin, hair loss. Disturbances in metabolism and the physiological functioning of organs are accompanied by active decay of tissues and lead to even greater suppression of appetite.
cachectic. At this stage, there is an occurrence of irreversible disorders caused by dystrophy of organs. As a rule, this period begins 1.5-2 years after the first manifestations of anorexia nervosa, when the patient loses approximately 50% of body weight. If untreated, dystrophic processes lead to the extinction of the functions of all organs and the death of the patient.

Diagnostics

Many people with anorexia nervosa think they are not sick or are able to control their condition 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 the loved one understand the problem and resort to the services of a specialist.

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

do you consider yourself complete;
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 (th), if others say that you are thin (th).

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

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

body mass index calculation (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 disorders;
blood tests to determine kidney and liver function;
and sex hormones.

If necessary, examination of a patient with anorexia nervosa can be supplemented (to detect osteoporosis), ultrasound of various organs and (to detect 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 shown in the following cases:

a decrease in body mass index by 30% below normal;
progressive weight loss on the background of 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 tactic for treating such a disease is a combination of psychotherapy, family and conservative therapy. It is extremely important that the patient himself participate in this process and realize its necessity.

Even after treatment, some patients remain prone to 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 made depending on the characteristics of the disease and the personality of the patient. The composition of complex therapy includes several methods.

Lifestyle change

A patient with anorexia nervosa needs the following changes:

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

Restoration of normal nutrition and weight gain

This part of the treatment plan for anorexia nervosa is fundamental, as the normalization of nutrition and weight contributes to the restoration of 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 in response to weight gain. Over time, as you gain weight, these symptoms decrease and disappear.

Parenteral and intravenous nutrition is not usually used for the treatment of anorexia nervosa, since in the future such methods may lead to difficulty in restoring normal nutrition, and many patients perceive such methods as punishment and compulsory 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 supplementation

Patients 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. For this, the following dietary supplements can be used:

multivitamin products (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 following recommendations may be followed:

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

Cognitive Behavioral Therapy

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

Cognitive behavioral therapy consists in the fact that for several months or six months the patient himself draws up his own menu and includes in it products that he previously refused in every possible way. He monitors his diet and records unhealthy thoughts and reactions associated with food. In addition, he notes that he has relapses in the form of vomiting, taking laxatives and excessive physical exertion.

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

Family Therapy

An important role in the complex treatment of anorexia nervosa belongs to family psychotherapy. The patient needs to feel the support and understanding of friends and relatives.

The involvement of parents, relatives and friends helps the patient cope with the difficulties that arise. The doctor teaches them to develop the right tactics of behavior with him. In addition, family therapy is aimed at eliminating feelings of guilt and anxiety that arise in the relatives themselves and the patient's relatives.

Maudsley method

This tactic is a type 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 over the planning of the menu and control the use of prepared dishes. Gradually, as correct judgments about nutrition are restored, the patient begins to make his own decisions about when and how much to eat. Weekly, the results of treatment are discussed with a psychotherapist, who gives additional recommendations and evaluates the effectiveness of this technique.

Hypnotherapy

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

Medical therapy

Taking medications for the treatment of anorexia nervosa is recommended only if it is impossible to eliminate existing problems with the help of 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, anxiety and obsessive-compulsive disorders;
atypical antipsychotics (Azenapine, Ziprasidone, Clozapine, Sertindole, etc.) - are used to reduce an increased level of anxiety.

In addition, drug treatment is supplemented by symptomatic therapy of emerging complications of anorexia nervosa (gastritis, peptic ulcer, arrhythmias, etc.). If mental illnesses that cause eating disorders are identified, their treatment is prescribed.

Forecasts

The recovery process of a patient with anorexia nervosa can take about 4-7 years. Even after recovery, there is a possibility of recurrence 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 probability of a fatal outcome in anorexia nervosa depends on the stage of the disease, the mental and physiological characteristics of the patient's body. Death may be due to natural causes (i.e., resulting complications and diseases) or due to suicide.

Which doctor to contact

If you are extremely concerned about your weight, refuse to eat openly or hidden from others, and suddenly lose weight, you should contact a psychotherapist. When anorexia nervosa is detected, a nutritionist and a general practitioner 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, which belongs to the category of mental disorders, is characterized by the need to refuse food and an obsession with one's own weight.

It is generally accepted that anorexia is mainly affected by 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 refuse food, strive to cope with, keeping one of the few completely accessible areas of life under control.

We have collected basic information about the causes, consequences and treatments of 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 the main triggers of anorexia at the moment are three - 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 U.S. expert on eating disorders and a fellow at the University of California, told Scientific American Mind. of California). Like the genetic variant, the features of metabolic function do not depend on the person, being the individual characteristics of the organism.

As for psychology, Live Science notes that the experts managed to fix 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 the refusal of food or the restriction of its quantity over 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 not attend social events that involve eating. In addition, they often become moody, depressed, obsessive about their weight (and the weight of others), indifferent to things that they once liked.

However, people with anorexia do not necessarily refuse food. They may eat very little, burning calories in the gym, or get rid of the food they have eaten. Despite the fact that instant relief from food is considered the main symptom, bulimia itself often becomes the first symptom of anorexia.

Anorexia and Bulimia: What's 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 severe weight loss, while patients with bulimia can maintain a normal weight due to excessive food intake and "cleansing", as a result of which it is possible to get rid of not all of what was eaten, but only part of it.

Why is anorexia dangerous?

Since food is the fuel for our body, dietary restrictions can lead to drastic health-related changes. Weight loss remains the most noticeable, but not the most important of them. 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. The lack of vitamins and minerals in the diet leads to the fact that the hair becomes brittle or, and the 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 the removal of symptoms. Experts say that it is good to take vitamins in the first stage of recovery, and carefully monitor nutrition in terms of the ratio of proteins, fats and carbohydrates on the plate. Of course, all this should be done under the supervision of a specialist.

Once the symptoms have been resolved, action is usually taken to address the underlying causes of the disease. Therapy, or hospitalization, is the most common treatment. At the same time, 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 stage of anorexia.