How to recognize the disorder
The beginning often looks harmless: a person decides to eat healthy, gives up sweets and starchy foods, and starts counting calories. Gradually, the list of prohibitions expands, rituals around food appear - cutting into small pieces, chewing for a long time, eating alone. There is avoidance of dinners together, lies about what you have already eaten, constant weighing and looking at your body in the mirror. At the same time, exhausting training increases. The person himself does not consider what is happening to be a problem and defends his regime, so those close to him are usually the first to sound the alarm.
- Progressive food restriction
- Rituals around meals
- Avoiding shared meals
- Frequent weighing and body measurements
- Exhausting physical activity
- Wearing baggy clothes
- Denial of the problem and irritation when talking about food
What happens to the body
With a long-term nutritional deficiency, the body goes into saving mode: the pulse slows down, the blood pressure and body temperature decrease, and the person constantly freezes. The menstrual cycle stops, growth and puberty slow down in adolescents. The skin becomes dry, the hair becomes brittle, and thin fluff appears on the body. Due to a lack of protein and electrolytes, muscles suffer, including the heart, causing weakness, fainting and rhythm disturbances. Bone density decreases, which increases the risk of fractures at a young age.
- Rare pulse and low blood pressure
- Constant feeling of cold
- Stopping menstruation
- Hair loss and dry skin
- Muscle weakness and fatigue
- Heart rhythm disturbances
- Decreased bone density
- Constipation and abdominal pain
Causes and risk factors
Anorexia nervosa occurs due to a combination of biological vulnerability, psychological characteristics and external pressure. Hereditary predisposition and features of the regulation of eating behavior are significant. Psychologically, perfectionism, anxiety, low self-esteem and the need to control at least one area of life contribute to the disorder. External factors - the cult of thinness on social networks, remarks about appearance, bullying, and participation in sports with weight requirements. Often the starting point is a regular diet, after which weight loss begins to be reinforced by the praise of others.
- Hereditary predisposition
- Perfectionism and high anxiety
- Low self-esteem and need for control
- The pressure of the cult of thinness and social networks
- Body remarks and bullying
- Sports with weight categories and aesthetic types
- Starting a regular diet as a trigger
Diagnosis and assessment of the condition
The diagnosis is made by a psychiatrist based on a conversation, but a mandatory part is a medical assessment of the severity of exhaustion. The doctor measures weight and height, assesses dynamics, pulse, blood pressure and temperature. Laboratory examination reveals dangerous disorders: decreased potassium and sodium, changes in blood tests, impaired liver and kidney function. An ECG is necessary due to the risk of rhythm disturbances. Additionally, hormonal status and bone density are assessed. The presence of vomiting and taking laxatives should be checked separately, as they sharply increase the risk of complications.
- Assessment of weight, height and decline dynamics
- Measurement of pulse, pressure, temperature
- General blood test
- Blood electrolytes: potassium, sodium, chlorine
- ECG
- Thyroid hormones and sex hormones
- Bone density assessment
- Screening for depression and suicide risk
Treatment
Treatment is always complex and long-term. The first priority is the safe restoration of nutrition: it is increased gradually and under the supervision of a doctor, because resuming food too quickly when exhausted is dangerous by disrupting electrolyte metabolism. In parallel, psychotherapy is carried out, aimed at working with fear of weight gain, distorted body image and underlying difficulties. When treating adolescents, family therapy has proven effective, where parents are actively involved in restoring nutrition. Severe exhaustion, rhythm disturbances and suicidal risk require hospital treatment.
- Gradual restoration of nutrition under medical supervision
- Electrolyte monitoring at the beginning of recovery
- Psychotherapy focused on eating disorders
- Family therapy for adolescents
- Treatment of comorbid depression and anxiety
- Hospitalization for severe exhaustion and complications
- Long-term follow-up to prevent relapse
- Support from loved ones without reproaches and pressure