Anorexia nervosa is an eating disorder characterised by extremely low body weight and a fear of gaining weight. Low body-weight is achieved by restricting food intake, excessively exercising, purging (through vomiting or laxative use) or combining several of these methods. Beat UK estimate that 1.25 million individuals within the UK have an eating disorder; with 10% of these individuals having anorexia nervosa. Prevalence may be higher, however; an exact statistic is difficult to ascertain. Some individuals may not be seeking professional support resulting in them not receiving a formal diagnosis, thus not being included in finalised statistics. Anorexia nervosa can develop in both males and females with 1 in 3 of those diagnosed being male. Despite this, anorexia nervosa tends to develop most commonly in female adolescents.
A diagnosis of anorexia nervosa requires the presentation of both physical and psychological symptoms. Additionally to extremely low body weight, other physical characteristics of anorexia nervosa can include: dizziness, irregular heart rhythms, low blood pressure, osteoporosis (weakening of bones), menstruation absence and dehydration. Psychological characteristics can include: preoccupation with food or body weight, fear of gaining weight and low self-esteem. Individuals with anorexia nervosa can also co-present with: anxiety, depression, and Obsessive Compulsive Disorder, self-harm and suicidal ideation. Due to the individual’s physical health being severely compromised as well as experiencing intense psychological distress, anorexia nervosa has the highest mortality rate of any mental illness. This makes it essential to urgently seek and receive help from healthcare professionals.
No definitive causal factor for anorexia nervosa have been established, instead research suggests various multifaceted predictors. This includes genetics, witnessing or experiencing abuse bullying, neglect and body dissatisfaction. Genetic research has found that anorexia nervosa is 10 times more common in individuals with a close relative (parent or sibling) who has the eating disorder. A combination of the above suspected risks can lean an individual to exhibit anorexia nervosa symptomology. For example, perfectionism traits and body dissatisfaction could result in an individual having an unrealistic body shape or weight “goal” which they pursue using drastic methods (e.g. restricted diet). Sociocultural factors including exposure to body image focused media can contribute to the maintenance of the eating disorder.
Due to anorexia nervosa having both physical and psychological characteristics, it is important to note that treatment must focus on restoring physical health and challenging the patients’ thinking styles. Treatment can either be carried out at home with community support or in an inpatient hospital setting. Initially, treatment focuses on emergency procedures to restore weight. Medication can be used to regulate instances of low mood and anxiety. Patients are offered talking therapies such as ‘Cognitive behavioural therapy’ and ‘Cognitive remediation therapy’ to challenge psychological aspects of anorexia nervosa and increase cognitive flexibility. Individual therapy aims to help patients understand their anorectic cognitions and why they may have developed, attempting to change their thinking style and automatic thoughts. Family therapy is recommended by NICE to young people by teaching all family members techniques to manage effectively as a family unit and to support recovery and prevent relapse.
Click here to learn more about how Anorexia Nervosa is treated at Rhodes Wood Hospital CAMHS Specialist Eating Disorder service.