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Anorexia Nervosa

Anorexics are strict and disciplined in their daily routine. They are extremely afraid of becoming fat. They have such a distorted self-perception that even when completely emaciated, they consider themselves as fat. Anorexics use different methods in order to lose weight. They are either bulimic (binge-eat and then vomit) or they do exorbitant amounts of exercise, abuse laxatives or fast. The feeling that they have absolute control over their bodies gives them self-confidence and pride.

Usually girls and young women suffer from anorexia however men can also be affected. Anorexic patients usually have very serious complications as a result of the extreme weight loss. Their weight usually lies about 25% or more below the normal weight (BMI <17). About one-tenth of anorexics die as a result of the starvation. Menstruation and ovulation stop in the early stages of anorexia. Heart and kidney problems come at a later stage.

For a definite diagnosis of anorexia, the following criteria are required:

  • Having an intense fear of putting on weight even though clearly underweight
  • A body-image distortion: the person believes that they are fat despite the fact of being very thin.
  • She misses three menstrual periods in a row.

Anorexics are usually extremely achievement-oriented. They are usually not prepared to make a lot of emotional contact with other people and are often socially isolated. There is hardly ever any sexual desire as they fear such contact with other people.

How often does anorexia occur?

Young women aged between 15 and 25 years are most prone to getting anorexia. Between 50 to 75 women out of 100 000 women in this age group get anorexia each year. The risk of getting this illness is about 1% for women. Anorexia is also becoming more common amongst men.


Help Your Teenager Beat an Eating Disorder, James Lock MD PhD, Daniel Le Grange PhD

Anorexia Nervosa: A Guide to Recovery


Reasons for Anorexia:

Anorexia is a psychological illness. There are various factors which contribute to the development of anorexia:

Some of the causes are as follows:

  • Low or no self-esteem: if you constantly feel insecure, too fat and unattractive or you are just unsatisfied with your physical appearance, you could be vulnerable to getting anorexia.
  • The cultural and social conceptions of the perfect female body play an important role. Fashion, advertisements and media in general give the impression that women who are thin are particularly attractive and successful. Models and actors are beautiful, thin and attractive and many young people look up to them.
  • Having control over their body and their life gives them a feeling that they are able to achieve something well. It makes them proud.
  • Scared of growing up: anorexia usually starts at the beginning of puberty as this is the time of sexual, physical and emotional changes.
  • Family problems e.g. parents getting a divorce
  • In order to get attention. Anorexia is sometimes a cry for help.
  • Athletes who are expected to be particularly thin for their discipline e.g. ski-jumper and dancers are usually very vulnerable to getting anorexia.

How can you treat anorexia?

Treating anorexia is done in two stages.

1. Putting on weight
2. Treating the psychological problems

Putting on weight takes priority when treating anorexia. Psychological therapy can only take place once the physical condition of the patient has stabilised and is no longer life-threatening. Hospitalisation as well as psychotherapy is usually necessary for patients with anorexia because not only do they tend to deny that they are thin but they also have great difficulties in normalizing their eating habits. Hospitalisation is an ideal start in the psychotherapeutic treatment however the therapy needs to continue on an outpatient basis in order for it to be successful. Psychotherapy can offer anorexic women a variety of strategies to deal with and handle many problems without having to develop methods which are aimed at altering their dysfunctional eating habits.

Family therapy is common with younger patients who still live with their parents. This helps to examine ways in which the family may be a factor in the development or perpetuation of the young person's illness. Family therapy includes parents and siblings in the therapy sessions.

About 30% of anorexics remain chronically ill. 60% are healed either by therapy or spontaneous recovery. 1 in 10 cases of anorexia end in death from starvation. Therapy usually lasts for many years.


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