Anorexia Nervosa: Going Back to School With Eating's No. 1 Disorder

By Martha Michael

As teens return to high school and interface with peers, they’re faced with challenges to their mental health as they attempt to fit in with an evolving cultural vibe from haircuts and hemlines to music and media. Discussions about some issues have become commonplace, including problems associated with disordered eating, thanks to famous people with anorexia nervosa who have shared their unhealthy patterns openly. Celebrities such as Demi Lovato, who struggled with eating disorders, keep the conversation alive between adolescents and their parents and teachers.

What Is Anorexia Nervosa?

Anorexia, bulimia, and other food-related disorders, affect more than 30 million Americans, according to an article by the Center for Discovery. Body dissatisfaction is the biggest contributor to the onset of anorexia nervosa and it’s typically preceded by a traumatic event. It is also more likely to be fatal than other eating disorders.

Anorexia nervosa is defined by an unhealthy pattern of behavior intended to cause extreme weight loss, according to an article by Johns Hopkins Medicine. Basic facts about the condition were first introduced to the public at large after the late pop music star Karen Carpenter died in 1983 due to complications from anorexia.

Because they’re struggling with body image, people with anorexia nervosa are obsessive about their physical size and their food intake. When they look in the mirror they see themselves as fat, even in cases in which they are underweight. This condition is known as body dysmorphia.

Anorexic people typically eat far less than they need in an effort to avoid gaining weight, which psychologists attribute to a reaction to stress, anxiety, and a low self-image. Anorexia is also linked to an attempt to gain control and is sometimes found in family systems where a teenager has an overly controlling parent. Teenage females between the age of 15 and 19 have the highest incidence of anorexia nervosa.

There are two subtypes of anorexia:

• Restrictor - They limit their food intake, particularly food that’s high in fats and carbohydrates
• Bulimic - They eat too much and then take laxatives or vomit to reduce the effects of overeating

What Are the Symptoms of Anorexia Nervosa?

The impact of Karen Carpenter’s death on research into eating disorders can’t be overstated. Because of her fame and the fact she was only 32 years old, there was tremendous interest in the rare circumstances of her death, so it led to studies to understand its causes and recognize its symptoms. The Karen A. Carpenter Memorial Foundation was established by her family to raise money for research on anorexia nervosa and other eating disorders.

There are many signs and symptoms that you or a loved one is suffering from anorexia. As a matter of course -- as a mindful parent and friend -- it’s a good idea to be aware of your own behaviors as well as looking out for your friends and their teen children. Look over these symptoms and make some effort to remember them; better to recognize them sooner than when it’s too late.

Symptoms related to food intake or weight include:

• Fear of being fat
• Excessive exercise
• Denying hunger pangs
• Fixation regarding food
• Low body weight
• Altered body image
• Strange eating patterns

Physical symptoms can include:

• Stomach pain
• Extremely thin appearance
• Dehydration
• Poor nutrition
• Bloating and constipation
• Thin hair
• Brittle nails
• Dry skin
• Extreme fatigue
• Constant chills
• Fine body hair (called lanugo)

Emotional symptoms of anorexia include:

• Irritability
• Changing moods
• Anti-social behavior
• Loss of interest in sex
• Depression

What Are the Different Types of Eating Disorders?

Anorexia nervosa is one of many types of eating disorders defined by psychiatric professionals. They typically occur during adolescence or young adulthood and mostly affect females between the ages of 12 and 35, according to an article on the American Psychiatric Association website.

Various forms of disordered eating are evidenced by behaviors from bingeing and purging to mealtime inhibitions, and they are often experienced by individuals struggling with other psychiatric disorders. Some of the most common co-occurring conditions include:

• Mood disorders
• Anxiety disorders
• Obsessive-compulsive disorder
• Substance abuse

Just as heritability explains the presence of many forms of mental illness, genes are considered a primary cause of a person struggling with an eating disorder. Because of the serious psychiatric problems affecting an individual’s patterns in which eating is concerned, it’s important to take a deep dive into what’s fueling unhealthy eating behaviors.

Bulimia Nervosa

People struggling with bulimia fall into a cycle of dieting and watching their calorie intake, then swinging to the opposite extreme and consuming an excess of junk food. They feel guilty and out of control, so they vomit to relieve the discomfort of feeling full. If you’re bulimic, you binge at least once per week and you overdo your efforts to lose weight using extreme fitness, fasting, or laxatives.

Like other disorders, people with bulimia have a fear of gaining weight, but they come in all shapes and sizes; those who are extremely thin are typically suffering from anorexia nervosa. Bulimic behaviors are often done in secret, so the condition can go unnoticed.

Symptoms of bulimia nervosa include:

• Frequent sore throat
• Dental decay due to stomach acid from purging
• Going to the bathroom immediately following meals
• Recurring bouts of diarrhea
• Swollen salivary glands in the cheeks
• Unexplained disappearance of food in the household
• Gastroesophageal reflux
• Misuse of water pills or other diuretics
• Fainting or dizziness due to dehydration

If left untreated, bulimic behaviors can lead to health problems or even death. Some people end up with gastric ruptures, esophageal tears, or cardiac arrhythmias. Psychotherapists and psychiatrists treat patients with bulimia using a range of modalities.

Binge Eating Disorder

Like a person who struggles with bulimia, an individual with a binge eating disorder has a pattern of consuming large quantities of food in one sitting. It’s followed by emotional distress while facing their loss of control, but they typically don’t complete the pattern with compensatory behaviors such as vomiting or excessive exercising. People with this form of disordered eating tend to gain weight over time, according to the National Institutes of Health.

Signs that you have binge eating disorder include:

• Rapid food consumption
• Eating until you’re so full you’re uncomfortable
• Turning to food when you’re not hungry
• Eating alone due to feelings of embarrassment
• Self-hatred and depression

If you binge eat once per week for three months it may indicate you have a problem. Many people get help with a binge eating disorder through individual or group cognitive behavioral therapy.

Avoidant Restrictive Food Intake Disorder

Another form of disordered eating, avoidant restrictive food intake disorder, or ARFID, refers to a condition in which a person lacks proper nutritional intake because they are a picky eater. They are not concerned about body size or shape, but refuse foods because they:

• Lack an appetite or interest in eating
• Have an aversion to foods due to sensory characteristics such as texture, appearance, color, or smell
• Have fears about a negative consequence such as choking, nausea, constipation, or an allergic reaction.

For a person to be diagnosed with ARFID, their disordered eating needs to be accompanied by:

• Deficient nutrition
• Significant weight loss
• Negative social effect such as reluctance to eat with others
• Need for supplemental nutrition

An ideal treatment program for ARFID involves a nutritionist, a mental health professional, and other specialists.

Pica

First occurring in childhood, teens, or adulthood, a person with pica has a pattern of eating non-food substances.

They consume items such as:

• Metal
• Pebbles
• Coal
• Paper
• Hair
• Soap

A person may be diagnosed with pica if the behavior persists for more than a month and requires clinical help. It is often associated with autism spectrum disorder or intellectual disabilities, but is also found among neurotypical children.

Pica can lead to intestinal blockages or consequences of ingesting toxic substances. If someone is suspected of suffering from pica, they may be tested for nutritional deficiencies and receive psychological intervention.

Awareness

It’s a tall order to remain vigilant enough to identify when someone you care about is hurting themselves. There are many potential threats to the mental health of members of your community, including the effects of eating disorders.

The beginning of the school year is a great time to be aware of those people at risk, especially if you notice a child’s classmate who is suddenly thin after the summer vacation. ProjectKnow.com, a subsidiary of American Addiction Centers, offers a 24/7 help and support line e at (877) 453- 4127 if you need someone to talk to or advice on how to deal with a situation concerning a child or friend.

As long as the world hears from stars such as Taylor Swift who are willing to talk about how they struggled with anorexia, people don’t feel they have to hide their own mental health challenges. The problems associated with battling an eating disorder are more likely to be treated if you sing about it rather than sweep it under the rug.

The information, including but not limited to, text, graphics, images and other material contained on this page are for informational purposes only. The purpose of this post is to promote broad consumer understanding and knowledge of various health topics, including but not limited to the benefits of chiropractic care, exercise and nutrition. It is not intended to provide or be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your chiropractor, physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this page.