Anorexia is a severe mental disorder accompanied by an eating disorder. It is motivated by the desire to lose weight, as well as prevent weight gain. As a result, pathological passion, accompanied by a powerful fear of obesity, leads to a loss of 30 to 60% of body weight.
Features
Many patients with anorexia nervosa cease to critically evaluate their behavior, they do not pay attention to obvious dystrophy. They begin hormonal disorders, but to convince the patient of the need for therapy is an extremely difficult task. Some may be aware of their own exhaustion, but they have such a deep fear of eating that they are no longer able to restore their appetite without external help.
If left untreated, anorexia nervosa is fatal in 10-20% of all cases. This condition is rightfully considered a disease of stereotypes. Most often it develops among those who belong to the we althy segments of the population. Statistics say that every year the number of patients with anorexiaincreases. Anorexia nervosa is extremely rare in men. About 95% of all patients are girls and women. At the same time, the age of about 80% of all patients is 12-26 years old, and only 20% belong to a more mature age category.
In the ICD, anorexia nervosa has code F 50.0. Its key symptoms are amenorrhea, severe fear of obesity, severe weight loss.
Risk factors
Anorexia is always accompanied by an obsessive desire to lose weight. It is a kind of syndrome when a person has no appetite at all. Risk factors for developing anorexia nervosa are:
- Biological predisposition to psychological disorders.
- Intrapersonal conflict, which can be complicated by family difficulties.
- Societal values that equate the ideal of beauty with thinness.
What causes illness?
Several factors lead to the occurrence of the disease. The causes of anorexia nervosa are conventionally divided into three categories - biological, psychological and social.
- Genetic predisposition. When adverse environmental conditions occur, people with certain genes begin to suffer from mental disorders.
- Biological. This category of factors includes excess weight, early onset of the first menstruation, dysfunction of certain neurotransmitters (dopamine, serotonin).
- Personal. The likelihood of developing anorexia is higher in those who belong to the perfectionist-obsessive type,suffers from low self-esteem, self-doubt.
- Family problems can also be a cause of anorexia nervosa. The risk of getting sick increases among people in whose family someone suffers from depression, alcoholism, bulimia, drug addiction.
- Age. Teenagers and young men are most susceptible to the desire to please the opposite sex, the desire to imitate idols.
- Cultural. People living in large metropolitan areas are often more willing to comply with the generally accepted canons of attractiveness and success, which are expressed in a slender figure.
- Stressful. It can be physical, psychological or sexual abuse. Also, anorexia can be caused by traumatic events - the death of a loved one, divorce.
- Psychic. There are many disorders that are accompanied by disruptions in eating behavior - for example, schizophrenia.
Signs
As a rule, anorexia nervosa begins with the fact that the patient has an obsession: allegedly overweight is the cause of all his troubles (lack of external attractiveness, parting with a lover, lack of career growth). Then the patient begins depression, leading to severe self-restriction in nutrition. Most often, patients tend to hide their problem from others (they can give food to a pet, shift part of the dinner back into the pan, etc.).
Permanent malnutrition leads to another symptom. A person sometimes "breaks down" andstarts eating everything. At the same time, he reproaches himself and invents ways to limit the absorption of food. For example, provoke vomiting, use laxatives, enemas.
Against the background of the changes that occur in the body due to malnutrition, a person loses the ability to be critical of his condition. Even after he or she achieves the desired result in getting rid of extra pounds, it begins to seem unsatisfactory. Anorexia sufferer sets new "goals".
Mental disorders
From the side of the psyche, the following signs of anorexia may be observed:
- Not critical to signs of exhaustion.
- The constant feeling of being "full", the desire to lose weight more and more.
- Changing the way you eat (eating small meals or standing).
- Food obsession - collecting various recipes, diets.
- Panic fear of gaining extra pounds.
- Depression, irritability, reduced activity.
- Reducing the number of social contacts, isolation. Too many sports activities. Reluctance to attend events that include meals (such as birthdays).
Pathological ideas
One of the most characteristic signs of anorexia is reasoning like: “My height is now 167, and my weight is 44 kg. However, I want to weigh 35 kilograms.” In the future, the numbers become even smaller. Any results become desirableachievement, and gaining even a few pounds can be seen as a lack of self-control.
It is not uncommon for anorexics to wear baggy clothes so that their appearance does not cause unnecessary questions from others who do not share their ideas about the "standard of beauty".
Anorexia nervosa in adolescents
As a rule, the patients in the children's psychiatric department are girls who, with a height of about 1.5 m, can weigh 30 kg. They look very emaciated. Weight loss can be up to 30-40%. Parents should pay attention to the following symptoms of anorexia nervosa in teenagers.
- No food on a regular basis.
- Fear in a child to gain weight even with its lack, dependence of self-esteem on weight.
- Denial of the problem ("Get off me! I'm fine!").
- Disappearance of menstruation in girls.
- Reduced emotional background.
If you have these symptoms, you need to see a doctor - it is possible that the child will be diagnosed with Anorexia Nervosa.
Physical disorders
Over time, constant malnutrition leads to severe metabolic disorders, diseases of internal organs. Initially, these are hormonal changes that are caused by decreased production of thyroid hormones, sex hormones, and increased cortisol levels. The consequences of anorexia nervosa can be:
- constant weakness;
- for women -menstrual irregularities;
- reduced sex drive.
Then there are disturbances in the work of various body systems:
- dizziness, fainting, feeling cold, arrhythmia (may cause sudden death);
- immunity decreases, susceptibility to infectious diseases becomes higher;
- from the gastrointestinal tract there is dyspepsia, pain, peptic ulcer, gastritis, constipation, nausea;
- dry skin occurs, hair falls out, nails peel off;
- musculoskeletal system may experience osteoporosis, increased risk of fractures, muscle atrophy;
- there is a tendency to urolithiasis, kidney failure.
Some of the described symptoms are manageable with timely and adequate treatment, but most of the consequences can be irreversible.
What does overdoing cleansing lead to?
Excessive induction of vomiting artificially or taking laxatives is also fraught with consequences:
- difficulty swallowing food;
- ruptures of the esophagus;
- weakening of the walls of the rectum;
- rectal prolapse.
Women's he alth and anorexia
Often, pregnancy with this disorder can be extremely difficult. However, after the therapy, the level of estrogen in the body is restored, and conception is quite possible.
However, even after thetherapy, a woman may experience difficulties with the hormonal background:
- difficulty conceiving;
- high risk of fetal malnutrition, the presence of congenital malformations in the unborn baby;
- high risk of complications during pregnancy and childbirth;
- high risk of anorexia nervosa recurrence on news of pregnancy;
- with complex forms of the disease, the restoration of reproductive he alth does not occur on its own, and even after therapy, the woman is not able to become pregnant.
Stages
The following stages are distinguished during the course of the disease.
- Dysmorphomanic. The patient has painful ideas that he is inferior. These thoughts are connected with imaginary completeness. The emotional state becomes anxious, depressed. The patient can stand in front of the mirror for a long time, examining the outlines of his figure, constantly being weighed. At this stage, for the first time, he makes attempts to limit himself in food, begins to look for the "ideal" diet.
- Anorectic. The patient begins to attempt fasting and for this reason loses up to 30% of body weight. Such “successes” are perceived with a sense of euphoria. There is a desire to lose weight even more. The patient begins to torment himself with very high physical exertion, and, on the contrary, eats even less. He tries to convince himself and loved ones that he has no appetite. At this stage, he is not critical of exhaustion and underestimates the consequences of his actions. Starvation and lack of nutrients in the body lead to the appearance of the first somaticsymptoms: hypotension, fainting, dry skin, hair loss. The metabolism is disturbed. Failures in the physiological functioning of organs are accompanied by tissue breakdown, which leads to even greater suppression of appetite.
- Cachectic. At this stage, irreversible consequences occur, which are caused by dystrophy of internal organs. As a rule, this stage begins 1.5-2 years after the first symptoms of anorexia nervosa. The consequences at this stage are the most deplorable: the patient loses about 50% of body weight. If there is no treatment, organ dystrophy leads to the death of the patient.
Diagnosis
For those who monitor their psychological he alth, the question of how to treat anorexia nervosa is unlikely to ever become relevant. Therefore, it can be said that the best way to treat this disorder is to prevent its development.
In the event that such a diagnosis has already been made, therapy can be carried out by doctors of several specializations. Who to contact for anorexia nervosa? It can be a psychotherapist, psychiatrist, and also an endocrinologist. Often, a nutritionist is also involved in the treatment. Treatment is carried out in a hospital or at home.
Hospitalization is needed in the following cases:
- Reducing body mass index by a third below normal.
- Increasing weight loss.
- Irregularities in the work of the heart.
- Hypotension.
- Severe depression.
- Suicidal tendencies.
Features of therapy
The main goal of treatment is primarily to restore the previous weight. It is desirable that the patient added about 1 kg per week. Therapy aimed at eliminating mental and physical complications is also carried out. It is very important that the patient is aware of the importance of treatment and shows participation in his own destiny. The following factors can complicate the process of therapy:
- Chat with friends, relatives, coaches who are delighted with thinness.
- Lack of emotional support from loved ones.
- The inability to overcome the belief that excessive thinness is the only way to fight excess weight. Therapy usually includes several different methods.
Lifestyle change
To overcome anorexia, the patient needs the following changes:
- Regular he althy eating.
- Adequate formation of a daily diet, menu preparation with the help of a professional nutritionist.
- Getting rid of the addiction of constant weighing.
- Exclusion of serious physical exertion (only after the condition is normalized, the doctor can include physiotherapy exercises in the schedule).
- Psychological support from loved ones.
Restoring power
This component of treatment is one of the fundamental in the fight against the disease. In order for the weight to increase, the patient is prescribed a special diet. Her principleis that every day the caloric content of the diet should increase. At first, it is 1000-1600 kcal per day. Then gradually increases to 2000-3500 kcal. The patient should eat 6-7 times a day in small portions.
In the initial stages, the patient may feel anxiety, depression. Over time, these symptoms disappear.
As a rule, intravenous nutrition is not used in the treatment of anorexia, because in the future such methods can lead to difficulties in normal nutrition. Also, patients may perceive these methods as compulsory treatment. However, in some cases, such measures are quite justified. For example, if a patient categorically refuses to eat for a long time, he has disturbances in the functioning of the cardiovascular system, bleeding from the oral cavity, etc.
Food supplements
Sick suffer from a serious lack of vitamins, minerals, various nutrients. Treatment of anorexia nervosa at home must necessarily take place under the supervision of a physician. Close people should understand that improving the diet and taking vitamins is one of the fundamental factors of recovery. If the lack of nutrients is replenished, the mental and physical condition becomes much better. If necessary, diet therapy is supplemented by the use of special additives, dietary supplements. These could be:
- multivitamin preparations;
- Omega-3 fish oil;
- coenzyme Q-10;
- probiotics.
Other recommendations
To improve nutrient absorption, the following should also be observed:
- drink enough liquid every day (about 6-8 glasses a day);
- include sources of protein in the diet - meat and dairy products, eggs, protein shakes;
- quitting smoking and drinking alcohol;
- no caffeinated drinks;
- limiting products that contain refined sugar - candy, soda, etc.
Methods of working with a psychologist
As a rule, psychotherapy for anorexia nervosa is carried out in one of three directions: it can be behavioral, cognitive or family therapy. Behavioral leads the patient to the need for weight gain. Cognitive is aimed at transforming the distorted ideas of thinking that led to the disease. Family therapy tends to be most effective for patients under 18 years of age. In some cases, work with a psychologist can be supplemented by taking pharmacological drugs - Chlorpromazine, Fluosxetine, Cyproheptadine. However, drugs are prescribed only in cases where working with a psychotherapist is not enough.
Hypnosis
In some cases, hypnotherapy can become part of the treatment. Sessions allow the patient to regain self-confidence, increase resistance to stress. Hypnosis allows you to restore the right relationship with your body. As a result, this approach allowsreturn to proper nutrition and a normal life in general.
Exodus
As a rule, recovery is observed after treatment. The course of the disease is recurrent. Death can occur without treatment in 5-10% of cases as a result of irreversible changes in the functioning of internal organs.
Anorexia is a fairly serious mental disorder. If it is found, you should immediately consult a doctor. Timely treatment will help to avoid terrible consequences. All information is given for reference, before using any drugs and methods, a specialist consultation is necessary.
