What is Anorexia Nervosa?

Adolescence is a critical time for physical development in a person’s life. Given the proper nutrition, adolescence will be the time in a person’s life where they grow the most aside from the first five years. The difference, however, between a 5 and 15-year-old, is that the 5-year-old has not yet learned from their parents, peers, and favorite celebrities to be ashamed of their bodies growing larger. This puts adolescents at high risk for disordered eating at a time where nutrition is critical for growth. In this post, we will define anorexia nervosa, how it can negatively affect your health and development, and how to get help when you need it.

How does it affect your life?

More commonly referred to as just "anorexia", this condition causes people to feel upset, or worried, about gaining weight to the point where they may not eat enough, or exercise so much, and are not getting enough nutrients to fuel their body. Mental distress can be linked to an obsession about body size, food choices, and wanting a sense of control over your life (John Hopkins Medicine, 2019).

These behaviors, and mindsets, will, in the short term, lead to weight loss, fatigue, changes and mood, and withdrawal from social activities. Long-term they will become more dangerous, potentially causing delayed puberty, bone and hair thinning, anemia, infertility, and damage to major vital organs like the heart and brain (National Eating Disorders Collaboration, 2024).

Anorexia can have major, life-altering side effects to your physical and mental health. Anorexia can cause rifts between you and your loved ones, a lost sense of self, a destroyed sense of self confidence, and a lifetime of obsessive thoughts surrounding eating. Recovering from anorexia can be a challenging journey, but it’s totally worth it! Without recovery, the damage done by anorexia can be life-threatening, with those who have anorexia having a suicide risk 18 times higher than those without (National Association of Anorexia Nervosa and Associated Disorders, 2023).

Symptoms

The symptoms associated with anorexia are more complicated than the simple lack of desire to eat:

1. Depriving your body of the energy it needs, by restricting eating, or excessively exercising, to the point where your weight is much lower than what is recommended for someone of your height (levels of severity can range from mild to extreme and are defined by how low your Body Mass Index, or BMI, is).

   
   

2. Are extremely afraid of gaining weight, or continue to prevent weight gain when your BMI is lower than what is considered healthy for your height.

   
   

3. The way you experience your body's size is distorted. You might think you look heavier than you actually are, your perception of your size greatly influences your self-esteem, and you may not be willing to accept how dangerous the low weight is for your health.

Most often, the mental symptoms of anorexia develop first, such as dissatisfaction with your body, distorted image of how your body looks, and irrational fear of gaining weight (National Institute of Mental Health, 2024). These mental factors lead a person to develop unhealthy behaviors such as excessive exercise and fasting, and to develop harmful mindsets such as fear and/or rules surrounding eating and food (Anorexia Nervosa: Causes, Symptoms, Diagnosis & Treatment, n.d.).

Risk Factors

There are lots of things that can make someone more likely to develop anorexia. Factors such as family history, mental and physical health conditions, personality, and even which sports you choose to get involved in can all put you at risk for developing an eating disorder.

Some risk factors are lifestyle based. These are the factors that guide how you live your life and the unhealthy habits/mindsets you may develop because of certain lifestyle choices. These factors include things such as having a history of using diets to control weight, engaging in excessive exercise as part of certain sports such as wrestling, or gymnastics (John Hopkins Medicine, 2019), and the misuse of illegal drugs (Dennis, 2024).

Other risk factors are those you are born into, like your family history, or the society you grow up in. Biological factors can include age, gender, history of mental health conditions, such as depression or OCD, or physical health conditions, such as type 1 diabetes (Dennis, 2024). Overall, women have an increased risk in having anorexia compared to men. For instance, the rate of anorexia in teenage girls has been increasing steadily since 1930 (Dennis, 2024). Today, about 12% of adolescent girls experience some form of eating disorder (National Association of Anorexia Nervosa and Associated Disorders, 2023). Additionally, having a family history of eating disorders, or mental health problems, as well as having an unsupportive family, can increase your risk. Within society, factors such as changing beauty standards and bullying increase someone’s risk for anorexia (Dennis, 2024).

It is also known that certain personality traits can increase your risk. such as those who experience alexithymia. This refers to those who have difficulty identifying and expressing emotions – patients with anorexia have been shown to have higher levels of alexithymia (Calvo-Rivera et al., 2022).

How does it affect your brain?

Much of what causes anorexia, from within the brain itself, is unclear, although there are several potential theories. Some suggest that neurotransmitters, the chemical messengers in your brain, are impaired which impacts the body’s ability to properly function. This is especially true for both dopamine and serotonin (Riva, 2016). For instance, dopamine is in charge of motivating your body to continue to seek out positive sensations. Someone with a dopamine deficiency may lose motivation to engage in previously pleasurable activities such as eating (Cleveland Clinic, 2022). Additionally, serotonin is in charge of signaling that the body is satisfied. A lack of serotonin can lead to obsessive thoughts and phobias which leads to fear and anxiety around food and gaining weight (Moyer, 2018).

There is a link between depression and anorexia (Calvo-Rivera et al., 2022). About 30% - 40% of adolescents with anorexia nervosa are diagnosed with major depression, but it could be even higher. Teens may turn to unhelpful strategies as a way of dealing with poor mental health, such as anger outbursts, avoiding things, or thinking too much about things. These depressive thoughts can prevent the brain from using more healthy coping strategies and can make anorexia even worse (Zsigo et al., 2022).

Treatment Options

A very common method of treating anorexia is talk therapy, which involves speaking with a licensed psychologist about your emotions, fears, and beliefs surrounding food and eating. A popular type of talk therapy is Cognitive Behavioral Therapy (CBT), which can teach you to challenge unhealthy beliefs about nutrition and help with developing more healthy eating habits again. Early intervention for anorexia is crucial, to minimize the damage done to your mind and body.

Additionally, treatment for adolescent patients may involve being referred to a children's health team in the hospital. The goal of these treatments is to help the patient understand their eating problems and eventually become more comfortable with food, with the goal of eventually being able to gain a healthy amount of weight. Other important interventions for those with anorexia involve working with a nutritionist to ensure you are getting proper portions of macro and micro-nutrients, as well as using family therapy to rebuild support systems and help your loved ones understand how to help you best recover.

For the most part, treatment can typically be done at home with regular visits to the clinic. However, if doctors think the disorder is sticking around for too long at a very unsafe level, they may want you to stay in the hospital for a while, and that’s okay. This is called inpatient care, and the medical staff are experts in helping you learn to eat in a healthy way again (NHS, 2021).

Closing

Anorexia nervosa is dangerous disorder that is unfortunately more common in teens today because of how beauty standards are portrayed unrealistically on social media. The effects of anorexia can be life-altering; it is important to know the warning signs and seek treatment as soon as possible.

Call to Action

If you or someone you know is struggling with food restriction or body image issues, please consider visiting the following websites or calling these helplines.

If you are in the United States, you can visit the NEDA website, or call the ANAD helpline at 1 (888) 375-7767.

If you are Canadian, you can visit the NEDIC website, or call 1-866-NEDIC-20.

References

Anorexia Nervosa: Causes, Symptoms, Diagnosis & Treatment. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa#symptoms-and-causes

Cleveland Clinic. (2022, March 23). Dopamine Deficiency: Symptoms, Causes & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22588-dopamine-deficiency

Calvo-Rivera, M. P., Navarrete-Páez, M. I., Bodoano, I., & Gutiérrez-Rojas, L. (2022). Comorbidity Between Anorexia Nervosa and Depressive Disorder: A Narrative Review. Psychiatry investigation, 19(3), 155–163.

Dennis, A. B. (2024). Eating Disorder Risk Factors- National Eating Disorders Association. National Eating Disorders Association. https://www.nationaleatingdisorders.org/risk-factors/

John Hopkins Medicine. (2019). Anorexia Nervosa. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/eating-disorders/anorexia-nervosa

Moyer, N. L. (2018, May 24). Serotonin Deficiency: What We Do and Don’t Know. Healthline; Healthline Media. https://www.healthline.com/health/serotonin-deficiency#symptoms

National Association of Anorexia Nervosa and Associated Disorders. (2023, November 29). Eating Disorder Statistics | ANAD - National Association of Anorexia Nervosa and Associated Disorders. Anad.org. https://anad.org/eating-disorder-statistic/

National Eating Disorders Collaboration. (2024). Risk & Protective Factors. Nedc.com.au. https://nedc.com.au/eating-disorders/eating-disorders-explained/risk-and-protective-factors

National Institute of Mental Health. (2024). Eating Disorders: What You Need to Know. National Institute of Mental Health; National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/eating-disorders

NHS. (2021, February 11). Treatment - Anorexia. Nhs.uk. https://www.nhs.uk/mental-health/conditions/anorexia/treatment/

Riva, G. (2016). Neurobiology of Anorexia Nervosa: Serotonin Dysfunctions Link Self-Starvation with Body Image Disturbances through an Impaired Body Memory. Frontiers in Human Neuroscience, 10.

Zsigo, C., Sfärlea, A., Lingl, C., Piechaczek, C., Schulte-Körne, G., Feldmann, L., & Greimel, E. (2022). Emotion regulation deficits in adolescent girls with major depression, anorexia nervosa and comorbid major depression and anorexia nervosa. Child Psychiatry & Human Development, 54(5), 1476–1488.