What
is anorexia?
Anorexia nervosa (also referred to simply as anorexia) is a condition
characterized by significant weight loss due to an intentional attempt
to stop eating. While the word anorexia is Greek for "without
hunger," it is a misnomer, for when you have anorexia you're
actually painfully hungry, despite your denial of food. You just
won't admit the hunger. One percent of teenage girls in the US develop
anorexia and 10% of them may die as a result. A formal diagnosis
of anorexia is made when you:
Are
at least 15% below what would be considered a normal body weight
(for your height and age)
Are
still dieting to lose more weight, and you are unwilling or unable
to stop
When,
you, if you are a female, have stopped menstruating for three
consecutive months
When
there is a distortion in how you perceive your shape and size
You
put an excessive investment of your self-esteem into your shape
and size
You
have an intense fear of being "fat"
You don't
have to meet these specific symptoms to be considered to have an
eating disorder and to need help. You may not have the full-blown
condition; rather you may range in your symptoms of anorexia. Additionally,
if you have anorexic symptoms, you may also have symptoms of bulimia:
weight loss can occur through food deprivation and also through
vomiting, taking laxatives, using diuretics or exercising excessively
and rigorously.
What
are danger signs of anorexia?
Losing
a significant amount of weight
Continuing
to diet (although thin)
Feeling
fat, even after losing weight
Fearing
weight gain
Losing
monthly menstrual periods, also known as amenorrhea
Preoccupation
with food, calories, nutrition and/or cooking
Exercising
compulsively
Bingeing
and purging
What
are the physical complications?
Hair
loss
Gaunt,
hollow facial features
Shrunken
breasts
Dry
skin
Bruises
Sharply
protruding bones
Cold
and blue hands and feet
Delayed
puberty: preadolescent females fail to menstruate and develop
breasts at normal age. In males, testosterone levels might remain
low, leading to impotence.
Menstruation:
hormone levels drop, alerting the body that it cannot support
a fetus; menstruation becomes irregular or stops completely -
can result in temporary or permanent infertility
Permanent
bone loss: susceptibility to stress fractures and osteoporosis
Insomnia,
constipation, sensitivity to cold, kidney failure, abnormally
low heart rate and blood pressure
Cardiac
arrythmias, heart failure, death
Why
deprive yourself of food?
Anorexia often begins with a diet or an intent to shape up physically.
You don't start this with the intention of developing anorexia.
However, if you become anorexic, the dieting and weight loss take
on psychological functions that, although unanticipated and unplanned,
are very powerful. As you begin to lose weight, for instance, you
may enjoy having a new sense of control in a life in which you previously
did not feel effective or strong at all. Oftentimes you do not have
a comfortable sense of your own abilities and are driven to keep
proving or establishing your competence in a variety of things.
Being able to say "no" to food, to hold forth over hunger,
and being able to command your body weight, all may shore up a your
self-esteem or sense of self in the short run.
Are
there other psychological dynamics?
It often turns out that if you develop anorexia or are at risk for
developing it, you live with a great amount of secret emotional
pain. Some of this may come from feelings and beliefs about being
inadequate or incompetent, like those mentioned above. You may struggle
with very negative views of yourself, even when others see you as
almost perfect. Another common psychological aspect of anorexia
is a belief that in order to be cared about, you must win the approval
of others -- even if this means squelching your own feelings or
acting in ways that make you feel uncomfortable. To live by this
set of beliefs is virtually annihilating to your natural, healthy
sense of self. When you turn to excessive weight loss as a means
of asserting something worthy of yourself, ironically you are likewise
doing something annihilating to your natural, healthy physical being.
It
takes on a life of its own
Initially, through dieting and weight loss, you may (if you've developed
anorexia) feel powerful and full of good feelings about yourself.
First off, you probably "look good" and probably get a
positive reinforcement for this, given our culture's obsession with
thinness and glamorizing of the very thin body shape. However, as
your body enters a more and more food-deprived state, the mental
effort needed to sustain continued dieting and weight loss drives
you into obsessive thinking and ritualistic means of controlling
your food intake. You become more self-absorbed, more secretive
and hide from those you were close to, and you are less able to
engage in a full range of your interests and activities. What compounds
this, of course, is that your body is entering a state of malnourishment
and is not getting what it needs to support normal mental and physical
functioning.
Denial
With anorexia, you will strongly deny that anything is wrong. You
will deny the fatigue and weakness you feel constantly, you will
deny that you need more food than you are eating, and when confronted
by concerned others, you will typically deny that there is a problem
or that you need help for it.
The
progression of anorexia
Anorexia, more than other eating disorders, can be fatal. Truly
so. The more entrenched the behavior becomes, the more damage is
done to your body. Much of this is reversible with treatment, and
with restoration of a healthy body weight and healthy nutrition.
However, without these things, you may literally starve yourself
to death. At minimum, medical care (by a medical provider knowledgeable
about the effects of eating disorders), and psychological or psychiatric
care (also by a person experienced in the treatment of eating disorders)
will be required. Nutritional counseling is also typically part
of treatment. Change will not be easy, but it is possible, and its
reward will be finding and claiming yourself and your life.
Located on the third floor of Health Services.
Confidential information or care is available through individual
appointments or phone consultation with a Nutritionist to discuss
the many types of eating concerns you may have regarding yourself,
a friend, roommate or teammate. Health Education also offers workshops,
pamphlets, and reading materials covering these and related issues.
There are no fees for Health Education services.
Located at the corner of Brown and Charlesfield streets.
Confidential information and care is available on a walk-in, or
by scheduled appointment basis. Care is available for initial, current
or past disordered eating patients. There are no fees for medical
care at Health Services. However, there may be fees incurred if
laboratory tests, medications, specialist or emergency hospital
care is needed.
Located on the second floor of Rhode Island Hall.
Confidential appointments are available at Psychological Services
for students concerned about their eating issues. Guidance is also
available for those who are concerned about a friend, roommate,
or teammates' eating. Services include crisis intervention, short-term
psychotherapy and referrals. There are no fees for appointments
at Psychological Services.
Links
you can use
This site looks at ways we can feel good in the bodies we have.
One of their slogans: "Remember, your body hears everything
you think." Other topics on the web site: Size Acceptance;
What do you say when everyone around you is dieting? 200 Ways to
Love the Body You Have; Dieting Detox; Evaluating Weight Loss Programs:
What are the Red Flags? Free subscription to email newsletter "Body
Positive Pages."
Highly recommended web site, offering support and programs for people
seeking a lifestyle without diets. You can take a self-profile quiz
that cues you to the many benefits of a non-diet life. Slogan: "You
Count, Calories Don't." Run by a registered dietitian. This
site includes a chat line, resources and links to other sites.
This site provides signs of eating disorders, motivational support
talks, information on cultural issues and how to help loved ones.
This site includes definitions, statistics, warning signs, causes
and frequently asked questions.
This site provides general information about eating disorders and
body image concerns, tips for helping a friend and referral sources.
Provides information and treatment resources for all forms of eating
disorders.
Articles from the ADA on eating disorders, including The Female
Athlete, Compulsive Eating and Anorexia.
Information on eating disorders, books for sale and resources in
Spanish.
Adapted from the Boston College Eating Awareness
Team
Written by Boston College Counseling Services
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.
