Anorexia: Symptoms, Causes and Risk Factors

The deadliest psychological disorder that has been studied is Anorexia Nervosa. This illness dates back to St. Catherine of Sienna in the 13th century and was originally considered a "wasting" disease. Mid-20th-century research by Hilde Bruch brought awareness to eating disorders, especially Anorexia Nervosa. Anorexia is rare but has the highest mortality rate of all psychological disorders and has high comorbidity with several other disorders like depression and anxiety. This disorder distorts how patients view their appearance, leading them to engage in activities that will make them lose weight rapidly.

The weight loss usually results in severe physical symptoms and in some cases, death. There are also many psychological and behavioral symptoms that can worsen as the disorder develops. Causes and risk factors are often related to comorbidity, abuse, and genetics. Prevalence is highest in developed countries where appearance is heavily weighted in society. There is a wide range of treatment options to help the patient reduce or eliminate harmful behaviors, gain and maintain a healthy weight, and treat comorbid disorders.

Symptoms and Comorbidity

Causes and Risk Factors

General risk factors of Anorexia Nervosa can be psychological, social, biological, and external. Obsessive compulsive personality traits are common in anorexic patients, and make it easier for them to adhere to a strict diet due to a preoccupation with details and perfection (Mayo Clinic). Perfectionism often leads to setting unrealistic goals to boost self-esteem and exert control. However, when these goals are not achieved, self-esteem drops and another unrealistic goal is set, creating a dangerous cycle. External locus of control is more common in anorexia patients than internal locus of control, because they feel a lack of control over their lives and their environment (Jaros & Oszwa). Controlling their diet and body weight gives the patients a sense of improved self-esteem, but they eventually lose that control (Marucci & Ragione, 2018). Other psychological factors include feelings of inadequacy, depression, anxiety, the belief that affection from loved ones is tied to success, difficulty in expressing negative emotions, ineffective coping strategies, and an excessive concern with the opinions of others (eatingdisorders.org). Social factors include how society or culture defines standards of beauty and achievement, which can affect a person's self-perception.

Media, such as social media, magazines, and television, can portray an unrealistic body type that is usually thin. This can make patients yearn for that body type in an effort to be accepted by their culture or society (eatingdisorders.org). Athletes, dancers, and models are more likely to be predisposed to anorexia due to the emphasis on maintaining a certain weight or shape (eatingdisorders.org). Other social factors include societal pressure to succeed or achieve, and a tendency to value a person for their outward appearance without regard for inner qualities. Biological factors mostly depend on genetics, chemical imbalances, and hormonal and neural changes. Although it is not yet proven, people with a first-degree relative (parent, sibling, or child) with anorexia are predisposed to developing Anorexia Nervosa. In some cases, the diagnosis could be due to predisposition rather than learned behavior (Mayo Clinic; eatingdisorders.org). There has been evidence of an imbalance in serotonin and dopamine in the brains of anorexic patients (www.nationaleatingdisorders.org). Walter Kaye hypothesized that starvation makes anorexic patients feel better due to a decrease in serotonin. However, as starvation continues, serotonin receptors employ lingering serotonin. When patients eat again, serotonin levels spike, leading to severe anxiety and emotional distress (www.nationaleatingdisorder.org).

The hypothesis for dopamine is that overproduction of the neurotransmitters is associated with anxiety, avoidance, hyperactivity, and an inability to derive pleasure from food within anorexic patients (Kontis & Theochari, 2012; Bailer et al., 2012b; www.nationaleatingdisorders.org). Adolescents who develop anorexia are likely to have experienced physical, hormonal, and neural changes during puberty. Teenagers becoming more self-aware and conscious of their bodies once puberty begins. As physical changes such as weight gain become easily noticeable, those who experience puberty earlier than their peers often feel uncomfortable with their bodies and feel the need to change. Others alter their appearance in an attempt to attract attention from their peers, particularly potential love interests.

External factors include major life events, history of abuse, history of being bullied, peer pressure, and inability to cope with stress. Sudden changes in a patient's life that induce emotional distress — such as moving or changing schools, losing a job, losing a friend or family member, or ending a romantic relationship — can increase the risk of developing anorexia. Many patients cannot handle stress as well as the average person, and often use dieting to cope with the stressors of their daily lives. This can morph into anorexia when the patient develops obsessive behaviors. Physical and sexual abuse are among the most common risk factors for anorexia as they often serve as means for survival and coping for those who have experienced or witnessed such abuse. Bullying due to being overweight is common during adolescence, often resulting in extreme dieting to stop or avoid the bullying. Peer pressure becomes evident when patients join large groups that engage in anorexic behaviors and feel the need to participate in order to gain acceptance from that group.

Did you like this example?

228

12