Anorexia nervosa is one of the more widely known eating disorders. Of all the eating disorders, anorexia nervosa produces the most numerous and serious health complications. To be diagnosed as anorexic, a person must weigh 85 percent or less of the normal body weight for their size, in addition to displaying behavioral symptoms of anorexia.
An anorexic (the term used to describe a person suffering from anorexia nervosa) may display a number of behavioral and physical health problems. Central to anorexia is an abnormal fear of gaining weight. An anorexic feels pleasure and self-control when weight is lost, and guilt and disgust if even a small degree of weight is gained. Anorexics often severely restrict their food intakes to lose weight, effectively starving themselves to death.
Anorexia Nervosa Statistics
Anorexia nervosa affects one to five percent of the population. Ninety percent of anorexics are women between the ages of 13 and 20. While other eating disorders are more likely to develop in older adolescents and adults, anorexia and health problems related to anorexia have been detected in girls as young as eight years old. The average age of anorexic onset is estimated to be seventeen years old.
Anorexia statistics vary with ethnic make-up and socio-economic status: White women of middle to high socioeconomic status are most at risk of developing anorexia. Women of African and Asian ethnicity are less likely to develop anorexia.
Anorexia does not appear to be related to food shortages. Anorexia nervosa is rare in geographic areas where starvation is a real health risk or where food supplies are limited. Instead, anorexia (and other eating disorders) appears to primarily be a health risk of industrialized, food-wealthy countries.
Defining “Anorexia Nervosa”
Case histories detailing the health risks of anorexia nervosa go back over one hundred years. The name “anorexia nervosa” itself, however, is misleading. Translated, anorexia nervosa means “nervous loss of appetite.” However, anorexics have normal appetites and hunger signals. Anorexics feel intense hunger as they strive to lose and maintain weight loss, but the abnormal psychological drive to be thinner overpowers the hunger signals. In fact, hunger signals often give anorexics a sense of power and control.The control over consumption translates into power over other aspects of anorexics lives that make them feel helpless and out of control.
Anorexics and Self-Perception
Anorexics are unable to objectively judge their own body shape and weight. An anorexic in the late stages of starvation remains capable of looking into a mirror and judging herself “fat.” Anorexics gain satisfaction and feelings of self-control when they lose weight, and often exercise to excess to burn calories.
Anorexia nervosa centers on a preoccupation with food and body shape. Eating disorders have been associated with media and social perceptions of fatness, thinness and beauty, especially in western industrialized countries. Thinness and beauty are associated with success, love, happiness, and self-control, while images of overweight or obesity are often the target of mockery, scorn, and contempt.
Thinness is especially desirable in North American culture, where the ultra-thin supermodel is seen as the ideal. Only a very small percentage of women either have, or can attain this “ideal” weight, size, and shape, leading to dissatisfaction with body image at a very young age. Nearly fifty percent of pre-pubescent girls admit to dieting or using other methods of weight control methods.
While it’s tempting to draw obvious links between anorexia nervosa, other eating disorders, and social pressures, anorexics and other victims of eating disorders are relatively rare in the general population. The root cause of anorexia cannot lie solely with social conditioning, but may also include biological, psychological, or other triggers.
Anorexics themselves often deny that they have any health problems associated with their weight loss, and resist suggestions that they may suffer from eating disorders. In some ways, anorexia nervosa can be compared to substance abuse addictions: the anorexic is addicted to weight loss. Anorexia nervosa treatments are often resisted by anorexics, and a diagnosis may only occur when family or friends intervene, or if the anorexic approaches her doctor with other health concerns, or complains of health problems caused by anorexia (such as bloating or constipation).
Types of Anorexia
Depending on severity, anorexia may be short-lived and mild or chronic and severe. Approximately fifty percent of anorexics lose weight through restricting food and exercising strenuously. However, the second fifty percent of anorexics lose weight by binging and purging (eating large amounts of food and then inducing vomiting or abusing laxatives to “purge” the food). The cycle of binge/purge is seen in bulimia nervosa, implying that there may be some connection between the two eating disorders.
Anorexia and Health
Whether an anorexic loses weight by restricting food consumption or binging and purging, anorexia nervosa produces a wide variety of health complications. As anorexia nervosa progresses, anorexics may experience symptoms of starvation that can have serious effects on health. Mortality rates from anorexia are high; approximately ten to twenty percent of anorexics die from anorexia-related health problems, including a variety of heart problems caused by starvation.
Fortunately, anorexics who respond to treatment have a better prognosis that those who go undiagnosed. Treatment can help alleviate anorexia and related health problems in up to 75 percent of patients. However, anorexia nervosa is rarely completely cured: Anorexics continue to have a preoccupation with weight and food. If treatment is effective, however, anorexics can control their eating disorders.
American Psychiatric Association. (2000, January). III. Disease definition, epidemiology, and natural history. Practice Guideline for the Treatment of Patients with Eating Disorders, 2nd Edition. American Psychiatric Association, 2000.