Emily(name changed) at the age of 19 was admitted to a mental health centre inpatient unit weighing 29 kgs, about 24 kgs underweight along with liver, kidney, and pancreas damage. Emily’s treatment included utilizing a hierarchy of reinforcements in the form of privileges that had to be earned. For the kilograms gained privileges were granted, for kilograms lost privileges were curtailed. However, her eating behaviour was seen as an unconscious spite and revenge reaction toward her parents as well as an attempt to elicit attention. Emily was discharged after two months and at the time she weighed 47 kgs. Follow up after two years revealed that her weight remains at the same level. What Emily suffered is known as Anorexia Nervosa.
Anorexia Nervosa is a psychological and potentially life-threatening eating disorder Those suffering from this eating disorder are typically suffering from an extremely low body weight relative to their height and body type. The first medical report of Anorexia goes back to 1689, written by London physician Richard Morton who described it as “a neurons consumption” caused by “sadness and anxious cares.” The awareness of the disorder was limited to the medical profession until the latter part of the 20th century when German-American Psychoanalyst Hilde Bruch published her work “The Golden Cage: The Enigma of Anorexia Nervosa” in 1978. This book created a wider awareness of anorexia nervosa among the general public. Further, the death of popular singer Karen Carpenter in 1983 further spread awareness due to media coverage on anorexia. According to The Diagnostic and Statistical Manual of Mental Disorders for an individual to be diagnosed as having Anorexia Nervosa one must display:
- Persistent restriction of energy intake leading to significantly low body weight in the context of what is minimally expected for age, sex, developmental trajectory and physical health.
- Either an intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes with weight gain even though significantly low weight.
- Disturbance in the way one’s body weight or shape is experienced, undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
In our society very early on, ideas such as “thigh gap”, “thin are beautiful” and “size zero”is instilled through social media. As a result, individuals barely eat and exercise much more than they should. Anorexia Nervosa in the most common form that exists predominantly in young women and teenage girls. Up to 1 in 5 people with chronic anorexia may die as a result of starvation and malnutrition or suicide. There are many celebrities who had suffered from anorexia. In 2012 the famous American singer, songwriter and actress Lady Gaga revealed that she struggled with anorexia since the age of 15. Her foundation ‘Born This Way’ deals with young people to help with body image etc. On January 2018, Swedish singer Javier Muñoz died after struggling for ten years with anorexia nervosa.
Signs and Symptoms:
- Rapidly losing weight or being significantly underweight and emaciated
- Chronic restrictive eating or dieting.
- Obsession with calories and fat contents of food.
- Fixation with food, recipes, or cooking; the individual may cook intricate meals for others but refrain from partaking
- Engaging in ritualistic eating patterns, such as cutting food into tiny pieces, eating alone, hiding food
- Depression or lethargic state
- Amenorrhea which is an abnormal absence of menstruation or loss of 3 consecutive menstrual cycles
- Development of lanugo i.e. soft, fine hair that grows on face and body
- A sensation of feeling cold
- Loss or thinning of hair
- Avoidance of social functions, family and friends
Anorexia Nervosa is a serious mental health condition. It can even lead to death. When you have Anorexia the desire to constantly lose weight is what becomes the central part of your life. You may even lose the ability to see yourself as you truly are. However, it is not an irreversible condition. Recovery is possible.
Steps to Recover:
- Admit that you have a problem: The first step to any recovery is admitting that the problem exists within you and that you truly need help.
- Talk to someone: It is hard to overcome any problem alone. It is vital to have a good support system.
- Stay away from people and places that act as a trigger: Spend less time with friends who are constantly counting calories, and stay away from websites that deal with weight loss.
- Seek help: Talk to a professional that can help regain your health. Admit yourself to a program.