Anorexia is primarily a serious mental health condition. People with anorexia have a distorted image of their bodies, thinking they are fat when they are underweight. They then try to reduce weight further by not eating enough food and by exercising too much. This leads to serious physical illness through starvation.
It is not easy for someone with anorexia to suddenly start eating more. Once a little weight is gained the brain or mental health condition thinks ‘too fat’ and puts effort into resisting food and taking more exercise. This is why anorexia is more of a mental health issue than a simple diet or weight issue.
Although anorexia is often associated with teenage girls, it affects both men and women. It often starts in mid-teens but the symptoms can carry on throughout adult life.
Most people with anorexia will be very thin or have a low weight and very low body mass index (BMI). But this can be hard for others to see, as those with anorexia are often skilled in dressing to hide the fact they are too thin.
Making comments about being fat when you clearly are not – this is a major warning sign of body image issues and might indicate anorexia. Also lying or being dishonest about weight loss is another common sign.
Missing meals, eating very little or developing rituals with how food is eaten are typical signs of anorexia. People who can only eat food cut a certain way, arranged in a certain way or served at a certain time, are subconsciously developing ways of slowing down eating and this is common with anorexia.
Physical symptoms such as hair loss, nails stopping growing, periods (for girls) stopping or not starting, and dry skin are all physical symptoms associated with anorexia.
Behavioural changes such as excessive exercise or always exercising or walking after a meal are another sign of anorexia or other eating disorders.
Sometimes people also take medication such as laxatives or diuretics or hunger suppressants when these are clearly not needed.
Although anorexia is mostly a mental health issue, the long-term impact on the physical body is extreme and very damaging. Your body is starved and you develop problems with your heart – heart failure and swelling of hands and feet, low blood pressure, problems with the brain – fits and memory loss, problems with muscles and bones – weakness and stunted physical development, bowel and bladder problems – needing the toilet very often and fertility issues. Untreated anorexia can cause hospitalisation or death.
It is common for someone with anorexia to avoid seeking help as they will deny there is any issue at all with their weight. They are deliberately starving themselves whilst their brain is thinking they are fat.
If someone with anorexia wants help and wants to get better then this is most of the battle won. The biggest difficulty is for them to understand there is a problem to start with.
Treatment focuses on talking therapies such as counselling and CBT (cognitive behavioural therapy) and developing a healthy lifestyle and a better image of yourself. Once you have a better image of yourself your brain will stop trying to stop you from eating. The aim of the therapy is to help you to develop good ways of coping with the negative thoughts and feelings that are associated with your anorexia. It seeks to empower you to dismiss these thoughts and turn them into something more positive.
Many people recover from anorexia or develop better lifestyles and a more healthy weight. However, there is always a risk of relapse and it can be helpful to have someone – a friend or a trusted 3rd party to talk to if the negative thoughts reappear and you cannot control them. This is especially true at stressful times in life – maybe a new job or relationship or change in family circumstance.