Signs and symptoms of anorexia may be difficult to distinguish from dieting behavior
and normal eating. Anorexia is defined as the lack or loss of appetite for food. Physical
symptoms of anorexia may include, but are not limited to, extreme weight loss, thin appearance,
fatigue, dehydration, and low blood pressure. To help prevent someone that may seem to be
anorexic look for the early signs. Early signs of anorexia are refusing to eat, skipping meals,
denying they are hungry, and even spitting out food after chewing it. Some men and women with
an abnormal preoccupation to food may also show signs of anorexia by lack of emotion,
repeatedly weighing themselves, excessive exercise, complaining about being fat, and wearing
baggy clothing. “Eating disorder cognitions were strongly associated with multiple forms of
emotion dysregulation in the current sample, namely, difficulties with emotion understanding,
poor emotion awareness, and lack of emotion acceptance” (Sarah E. Racine, 2014). Body Mass
Index (BMI) is a tool used by providers to assess the appropriate body weight for an individual.
Individuals suffering from anorexia often have a distorted view of themselves and view
themselves as much heavier than they actually are. Anorexia can affect almost every body
system. People going through anorexia can get so distracted from thoughts about food that it
causes them to lose focus on life. Eventually leading to isolation from friends and family, career
disruption, forced withdrawal from school, and even loss of faith or their connection to their
religion. Starvations physical effects are often irreversible and can lead to the shutdown of major
body systems, heart attacks, brain damage and even death. “The resulting extreme malnutrition
often leads to osteoporosis, bone fractures, interruption of menstruation in women, and loss of
brain tissue.” (Hoffman, 2015, pg. 390). Anorexia signs or symptoms in adolescents may include
abuse of stimulants such as dietary supplements and prescriptions stimulants that suppress
appetite. Anorexia can also lead to obsessive compulsive disorder, anxiety disorders, and
depression. Anorexia is a very serious disease and very harmful to the body and individuals
portraying these symptoms should never be ignored.
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Biological Explanations
Research provides strong evidence that eating disorders are biologically inherited.
Research suggest that about fifty-six percent of risk for developing an eating disorder is inherited
from biological and genetic factors. For instance, an individual is twelve times more likely to
develop anorexia if their mother or sister had anorexia. Researchers have started to focus on the
hypothalamus, the part of the brain responsible for regulating eating behaviors. They have
suggested that abnormalities in the structure or activity of the hypothalamus may not trigger the
normal satiation response in anorexic people. “Brain atrophy changes occur as a result of the
malnutrition of anorexia nervosa. Neurocognitive functioning may be permanently impaired
even though brain atrophy improves with weight restoration” (Patricia Westmoreland, 2016).
Researchers also suggest that there are several different neurotransmitters that are related to
eating disorders. Neurotransmitters are responsible for carrying messages from cell to cell
throughout the brain and nervous system, Multiple neurotransmitters work together to control all
kinds of functions such as, memory, appetite, mood and energy level. Serotonin is a
neurotransmitter that affects sleep, memory, muscle movement, eating, and temperature
regulation. Serotonin also serves as a host to other behaviors depending on what receptors are
specifically stimulated and where the receptors are located in the body. If the individual has low
levels or serotonin they have the feeling the are full when they have not eaten. Neurotransmitters
play a huge role in anorexia and they affect how your body responds to its surroundings.
Psychological Explanations
Researchers believe there are three main psychological explanations to anorexia;
psychodynamic, behavioral, and cognitive. The psychodynamic approach, proposed by Freud,
suggests eating is a substitute for sexual activity, so limiting your food intake is a way of
repressing sexual development. Behavioral approach is focused on the rates of anorexia due to
cultural differences. Western cultures being exposed to celebrities and the social norm of being
thin is believed to be the source of the anorexia. However, there is no evidence to support this
research due to the minority of people who develop anorexia. “In the United States, an estimated
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0.9 percent of females and 0.3 percent of males suffer from anorexia nervosa in their lifetime
with an increase in the age group of 15- to 19-year-old girls, based on national
epidemiology surveys” (Anorexia Nervosa, 2018). Eating disorders frequently affect an
individual who is suffering other psychiatric disorders, such as depression, substance abuse,
anxiety disorders, and borderline personality disorder.
Sociocultural Explanations
Sociocultural factors are one of the foremost variables in the development of anorexia.
One reason for the increase in anorexia is that being thin is observed as a symbol of success and
beauty in modern thinking. “Theories emphasize psychosocial factors, such as a need for a
perceived loss of control, teasing about body weight, destructive thought patterns, depression,
dysfunctional families, distorted body image, and or emotional or sexual abuse” (Hoffman, 2015,
pg. 390). One aspect to anorexia is parental attitudes towards weight control. Putting stress on
anorexic individuals acts as a precipitation factor in the management of this condition. In western
societies eating disorders flourish. There has been a recent increase in male eating disorders that
is being attributed to media images of the male bodies in western cultures. Media images portray
the message that all men should be lean and fit. Researchers believe the men are giving in to
media and to cope with their unhappiness they are becoming anorexic. Sociocultural theories
explain how cultures dictate certain forms of a mental disorder. These individuals usually follow
a set pattern that they witnessed from other sufferers. “Religiosity has been associated with
various forms of fasting and self-starvation for thousands of years” (yliopisto, 2017). “Many early
Christian saints and hermits abstained from eating as a part of ascetic-mystic practices”. Some
theorist believe that classical and operant conditioning are the result of behavioral theories of
eating disorders. One theory is that a patient relates food to anxiety through classical
conditioning connecting it to gaining weight. Then by the individual not eating they start losing
weight which makes them feel good. They feel even better when someone gives them a
compliment. This acts as a reinforcement result in an operant condition making them maintain
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their unhealthy behavior. These theories give us a better view on how people become anorexic
and why this condition continues to persist.
Treatment
Types of treatments for anorexia can be delivered in many different settings. Types of
treatment consist of outpatient, partial hospital, residential, and inpatient. The role of medications
is considered limited in the role of treating anorexia, however other psychiatric medications can
help treat other co-existing disorders that may also occur, such as depression or anxiety. When a
person's anorexia is severe enough with physical problems that are life threatening and may be
causing severe psychological or behavioral problems, inpatient or residential treatment may be
recommended. Individuals that are in an inpatient setting are considered unstable. They have
depressed vital signs, lab reports stating they are at acute health risk, and possible complications
due to coexisting medical problems. Individuals in a partial hospital setting are medically stable
but they daily assessment of their mental status. Also, individuals in a partial hospital have their
eating habits watched. A residential patient is medically stable and requires no intensive medical
intervention but still require psychiatric treatment. Outpatient care for anorexic individuals are
medically and psychiatrically stable that have symptoms under control and can function in
normal society. Psychologist play a big role in successful treatment of anorexia. They are a part
of a multidisciplinary team of physicians, and nutritionist. The psychologist is responsible for
identifying the important issues and staring a treatment plan. The nutritionist assesses and helps
them improve their nutritional intake. The physician is responsible for ruling out any medical
illness and make sure the patient is not in immediate physical danger. Psychotherapy have
different options too. Acceptance and Commitment Therapy, Cognitive Behavioral Therapy,
Cognitive Remediation Therapy, Dialectical Behavior Therapy, Evidence Based Treatment,
Family Based Treatment, and Psychodynamic Psychotherapy. Acceptance and Commitment
Therapy is the practice of changing your actions rather than your thoughts. These individuals
focus on identifying their core values and committing to creating goals that make these values
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(Patricia Westmoreland, 2016)come true. Cognitive Behavioral Therapy is a symptom-oriented
therapy, that is usually short term, which focuses on the cognitive processes, values, and beliefs
that help maintain the eating disorder. Cognitive Remediation Therapy is a process that helps the
individual focus on more than one thing. Dialectical Behavior Therapy is the development of
skills to replace the eating disorder behaviors. Evidence Based Treatment is a research-based
study that has been found to be effective in encouraging weight restoration, and decreasing
eating disorder thoughts and symptoms. Family Based Treatment, also known as Maudsley
Method, focuses more on adolescents to promote refeeding and full weight restoration to gain a
full recovery. Psychodynamic Psychotherapy is primarily focused on finding the root cause of
the disorder. Therapist believe eating disorders are the result of an internal conflict and to help
prevent relapse of the eating disorder. Eating disorders are a serious and chronic condition.
Studies find that anorexia has the highest mortality rate of all mental illnesses.