Anorexia Nervosa

Anorexia is an illness that is characterized by the desire to maintain a low body weight. For people with anorexia, becoming thin is all that matters. The condition may develop because of low body dissatisfaction or by the occurrence of external stressors. Anorexic behavior may be an attempt to take control of one’s life or emotions.

People with anorexia will restrict their calories, sometimes exercise excessively, and use purging behaviors such as vomiting and laxative use. Someone with anorexia may display a sudden drop in weight, have strict food rules, show anxiety about weight gain, have elements of body dysmorphia, and socially isolate themselves so that they may practice restrictive food rituals in private. Anorexia is more extreme than normal dieting behaviors and happiness is dependent on low body weight.

Anorexia nervosa has the highest mortality rate of any psychiatric illness. Psychologically, people with anorexia may suffer from depression, anxiety, social isolation and perfectionism. Physically, the restriction of food can have severe health consequences. These in include dry skin, hair loss, low body temperature, slow heart rate, low blood pressure, muscle weakness, the loss of bone density (osteoporosis) and sever dehydration. Women also can lose their periods and reproductive function.

Recovery is not impossible but it is important that people with anorexia seek professional help and treatment.

Early interventions with anorexia are essential, and are a good predictor of a positive outcome. If you are worried about a friend or family member, a loving confrontation, sharing your concerns and offering your support, is a good way to open the door to treatment.

Here are some warning signs that anorexia may be taking hold:

• Dramatic weight loss
• Preoccupation with weight, food, fat calories, fat grams and dieting
• Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates etc.)
• Frequent comments about feeling ‘fat’ or overweight despite weight loss
• Anxiety about gaining weight or being ‘fat’
• Denial of hunger
• Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate)
• Consistent excuses to avoid mealtimes or situations involving food
• Excessive, rigid exercise regimes – despite weather, fatigue, illness or injury – the need to ‘burn off’ calories taken in
• Withdrawal from usual friends and activities
• In general, behaviours and attitudes indicating that weight loss, dieting and control of food are becoming primary concerns

If you are experiencing the early stages of anorexia, you may be feeling things are out of control and that life is very stressful and difficult. Perhaps you are experiencing emotions that are new or overwhelming. You may feel that controlling your weight gives you a sense of control.

You may also recognise that you are finding it more and more difficult to cope in relationships with family and friends. We can provide a space where you can just be, with no judgement or pressure. We want to hear about what’s going on in your life, and what difficult feelings you may be experiencing.

Together we can explore new ways of dealing with emotions and life, providing you with new ways of feeling in control. We will take small steps, at your pace, always with honesty and clarity about the options you have to move forwards. Exploring your motivations to change or stay as you are will be an important early intervention. Your fear of weight gain, your need to gain weight and a plan to improve health will be an important focus of treatment.

Late stages of anorexia can be life-threatening and you may have experienced in-patient treatment at hospital or at an eating disorder treatment centre.

At this stage a team of support is necessary to help you, and your family or partner, reach the stage of recovery. We offer anorexia outpatient treatment services with a holistic team approach, combining psychiatric coaching, psychotherapy and our clinical dietician.

We can help you make steps towards recovery at your pace, helping you re-build a sense of self worth and aspirations for your life. As you become more skilled in challenging your unhelpful thinking, and turning down the volume of obsessive thoughts in your head, you will notice that some of your rules around eating and exercising will start to fade, being replaced with new ways of feeling safe and in control in daily life.

Emotional and stress management is always a key skill to learn, and as this develops you will gain greater confidence in how to manage relationships and social situations. As you grow in strength and confidence, challenging distorted thinking around your body image, and letting go of the need for perfectionism, will help you find a more compassionate inner self talk in your head.