Anorexia is a mental disorder that affects an increasing number of young people. The problem of this disorder is very complex and is caused by many factors. Not insignificant is the social pressure resulting from the promotion of a certain appearance, which by standards is a prerequisite for a successful and fulfilling life. Recently, the public has recognized this problem and is beginning to promote the “normal” appearance of women. Often the drama of these young people, in many cases subjected to trauma in childhood, is a cry for help.
The disorder is characterized by low weight, restricted eating, body image disturbances, fear of gaining weight, and an overwhelming desire to be thin. Attempts to lose weight can lead to starvation.
The adjective “nervosa” indicates the functional and unrestricted nature of the disorder.
Pathological control of this feeling, the need to eat, is a source of satisfaction for the patient.
These individuals also often deny that they have a problem with low weight. They may weigh themselves frequently, eat small portions, and only certain foods. Some exercise excessively, force themselves to vomit, or use laxatives to lose weight and control their appearance.
Many famous historical figures are believed to have suffered from the disease, including Catherine of Siena, and Mary, Queen of Scots.
However, it was not until the late 19th century that mental anorexia nervosa was widely accepted by medical professionals as a recognized condition.
In 1873, Sir William Gull, one of Queen Victoria’s physicians, published a landmark article that used the term “mental anorexia nervosa” and provided many detailed case descriptions and treatments.
In the second half of the 20th century, German-American psychoanalyst Hilde Bruch published her work “The Golden Cage: The Enigma of anorexia nervosa.” The book created a wider awareness of anorexia among laypeople.
A major event triggering the discussion of the disorder was the death of popular singer Karen Carpenter in 1983. It caused the eating disorder to become a major media topic. The singer’s brother, her singing partner, set up a fund for research on mental anorexia nervosa. Other celebrities, including Jane Fonda and Lynn Redgrave, also began to share their experiences with the disorder.
The sufferer is usually found to have malnutrition of various degrees, with secondary hormonal and metabolic changes and dysfunction.
The disorder occurs 6 to 12 times more often in women than in men. It is far more common in the Caucasian race, especially during adolescence. It is also more common in homosexuals and bisexuals.
These include:
People with this condition often isolate themselves at mealtimes and engage in intense sports.
It is thought to consist of a combination of biological, psychological, and environmental factors.
Prospective anorexics are characterized by high intelligence and are often primes at school. Their actions are often accompanied by a fear of failure. They have low self-esteem, are hypersensitive, emotionally tense, fearful, distrustful of others, and suspicious. They are characterized by a negative view of themselves, hypersensitivity to criticism, and a sense of hopelessness.
Some of these people may have obsessive-compulsive personality traits that make it easy for them to give up eating, despite the hunger they feel, or to stick very closely to a restrictive diet. They often suppress the feelings of anxiety that accompany them by not eating.
However, it has been found that the disorder is highly heritable. Studies of twins have shown that the heritability rate ranges from 28 to 58 percent. First-degree relatives of people with anorexia have about 12 times the risk of developing the disease.
A 2019 study found a genetic link to mental disorders such as schizophrenia, obsessive-compulsive disorder, anxiety disorders, and depression.
The widespread cult of beauty and a slim figure - the promotion of skinny models, excessive physical activity, the belief that success and fulfillment in life can only be achieved by wearing clothes of the smallest size - all these influence the consciousness of young people, especially girls. Therefore, they follow restrictive diets, exercise excessively, and ingest laxatives to meet these demands.
Approximately 72 percent of people with anorexia report a traumatic event before the onset of eating disorder symptoms (the highest percentage reporting bulimia).
One such traumatic event is childhood sexual abuse. Others include physical and emotional abuse. Individuals who experience repeated trauma, as well as those who experience trauma perpetrated by a caregiver or loved one, have increased the severity of anorexia symptoms and a higher incidence of co-occurring psychiatric diagnoses. Traumatic events can lead to intrusive and obsessive thoughts, and a symptom of anorexia is an increase in obsessive thoughts related to food. People who are out of control of their bodies due to trauma may use food as a means of control, as the choice to eat is an expression of control. By exercising control over eating, the patient can decide when and how much to eat. Limiting the amount of food can also be a way of communicating the pain the traumatized person is experiencing.
It is most common in girls and young women, although recently the disorder has been increasingly observed in young boys and men as well.
The disorder can occur in other age groups, although it is rare in people over 40.
It has the highest mortality rate of all mental disorders. Half of women with the disorder make a full recovery; 20-30 percent may make a partial recovery. About 20 percent of patients develop mental anorexia as a chronic disorder.
If anorexia is left untreated, serious complications can arise: heart disease and kidney failure, which eventually lead to death.
Relapse occurs in about one-third of people in the hospital and is greatest in the first six to 18 months after discharge from the facility.
