Anorexia is a serious mental illness where people keep their body weight low by dieting, vomiting, using laxatives, or exercising excessively. The way people with anorexia see themselves is often at odds with how they are seen by others, and they will usually challenge the idea that they should gain weight. The most important thing to remember about anorexia is that it's an illness, and patients need professional help. The sooner you spot the signs of the illness, the higher the chance of recovery.
People with anorexia limit the amount they eat and drink in order to control how their body looks. They lose weight quickly and drastically and may often lead other people to believe that they are eating far more than they actually are. Patients may be using other ways of staying thin, such as exercising too much, skipping meals, trying to be on a liquid diet and using laxatives. It's not uncommon that those with anorexia take appetite-suppressant medicines or diuretics. If the patient is a teenager and still growing, they may not lose weight, but may not be gaining it as they should. The result will be the same: The person is under the normal weight for their age and height.
People with anorexia think they are fat when they are actually very thin. Although other people see them as thin or underweight, it's impossible for them to see this. They have a severe dread, almost a phobia, of gaining weight. People with anorexia will do their utmost to avoid putting on weight because, in their mind, it's the worst possible thing that can happen. Studies show that when anorexics look at themselves in the mirror, what they see is different from what other people see. If they were asked to draw or match a computer image of what they think they look like, they might choose an image that is bigger than what they really are. People with anorexia also try hard to hide their thinness, for example, by wearing baggy clothes or putting heavy objects in their pockets when being weighed.
People with anorexia often restrict themselves to certain types of food. Eating food may even become a ritual. For example, each time they eat, they have to cut their food into very small pieces. Some of them exclude certain groups of products; they decide not to eat bread or any carbohydrates, skip eating all the foods rich in fat or don't touch sugar. It's all about repetitive patterns that keep them safe and give an illusion of control. They may also frequently think about their weight and even weigh themselves several times a day.
One of the diagnostic criteria for anorexia for women is the loss of menstrual periods for at least three months. In anorexics, severe weight loss reduces fat stores in the body, which in turn reduces thyroid levels and results in an increase in the stress hormone cortisol. This state, known as hypercortisolism, then reduces reproductive hormones. When reproductive hormones are insufficient to regulate the monthly menstrual cycle, amenorrhea, or the cessation of monthly periods, occurs. Periods may even stop altogether, or women with anorexia may never start their periods, especially if they began having eating problems when they were quite young. Some women with anorexia may become infertile and unable to have a baby.
Many people with anorexia nervosa have low bone density and, consequently, reduced bone strength. Thus, their risk of fracturing a bone is increased. The low bone density in anorexics has several causes related to how the body changes its hormone production in response to low body weight. Levels of insulin-like growth factor I (IGF-1) are reduced, while levels of the steroid cortisol are increased. In women, this leads to a reduction in estrogen, and estrogen protects a women's bones from osteoporosis. In women, poor nutrition and reduced muscle mass may also contribute to low bone density. Similarly, low hormone levels, weight loss, and malnutrition may be responsible for the low bone density found in men with the condition.
Eating disorder patients commonly complain of gastrointestinal (GI) symptoms, including bloating, abdominal pain, and constipation. All disordered eating behaviors such as self-induced vomiting, laxative abuse, and food restriction are bound to have negative effects on the digestive system. All these behaviors can damage the bowel muscle and nerve endings. This may eventually result in permanent constipation and, sometimes, abdominal pains. Chronic under-eating also causes the muscles of the small and large intestine to shrink; that's why people with anorexia often experience stomach aches, bloating, and acid reflux. Reduced organ size and production of enzymes lead to the food sitting in the organs for much longer than normal.
Anemia is a disorder that occurs when the red blood cell count in the body is low. It can occur in those with an eating disorder such as anorexia as a result of an unhealthy, very restrictive, or non-existent diet. Anemia results especially from a diet with low iron content, and it's very common for anorexic people to get rid of red meat from their diets because they think that it has too high of fat content. Low iron intake can make people feel weaker and more tired than normal. Dizzy spells and feeling faint can also occur. For those with eating disorders, anorexia treatment at an eating disorder treatment clinic is often very beneficial and can assist in preventing anemia.
Depression can lead to the development of eating disorders and, at the same time, eating disorders can result in depression, becoming co-occurring disorders. When a patient is malnourished, which is common in anorexia, psychological consequences may result, such as poor mood states or feelings of worthlessness. Although depression and eating disorders are two separate illnesses, one state can certainly trigger the development of the other. During anorexia, some people develop clinical depression, which can respond well to treatment. Talking to a doctor about any symptoms of depression is important. Many people find they become more moody or irritable; they feel hopeless and sadly most of the time and have suicidal thoughts.
Anorexia can cause problems with the heart and circulation, including leaking heart valves, low blood pressure, and abnormal heart rhythms. Additionally, as the body loses muscle mass, it loses heart muscle at a preferential rate, so the heart gets smaller and weaker. It gets worse at increasing circulation in response to exercise, and pulse and blood pressure drop. The cardiac toll is acute, significant, and sets in quickly. Heart damage is the most common reason for hospitalization in people with anorexia.
People who have deprived their bodies of nutrition for extended periods of time often develop soft, downy body hair, almost a thin film of fur, on their arms and other parts of the body. This hair, known as lanugo, is a physical adaptation to the perilously low weight and loss of body fat seen in some people with anorexia. It has been associated with decreased activity of the reductase enzyme system, probably due to hypothyroidism. People with anorexia also usually have very dry, thin, paper-like skin. The lack of nutrition often leads to breakouts, rashes, and blemishes that are difficult to get rid of.
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