Anorexia Nervosa

What is Anorexia?
Anorexia (a-neh-RECK-see ah) nervosa, typically called anorexia, is a type of eating disorder that mainly affects girls and young women. A person with this disorder has an intense fear of gaining weight and limits the food she eats. She

• has a low body weight
  
• refuses to keep a normal body weight
  
• is extremely afraid of becoming fat
  
• believes she is fat even when she's very thin
  
• misses three (menstrual) periods in a row—for girls/women who have started having their periods.
  

What causes it?
Anorexia is more than just a problem with food. It's a way of using food or starving oneself to feel more in control of her life and to ease tension, anger, and anxiety. While there is no single known cause of anorexia, several things may contribute to the development of the disorder:

• Biology. Several biological factors, including genetics and other related hormones, may contribute in the onset the disorder.
  
  
• Culture. Some cultures in the U.S. have an ideal of extreme thinness. Women may define themselves on how beautiful they are.
  
  
• Personal feelings. Someone with anorexia may feel badly about herself, feel helpless, and hate the way she looks. She has unrealistic expectations of herself and strives for perfection. She feels worthless, despite achievements and perceives a social pressure to be thin.
  
  
• Stressful events or life changes. Things like starting a new school or job or being teased to traumatic events like rape can lead to the onset of anorexia.
  
  
• Families. People with a mother or sister with anorexia are more likely to develop the disorder. Parents who think appearance is very important, diet themselves, and criticize their children's bodies are more likely to have a child with anorexia.

What are signs of anorexia?
A person with anorexia will have many of these signs:

• Looks a lot thinner
  
• Uses extreme measures to lose weight
  
• Makes herself throw up
  
• Takes pills to urinate or have a bowel movement (BM)
  
• Takes diet pills
  
• Doesn’t eat or follows a strict diet
  
• Exercises a lot
  
• Weighs food and counts calories
  
• Moves food around the plate; doesn't eat it
  
• Has a distorted body image
  
• Thinks she's fat when she's too thin
  
• Wears baggy clothes to hide appearance
  
• Fears gaining weight
  
• Weighs herself many times a day
  
• Acts differently
  
• Talks about weight and food all the time
  
• Won't eat in front of others
  
• Acts moody or depressed
  
• Doesn't socialize

What happens to your body with anorexia?
The body doesn't get the energy from foods that it needs, so it slows down. Look at the picture to find out how anorexia affects your health.

Can someone with anorexia get better?
Yes. People with this disorder can get better. The treatment depends on what the person needs. The person must get back to a healthy weight. Many times, eating disorders happen with other problems, like depression and anxiety problems. These problems are treated along with the anorexia and may involve medicines that help reduce feelings of depression and anxiety.

With outpatient care, the patient goes to the hospital during the day for treatment, but lives at home. Sometimes, the patient goes to a hospital and stays there for treatment. Different types of health care providers, like doctors, nutritionists, and therapists, will help the patient get better. These providers will help the patient regain the weight, improve physical health and nutrition, learn healthy eating patterns, and cope with thoughts and feelings related to the disorder. After leaving the hospital, the patient continues to get help from her providers. Individual counseling can also help someone with anorexia. Counseling may involve the whole family too, especially if the patient is young. Support groups may also be a part of treatment. Support groups help patients and families talk about their experiences and help each other get better.

Can women who had anorexia in the past still get pregnant?
It depends. Women who have fully recovered from anorexia have a better chance of getting pregnant. While a woman has active anorexia, she does not get her usual period and doesn't normally ovulate, so it would be harder to get pregnant. However, she may get pregnant as she regains weight because her reproductive system is getting back to normal. After they gain back some weight, some women may skip or miss their periods, which can cause problems getting pregnant. If this happens, a woman should see her doctor.

Can anorexia hurt a baby when the mother is pregnant?
If a woman with active anorexia gets pregnant, the baby and mother can be affected. The baby is more likely to be born at a low weight and born early. The mother is more likely to have a miscarriage, deliver by C-section, and have depression after the baby is born.

What should I do if I think someone I know has anorexia?
If you know someone like Jen, you can help. Follow these steps from the National Eating Disorders Association:

• Set a time to talk. Set aside a time to privately talk about your concerns with your friend. Be open and honest. Make sure you talk in a place away from distractions.
  
  
• Tell your friend about your concerns. Tell your friend about specific times when you were worried about her eating or exercise behaviors. Explain that you think these things may show a problem that needs professional help.
  
  
• Ask your friend talk about these concerns. She could talk to a counselor or doctor who knows about eating issues. If you feel comfortable, offer to help your friend make an appointment or go with her to her appointment.
  
  
• Avoid conflicts or a battle of the wills with your friend. If your friend doesn’t admit to a problem, repeat your feelings and the reasons for them. Be a supportive listener.
  
  
• Don’t place shame, blame, or guilt on your friend. Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements like, “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
  
  
• Avoid giving simple solutions. Don’t say, "If you'd just stop, then everything would be fine!"
  
  
• Express your continued support. Remind your friend that you care and want her to be healthy and happy.