Anorexia Nervosa

As years have gone by, social media has become increasingly popular, and although it's great that we are becoming more and more connected, it doesn't come without its downfalls. With the increasing presence of the ideal body image floating around in our everyday lives, many are beginning to worry about their weight. Focusing on a healthy lifestyle is not a problem and is good for one's health. But sometimes, weight loss can take a negative turn that can lead people down the path of an eating disorder, such as anorexia nervosa, if not handled carefully.

Anorexia Nervosa Anorexia Nervosa

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Table of contents

    Content Warning Sign, StudySmarter.

    • This explanation will offer a definition for anorexia nervosa.
    • Then the facts on anorexia nervosa will be presented.
    • Moving on from this, the difference between bulimia and anorexia nervosa will be discussed, as well as the difference between anorexia nervosa and atypical anorexia nervosa.
    • Last, the causes of anorexia are explored.

    Anorexia Nervosa Definition

    Eating disorders can have disastrous effects on a person's body and mind. According to the Balance Eating Disorder Treatment Centre's (2020) most recent statistics, anorexia nervosa has the highest mortality rate compared to other psychiatric disorders and affects around 1 in 250 women and 1 in 2000 men. Let's explore some anorexia nervosa facts to learn more about it.

    Anorexia nervosa is a severe eating disorder that causes a person to maintain a very low weight.

    A person with anorexia nervosa may become very underweight by over-exercising or suppressing their diet. People with anorexia often think they are overweight, even when this is not the case, and suffer from body dissatisfaction.

    Anorexia Nervosa Facts

    Psychologists have tried characterising the symptoms of anorexia nervosa to help trained professionals such as therapists. Therapists can then use these as guidelines when diagnosing patients with eating-related disorders.

    The DSM is a manual by psychologists that lists the different mental illnesses and the characteristics that trained professionals should use to diagnose mental illnesses. According to the DSM-5, to be diagnosed with anorexia nervosa, patients must meet all of the following criteria:

    • Fear of becoming fat or gaining weight.

    • Have a distorted view of themself.

    • Restricting how much they eat to stop them from gaining weight or help them lose weight.

    Anorexia Nervosa, Confident women looking at herself in the mirror, StudySrarterFigure 1: How we view ourselves is one of many characteristics that can help psychologists identify if people have eating disorders.

    The Symptoms of Anorexia Nervosa

    Some examples of symptoms are:

    • Overwhelming fears of gaining weight

    • Body dissatisfaction

    • Use of laxatives or other methods to get rid of calories after eating

    • Weight and height under healthy levels for their age

    • Lower BMI

    • Poor circulation

    • Sleep issues

    • Dizziness and vertigo

    • Frequent headaches

    • Digestive issues

    The problem with the similarities between eating disorders is that misdiagnosis can easily occur. As a result, the individual can receive the wrong treatment, which may exacerbate their disorder and symptoms.

    Bulimia vs Anorexia Nervosa

    A similar eating disorder to anorexia nervosa is bulimia. Some of the symptoms overlap in the two eating disorders.

    This concept is known as co-morbidity.

    For example, it is common to see in bulimia low or distorted body image or fear of gaining weight. And even more, in both cases, the person's goal is to lose weight. However, the two eating disorders manifest differently.

    People with bulimia usually consume excessive food in a short period. This is called binge eating, which is another eating disorder itself.

    A binge eating episode is when an individual over-consumes many calories in a short period, even though they felt full a long time ago.

    The main characteristic of bulimia is using methods of purging as a method to control weight gain. So a person with bulimia would eat a great amount of food quickly and then get rid of the food to avoid gaining weight. This is usually done by taking laxatives or forcing oneself to throw up.

    A way a person with bulimia may try to control weight gain is through extreme exercise. This is a non-purging type of bulimia in which the person would engage in frequent and high-intensity exercise practices. Although the person may have consumed a lot of food, these sports practices usually involve a higher caloric deficit than the food intake.

    Atypical Anorexia Nervosa

    Atypical Anorexia Nervosa is a type of anorexia nervosa, and they both share the most common symptoms. The main characteristic of atypical anorexia nervosa is that the person suffering from the disorder presents a weight within or above the normal range. These individuals are not as lean as those suffering from anorexia nervosa and do not show such a significant weight loss.

    In anorexia nervosa, the weight loss of those suffering from it can be detrimental to their health. These individuals may reach the point where their body organs cannot continue their regular functioning, leading to serious health issues. Differently, atypical anorexia nervosa does not put individuals at such risk in the short term.

    Causes of Anorexia Nervosa

    Among psychologists, there are disagreements on what factors cause the onset of eating disorders. For example, biological psychologists argue that our genetic makeup causes such illnesses. In contrast, cognitive psychologists explain anorexia in terms of faulty thoughts.

    Anorexia Nervosa: Biological Explanation

    Family studies and twin studies show that genes influence the onset of eating disorders. Research has found individuals have a higher risk of developing anorexia if an immediate family member has the same eating disorder (Strober, Freeman, Lampert, Diamond & Kaye, 2001).

    Twin studies found a 56% concordance rate in Monozygotic twins (identical, have the same genes) and 5% in dizygotic twins (share 50% of the same DNA) for anorexia nervosa (Holland, Sicotte & Treasure, 1988).

    Specific genes have been linked to anorexia. We inherit our genes from our parents; a variant of the EPHX2 gene has been linked to anorexia. Anorexia nervosa affects more women than men, and women are more likely to report weight dissatisfaction than men.

    The hypothalamus sends signals to the brain when we are hungry. However, research has shown disruptions in neural connections in the hypothalamus. Therefore, the brain may not be able to receive hunger signals well and, over time, cause the onset of anorexia. This is called the dual-centre theory of hypothalamic dysfunction.

    This is related to the glucostatic hypothesis (hunger and satiety are related to short-term shifts in glucose metabolism) and the lipostatic hypothesis (the fatty-acid concentration levels in the blood control the long-term food regulation).¹

    Dopamine is involved in reward-motivated behaviour. This theory suggests people with anorexia nervosa may have high amounts of dopamine, which causes anxiety. They may not seek pleasure, e.g. eating tasty food, so they can carry out avoidant behaviour not eating food.

    Neurodevelopmental (e.g. birth complications) abnormalities may also play a role in developing anorexia. Several birth complications have been associated with anorexia, including maternal anaemia (iron deficiency), premature heart issues, and diabetes.

    Anorexia Nervosa: Cognitive Explanation

    There are multiple cognitive theories exploring anorexia nervosa.

    Certain traits and characteristics have been associated with anorexia, including faulty thought processes concerning weight. Exposure to cultural and media norms of the 'idealistic, successful thin' person is also a concern.

    People with a perfectionist personality and high levels of self-doubt seem to be at higher risk of developing anorexia.

    Fairburn et al. (1999) found perfectionism to be a common trait amongst those with anorexia nervosa when compared to other psychiatric disorders. Grave importance, especially in western society, is placed on controlled eating, and self-worth is judged based on shape and weight.

    People with these traits also tend to have faulty schemas that lead them to develop a distorted image of themself and their bodies.

    The traits mentioned above can then lead to the following dysfunctional cognitive patterns:

    Cognitive Distortion

    Definition

    Example

    All or nothing approach

    A cognitive distortion where they see everything as black-and-white. Sufferers think they are fat if they can see some fat on their body or think they over-ate because they feel full.

    Only eat 'good' food and avoid 'bad' food.

    Overgeneralisation

    a cognitive distortion in which a person experiences or thinks of a negative experience and thinks it will be recurring in the future.

    "I'm fat because I always eat too much".

    Catastrophic thinking

    A cognitive distortion where an individual overthinks a negative experience that may occur even though it is unlikely. They may also overestimate how bad an event or behaviour is or underestimate their ability to cope with a particular event.

    Thinking that if they eat sugar, they will gain lots of weight or may not be able to stop themselves.

    Under this psychological pressure, the person is easily influenced and sensitive. If someone gives them positive feedback about their weight, it encourages them to continue this maladaptive behaviour. Or, if the person starts on a restrictive diet and does not lose weight, this leads to negative feedback and may cause them to believe they need to be even more restrictive.

    This thinking leads to a vicious cycle and causes the individual to fear food and weight gain, called Beck's vicious cycle (1967).

    Treatment of Anorexia

    Just as treating other psychiatric conditions, the treatment of eating disorders is complex. Usually, the treatment is supported by doctors and psychiatrists, psychologists or psychotherapists and the patient's family.

    In most cases, eating disorders require the patient to be admitted to a hospital or clinic. This is usually done because doctors cannot guarantee patients' well-being outside the facilities or because other treatments do not work. Patients in hospitals and clinics usually participate in individual and group therapy. At the same time, they are given medicines and are encouraged to eat and gain weight. Additionally, individuals can be supported and taught how to cope with anxiety, stress and anger management.

    In less extreme cases, individuals may benefit from family therapy and medication. Generally, patients who are not admitted to a clinic need to regularly talk to the doctor and attend check-in sessions in which their weight is checked, and they are supported in their recovery.

    Anorexia Nervosa - Key takeaways

    • Anorexia nervosa is a severe eating disorder that causes a person to maintain a very low weight.
    • Genetic makeup and neuroanatomical irregularities, such as dopamine levels, have been linked to anorexia.
    • The cognitive approach to explaining anorexia is that individuals with certain traits are likely to develop faulty schemas that lead to a distorted view of themself.
    • The family systems theory argues poor family dynamics cause the onset of anorexia and psychological pressures/illnesses to manifest into physical illnesses.

    References

    1. G. R. VandenBos, APA dictionary of psychology. American Psychological Association, 2007
    Frequently Asked Questions about Anorexia Nervosa

    What are the three characteristics of anorexia nervosa?

    Characteristics of anorexia nervosa are fear of becoming fat or gaining weight, having a distorted view of oneself and restricting how much one eats to stop oneself from gaining weight or help lose weight.

    What are the social causes of anorexia?

    Examples of the social causes of anorexia are psychosomatic families and the media.

    What are the three effects of anorexia?

    The effects of anorexia are weight loss, negative self-value and psychological distress.

    What are the biological causes of anorexia?

    The biological causes of anorexia are inheriting a gene variant linked to anorexia (EPHX2), neurotransmitter irregularities such as dopamine and serotonin levels, the dual centre theory (hypothalamic dysfunction, specifically the glucostatic and lipostatic hypothesis) and neurodevelopmental issues (birth complications).

    Is anorexia and anorexia nervosa the same thing?

    Anorexia and anorexia nervosa are often used together, implying that they mean the same thing. However, anorexia nervosa is the clinical term for the eating disorder, referring to the use of Nervosa, as this is a medical term (Latin, referring to the nervous system). 

    This means that there is a diagnostic criterion that one must meet to suffer from anorexia nervosa.

    Anorexia alone can describe an aversion to food and does not have the same medical connotations.

    Test your knowledge with multiple choice flashcards

    Is atypical anorexia a type of anorexia nervosa?

    Binge eating is a characteristic of ___.

    Which of the following is an example of an ‘all-or-nothing’ approach?

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