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Anorexia nervosa

Anorexia explained
Signs and symptoms
Related issues
Help, it sounds like me!
Associated dangers
Treatment for anorexia
Recovery and getting help

Signs and symptoms

Impossible to hide?
Anorexia is something which most people assume is impossible to hide, yet many anorectics DO manage to conceal their condition well. Someone usually finds out eventually, of course, but this may not be until the sufferer has reached a dangerously low weight. Wearing baggy clothes or even loose sweaters in the summer is a common attempt to stop others from noticing the weight loss.

In one sense this is something of a paradox, because do such attempts at concealment mean that an anorectic is acknowledging the fact that they are too thin and underweight? On the contrary, upon asking that question to a sufferer, they are likely to say: "Just because other people will think I am skinny doesn’t mean that I do".

Physical signs of anorexia
These are the most obvious indicators of anorexia and usually become more and more difficult to disguise. Apart from the obvious sign which will be considerable weight loss, the sufferer will also exhibit some or all of the following:

substantial weight loss, at least 15% of a person’s normal body weight
loss of appetite
loss of menstruation
fatigue and dizziness
constipation and abdominal pains
feeling cold to the touch even in warm weather
lanugo (fine, baby-like hair on the body), thinning of hair on head

Other issues tend to overlap with bulimia, such as excessive exercising, laxative or diuretic abuse and self-induced vomiting. A person who is suffering from both anorexia and bulimia is sometimes said to have "bulimarexia". Anorexia and bulimia together are a dangerous combination because, contrary to popular opinion, anorectics DO usually eat, if only in small amounts. However, if an anorectic is also vomiting any food which they do consume, their physical condition can deteriate even more rapidly than usual. There are also many associated dangers with anorexia nervosa, some of which can be life-threatening.

Psychological signs of anorexia
The psychological signs of anorexia are usually less obvious than the physical ones and, unfortunately, are often dismissed as merely "a teenage fad" or "just a phase she’s going through".

Anorectics have a distorted body image, believing they are fat or overweight even when it is painfully obvious to others that the opposite is true.

Because their body is being deprived of vital vitamins and minerals, mood swings are common with anorectics as well as changes in personality and attitude. Depression often goes hand-in-hand with an eating disorder, and anorexia is no exception. A sufferer may feel worthless and have low self-esteem. This can be because of the "voices" telling them how bad they are, how they don’t deserve to eat and must be punished if they do. This is something which is very common to all eating disorders.

Obsessive Compulsive Disorder (O.C.D.) can also play a large part with anorexia. Typically, the O.C.D. manifests itself through the sufferer becoming preoccupied with numbers. This need not necessarily be weights, although the sufferer’s weight will be something they spend a great deal of time thinking about. Another indicator of O.C.D. is the sufferer cutting their food up into small pieces before eating, often into a predetemined number. For example, the food HAS to be cut up into an even number of pieces or it HAS to be cut up into exactly 40 slices.

Diagnostic criteria
Bizarrely, although anorexia is now widely regarded as a psychological illness more than a phsyical one, doctors still use physical criteria to determine whether or not a person is anorexic. These criteria include a loss of menstruation in women, a loss of at least 15% of the sufferer’s body weight, refusal to eat or having a low daily calorie intake, and having a body mass index of less than 20.

If someone meets the psychological criteria for anorexia but only some or none of the physical ones, they may be diagnosed as having "atypical anorexia" or an "eating disorder not otherwise specified" (EDNOS). For example, they may have an extreme aversion to food and refuse to eat, believe they are fat when in reality this isn’t the case, yet may still be menstruating and be at a reasonably normal weight. In this situation, just because the individual doesn’t meet the physical requirements, IT DOES NOT MEAN THAT THEY DON’T HAVE AN EATING DISORDER. Tell me more about the diagnostic criteria for all types of eating disorders.

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