When and how does anorexia develop?
What is Anorexia?
Anorexia Nervosa, more commonly referred to as anorexia, is a psychiatric eating disorder classified by the DSM-5 as a restriction of energy intake coupled with an intense fear of gaining weight or engaging in behaviors that purposefully interfere with weight gain. At large, anorexia isn't really about food; it's an outlet individuals use to cope with emotional needs.
How Does Anorexia Develop?
Eating disorders affect millions of individuals daily, so how does anorexia specifically develop and can you develop Anorexia without knowing? Well, in short, there isn't always one specific reason it may develop in a person; rather, it's a combination of several different factors that range from internal to biological to more broad systemic issues. Let's dive into some specifics:
Internally: Individuals experiencing anorexia commonly display shared personality traits. Although it's essential to recognize that correlation doesn't imply causation, these traits are often observed in individuals who later develop anorexia. Some of these include perfectionism, low self-esteem, low self-worth and low self-confidence, feelings of inadequacy, and anxiety. Psychologically, restricting food may give a person a feeling of control, something they feel they don’t have in other aspects of their life. Experiencing some form of trauma may also internally manifest into the development of anorexia as studies have shown they are deeply entangled.
Biologically: Recent studies also support the theory that genes are likely responsible for the development of Anorexia in an individual. This debunks the myth that it is purely a psychosocial illness. Through a genetic linkage analysis it was determined that when two or more relatives had anorexia nervosa, there was a high possibility of a susceptibility gene. That being said, it is important to consider that sociocultural factors may play a stronger role in eliciting an expression of an eating disorder in someone with pre-disposing genetic factors.
Community: Individuals are shaped through lived experience. That being said, people may develop anorexia if those around them speak about or act towards food in a particular way. For example, some cultures correlate thin with beautiful while villainizing those in a larger body. Someone may grow up being teased or bullied and this may further contribute to feelings of inadequacy or a need to change one's body. Others may try and change their eating and body related to oppression and experiences around sexuality, gender and race. Overall, your perception and internalization of thoughts about food and body are closely connected to the community you associate with and the manner in which you hear others discuss these topics.
So you still may be wondering, can you develop anorexia without knowing? Yes, you absolutely can. As discussed above, within the intricate interplay of internal, biological, and community factors one may not comprehend or recognize the shift in their eating patterns towards anorexia. The gradual culmination of these elements can trigger an eating disorder that one may not be aware of as individuals often find a deceptive comfort within this disorder. In fact, many individuals remain in a state of denial as this disorder has taken effect, and many of our clients have actually experienced praise or positive feedback for the eating and body changes that were associated with their eating disorder
5 signs of Anorexia
Anorexia shows up differently in everyone through a multitude of behavioral and physical changes however there are 5 reliable and consistent indicators that should raise concern if you suspect someone may be suffering from anorexia. According to the National Eating Disorder Association, these include:
Dramatic weight loss
Dressing in layers to hide weight loss or stay warm
Preoccupation with weight and shape, food, dieting, cleanses or “clean eating.”
Changes in body weight or resistance to normal weight fluctuations and weight gain.
Maintains an excessive, rigid exercise regime – despite weather, fatigue, illness, or injury
Although these are the 5 most typical indicators someone may be experiencing anorexia, it is just as feasible that one may be suffering without exhibiting these symptoms. It is important to recognize that eating disorders can manifest in various ways, affecting individuals of any body shape or size, and we should hold space for everyone regardless of appearance and eliminate that bias.
Common causes of anorexia
There isn’t just one clear answer as to what causes anorexia, rather it is a combination of several factors. The section above discussing how Anorexia develops in a person dives into a few different contributors that play a role in its development. At large, eating disorders are multi-faceted under the idea that they are influenced by a combination of biological, psychological, and social factors.
Let's dive into an example: A common misconception for parents is that they are the reason for their child's eating disorder. In actuality, while a child's environment, including parenting, can play a role in the development of an eating disorder, it is seldom the sole cause. Their child may have experienced some form of bullying or trauma while growing up, or they may have been surrounded by a community that puts an overemphasis on thinness. So, with an environment that promotes weight loss, alongside precipitating factors like dieting or trauma, a child may fall into unhealthy eating patterns as a way to cope. The parent might see this as their fault but it's critical to remember that eating disorders are a result of many factors working together. See our course “I think my child might have an eating disorder,” for more support on this.
What age does anorexia Nervosa typically develop?
The development of anorexia can begin as early as childhood. While it is most common in women, it is not uncommon for men to experience these same struggles. Although various data sources present conflicting statistics, they generally revolve around similar figures. One study published in 2021 summarizes the main idea well here: “In females, the highest incidence rate of anorexia nervosa is around the age of 15. Several studies report a remarkable increase in the incidence of anorexia nervosa among girls aged 10–14 years. Although most research has been performed in young females, some studies report incident anorexia nervosa cases in later life as well. It is noteworthy that the peri-menopausal period has been suggested as another high-risk period in female life for the onset or recurrence of eating disorders. In males, findings regarding the peak period of anorexia nervosa onset are less clear. While some studies have shown comparable or a somewhat higher (age 16) peak age of onset, others found lower peak ages of 12–13 years in comparison to females.”
In sum, anorexia generally emerges during adolescence, although it can also begin during adulthood. Again, individuals of any age or gender may be affected by this condition, reiterating the importance of attaining the appropriate care no matter what.
Effects of anorexia
As mentioned earlier, anorexia is an incredibly harmful mental illness that can affect a person both physically and emotionally. With anorexia comes a self-starvation cycle, that over time limits and depletes the essential nutrients one's body needs to function properly.
Physically, those suffering from anorexia can exhibit extreme weight loss or not make expected developmental weight gains, linked with fatigue, dizziness, or hair thinning. But as we discuss in other blogs, anorexia can also show up independent of extreme weight loss. With the progression of anorexia medical complications become even more extreme. One may experience heart problems, bone loss, muscle loss, anemia or amenorrhea, lower testosterone levels, gastrointestinal and kidney issues, delayed cognitive development, and worst case, death. Sadly these are just some of the adverse effects one may experience and not a comprehensive list.
While a person lives with anorexia they may also isolate themselves. The combination of isolation and the struggles one may be experiencing create detrimental emotional effects as well. These effects may present themselves through the development of other mental health issues or substance use disorders. There are also many individuals who develop anorexia alongside or as a way to cope with other diagnoses such as complex trauma, anxiety, or dissociative disorders.
Treatment of anorexia nervosa
Anorexia can be an incredibly dangerous eating disorder that should be treated by a team of medical professionals including doctors, dietitians, therapists, and psychiatrists. Ensuring that you or a loved one potentially dealing with anorexia is willing and open to receiving the necessary care is the first vital step to the path of recovery.
When treating anorexia one can expect at least one if not a combination of the following care strategies:
Psychotherapy: Psychotherapy is a form of counseling that involves supporting healthier ways of thinking, feeling and behaving. Feeling safe and supported with your therapist as you work together is essential to having success in therapy. This treatment aims to increase an individual's sense of well-being and improve their mental health.
Medication: Medication can be a helpful addition to treatment for many. People can get relief and help for symptoms like anxiety and depression which often co-occur with eating disorders.
Nutrition counseling: Nutrition counseling is another form of anorexia treatment where an individual receives personalized nutritional care. Through education and discussion, one can restore normal eating patterns and a healthy relationship with food.
Group and/or family therapy: Within anorexia treatment, support for yourself both through peers or family is critical. Engaging in group or family therapy allows you to feel a sense of connection with others and educate those around you to be more aware and supportive
Hospitalization: In more severe cases of anorexia hospitalization may be vital to one's recovery in order to restore severe weight loss and malnutrition. Depending on the severity, individuals may receive inpatient or outpatient care.
No matter what, you are not alone! It is imperative to reach out for help if you or someone you know is suffering from anorexia as in the long term these issues worsen, but it is very much treatable!
There are many people out there who want to help and understand what you or someone you love may be going through.
Here are some of the first resources you can look toward:
National Eating Disorders Association: Call or text the helpline at (800) 931-2237, or visit the website to chat online / or click here for local treatment options.
National Association of Anorexia Nervosa and Associated Disorders: Call the helpline at (888) 375-7767. Visit the website to learn about support groups and local resources.
211: Call 211 to speak to someone who can give you a referral for help. Visit the website to learn more.
National Suicide Prevention Lifeline: Dial 988 or 800-273-8255 to connect to someone who can help if you're in a crisis.
Sources:
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t15/
https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591
https://www.webmd.com/mental-health/eating-disorders/anorexia-nervosa/mental-health-anorexia-nervosa
https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa
https://map.nationaleatingdisorders.org/
https://www.nationaleatingdisorders.org/help-support/contact-helpline
https://www-tandfonline-com.offcampus.lib.washington.edu/doi/full/10.1080/0966369X.2021.1873741
