Risk factors for anorexia
Anorexia nervosa - Symptoms and causes
Overview
Anorexia (an-o-REK-see-uh) nervosa — often simply called anorexia — is an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight. People with anorexia place a high value on controlling their weight and shape, using extreme efforts that tend to significantly interfere with their lives.
To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat. They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics or enemas. They may also try to lose weight by exercising excessively. No matter how much weight is lost, the person continues to fear weight gain.
Anorexia isn't really about food. It's an extremely unhealthy and sometimes life-threatening way to try to cope with emotional problems. When you have anorexia, you often equate thinness with self-worth.
Anorexia, like other eating disorders, can take over your life and can be very difficult to overcome. But with treatment, you can gain a better sense of who you are, return to healthier eating habits and reverse some of anorexia's serious complications.
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Symptoms
The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioral issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.
It may be difficult to notice signs and symptoms because what is considered a low body weight is different for each person, and some individuals may not appear extremely thin. Also, people with anorexia often disguise their thinness, eating habits or physical problems.
Physical symptoms
Physical signs and symptoms of anorexia may include:
- Extreme weight loss or not making expected developmental weight gains
- Thin appearance
- Abnormal blood counts
- Fatigue
- Insomnia
- Dizziness or fainting
- Bluish discoloration of the fingers
- Hair that thins, breaks or falls out
- Soft, downy hair covering the body
- Absence of menstruation
- Constipation and abdominal pain
- Dry or yellowish skin
- Intolerance of cold
- Irregular heart rhythms
- Low blood pressure
- Dehydration
- Swelling of arms or legs
- Eroded teeth and calluses on the knuckles from induced vomiting
Some people who have anorexia binge and purge, similar to individuals who have bulimia.
But people with anorexia generally struggle with an abnormally low body weight, while individuals with bulimia typically are normal to above normal weight.
Emotional and behavioral symptoms
Behavioral symptoms of anorexia may include attempts to lose weight by:
- Severely restricting food intake through dieting or fasting
- Exercising excessively
- Bingeing and self-induced vomiting to get rid of food, which may include the use of laxatives, enemas, diet aids or herbal products
Emotional and behavioral signs and symptoms may include:
- Preoccupation with food, which sometimes includes cooking elaborate meals for others but not eating them
- Frequently skipping meals or refusing to eat
- Denial of hunger or making excuses for not eating
- Eating only a few certain "safe" foods, usually those low in fat and calories
- Adopting rigid meal or eating rituals, such as spitting food out after chewing
- Not wanting to eat in public
- Lying about how much food has been eaten
- Fear of gaining weight that may include repeated weighing or measuring the body
- Frequent checking in the mirror for perceived flaws
- Complaining about being fat or having parts of the body that are fat
- Covering up in layers of clothing
- Flat mood (lack of emotion)
- Social withdrawal
- Irritability
- Insomnia
- Reduced interest in sex
When to see a doctor
Unfortunately, many people with anorexia don't want treatment, at least initially.
Their desire to remain thin overrides concerns about their health. If you have a loved one you're worried about, urge her or him to talk to a doctor.
If you're experiencing any of the problems listed above, or if you think you may have an eating disorder, get help. If you're hiding your anorexia from loved ones, try to find a person you trust to talk to about what's going on.
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Causes
The exact cause of anorexia is unknown. As with many diseases, it's probably a combination of biological, psychological and environmental factors.
- Biological. Although it's not yet clear which genes are involved, there may be genetic changes that make some people at higher risk of developing anorexia. Some people may have a genetic tendency toward perfectionism, sensitivity and perseverance — all traits associated with anorexia.
- Psychological. Some people with anorexia may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry.
They may have an extreme drive for perfectionism, which causes them to think they're never thin enough. And they may have high levels of anxiety and engage in restrictive eating to reduce it. - Environmental. Modern Western culture emphasizes thinness. Success and worth are often equated with being thin. Peer pressure may help fuel the desire to be thin, particularly among young girls.
Risk factors
Anorexia is more common in girls and women. However, boys and men have increasingly developed eating disorders, possibly related to growing social pressures.
Anorexia is also more common among teenagers. Still, people of any age can develop this eating disorder, though it's rare in those over 40. Teens may be more at risk because of all the changes their bodies go through during puberty. They may also face increased peer pressure and be more sensitive to criticism or even casual comments about weight or body shape.
Certain factors increase the risk of anorexia, including:
- Genetics.
Changes in specific genes may put certain people at higher risk of anorexia. Those with a first-degree relative — a parent, sibling or child — who had the disorder have a much higher risk of anorexia. - Dieting and starvation. Dieting is a risk factor for developing an eating disorder. There is strong evidence that many of the symptoms of anorexia are actually symptoms of starvation. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. Starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.
- Transitions. Whether it's a new school, home or job; a relationship breakup; or the death or illness of a loved one, change can bring emotional stress and increase the risk of anorexia.
Complications
Anorexia can have numerous complications.
At its most severe, it can be fatal. Death may occur suddenly — even when someone is not severely underweight. This may result from abnormal heart rhythms (arrhythmias) or an imbalance of electrolytes — minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body.
Other complications of anorexia include:
- Anemia
- Heart problems, such as mitral valve prolapse, abnormal heart rhythms or heart failure
- Bone loss (osteoporosis), increasing the risk of fractures
- Loss of muscle
- In females, absence of a period
- In males, decreased testosterone
- Gastrointestinal problems, such as constipation, bloating or nausea
- Electrolyte abnormalities, such as low blood potassium, sodium and chloride
- Kidney problems
If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys.
This damage may not be fully reversible, even when the anorexia is under control.
In addition to the host of physical complications, people with anorexia also commonly have other mental health disorders as well. They may include:
- Depression, anxiety and other mood disorders
- Personality disorders
- Obsessive-compulsive disorders
- Alcohol and substance misuse
- Self-injury, suicidal thoughts or suicide attempts
Prevention
There's no guaranteed way to prevent anorexia nervosa. Primary care physicians (pediatricians, family physicians and internists) may be in a good position to identify early indicators of anorexia and prevent the development of full-blown illness. For instance, they can ask questions about eating habits and satisfaction with appearance during routine medical appointments.
If you notice that a family member or friend has low self-esteem, severe dieting habits and dissatisfaction with appearance, consider talking to him or her about these issues.
Although you may not be able to prevent an eating disorder from developing, you can talk about healthier behavior or treatment options.
By Mayo Clinic Staff
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Causes and Risk Factors for Eating Disorders
What causes eating disorders?
The exact cause of eating disorders is unknown. However, many doctors believe that a combination of genetic, physical, social, and psychological factors may contribute to the development of an eating disorder.
For instance, research suggests that serotonin may influence eating behaviors. Serotonin is a naturally-occurring brain chemical that regulates mood, learning, and sleep, as well as other functions.
Societal pressure can also contribute to eating disorders. Success and personal worth are often equated with physical beauty and a slim physique, especially in Western culture. The desire to succeed or feel accepted may fuel behaviors associated with eating disorders.
Eating disorders can take various forms, including:
- overeating
- undereating
- purging
Each eating disorder has unique symptoms and behaviors that can help you recognize them.
Anorexia nervosa
Anorexia can be identified by unusually low weight and an intense desire not to gain weight or eat too much, if at all.
Anorexia is characterized by behavior meant to avoid gaining any weight at all, often to the point of malnourishment. With anorexia, a person may also see themselves as overweight, even if their body weight is far below normal.
Anorexia is most prevalent among young women. Up to 1 percent of women in the United States have anorexia, according to the National Eating Disorders Association. It’s much less common among men, who only make up 5-10 percent of people with anorexia.
Binge eating disorder (BED)
Binge eating disorder (or BED) occurs when you eat too much on a regular basis. You may also feel guilty about bingeing or feel like your bingeing is out of control.
With BED, you may continue eating long after you feel full, sometimes to the point of discomfort or nausea. BED can happen to people of all sizes and weights.
In the United States, BED affects more people than any other eating disorder, including 3.5 percent of women, 2 percent of men, and 1.6 percent of adolescents.
Bulimia nervosa
Bulimia occurs when you experience episodes of binge eating followed by purging. With bulimia, you may feel guilty or helpless after eating large amounts of food and try to vomit the food back up. You may use laxatives to quickly get the food through your digestive system. You might also exercise excessively to prevent the food from causing weight gain.
With bulimia, you may believe that you’re overweight even if your weight is normal, slightly above normal, or even below a healthy weight.
The prevalence of bulimia among young women in the United States is around 1-2 percent. This disorder is most common during the late teen years and early adulthood.
Only 20 percent of people with bulimia are men.
Read more: 10 facts about bulimia »
Pica
Pica is a disorder in which you eat objects or other non-nutritious substances uncommon to your culture. Pica occurs over the course of at least one month, and the substances you eat may include:
- dirt
- cloth
- hair
- chalk
- rocks
The prevalence of pica isn’t well known. But it appears more frequently in people with intellectual disabilities, such as autism spectrum disorder.
Rumination disorder
Rumination disorder occurs when you regurgitate food from your stomach frequently without having another medical or gastrointestinal condition. When you regurgitate the food, you may chew and swallow it again or spit it out.
The prevalence of rumination disorder is unknown. However, it seems to be more common among people with intellectual disabilities.
Symptoms vary with each disorder, but the most common symptoms include:
- abnormally low or high body weight
- an irregular diet
- the desire to eat alone or secretly
- using the bathroom frequently after a meal
- obsession with losing or gaining weight quickly
- obsession with physical appearance and perception of body by others
- feelings of guilt and shame around eating habits
- experiencing abnormal stress or discomfort about eating habits
Women are more likely than men to have eating disorders.
Other genetic, social, and environmental factors that may increase your risk for developing an eating disorder include:
- age
- family history
- excessive dieting
- psychological health
- life transitions
- extracurricular activities
Age
Although they can occur at any age, eating disorders are most common during the teens and early twenties.
Family history
Genes may increase a person’s susceptibility to developing an eating disorder. According to the Mayo Clinic, people with first-degree relatives who have an eating disorder are more likely to have one, too.
Excessive dieting
Weight loss is often met with positive reinforcement. The need for affirmation can drive you to diet more severely, which can lead to an eating disorder.
Psychological health
If you have an eating disorder, an underlying psychological or mental health problem may be contributing to it. These problems can include:
- low self-esteem
- anxiety
- depression
- obsessive-compulsive disorder
- troubled relationships
- impulsive behavior
Life transitions
Certain life changes and events can cause emotional distress and anxiety, which can make you more susceptible to eating disorders.
This is especially true if you’ve struggled with an eating disorder in the past. These times of transition can include moving, changing jobs, the end of a relationship, or the death of a loved one. Abuse, sexual assault, and incest can also trigger an eating disorder.
Extracurricular activities
If you’re part of sports teams or artistic groups, you’re at an increased risk. The same is true for members of any community that’s driven by appearance as a symbol of social status, including athletes, actors, dancers, models, and television personalities. Coaches, parents, and professionals in these areas may inadvertently contribute to eating disorders by encouraging weight loss.
Teenagers can be especially susceptible to eating disorders because of hormonal changes during puberty and social pressure to look attractive or thin. These changes are normal, and your teenager may only practice unhealthy eating habits every once in a while.
But if your teenager begins to obsess over their weight, appearance, or diet, or starts consistently eating too much or too little, they may be developing an eating disorder.
Abnormal weight loss or weight gain may also be a sign of an eating disorder, especially if your teenager frequently makes negative comments about their body or perceived size.
If you suspect your teenager has an eating disorder, be open and honest about your concerns. If they’re comfortable talking with you, be understanding and listen to their concerns. Also have them see a doctor, counselor, or therapist to address the social or emotional issues that may be causing their disorder.
Women are affected by eating disorders more often, but men are not immune. Research also suggests that men with eating disorders are underdiagnosed and undertreated. They’re less likely to be diagnosed with an eating disorder, even when they exhibit similar (or even the same) symptoms as a woman.
Some men suffer from a condition called muscle dysmorphia, an extreme desire to become more muscular. While most women with eating disorders wish to lose weight and become thinner, men with this disorder see themselves as too small and want to gain weight or increase muscle mass. They may engage in dangerous behaviors, such as steroid use, and may also use other types of drugs to increase muscle mass more quickly.
Research suggests that many young men with eating disorders don’t seek treatment because they consider them stereotypically female disorders.
If you believe someone you know might have an eating disorder, talk to them about it. These conversations can be difficult because eating disorders can trigger negative emotions or make someone feel defensive about their eating habits. But listening to their concerns or showing that you care and understand can help encourage someone to seek help or treatment.
Treatment depends on the eating disorder, its cause, and your overall health. Your doctor may evaluate your nutritional intake, refer you to a mental health professional, or hospitalize you if your disorder has become life-threatening.
In some cases, psychotherapy, such as cognitive behavioral therapy (CBT) or family therapy, can help address the social or emotional issues that may be causing your disorder.
There’s no medication that can fully treat an eating disorder. But some medications can help control symptoms of the anxiety or depressive disorder that may be causing or aggravating your eating disorder. These can include anti-anxiety medicines or antidepressants.
Reducing your stress through yoga, meditation, or other relaxation techniques can also help you control your eating disorder.
Read more: The best eating disorder apps of 2016 »
Risk factors for anorexia
genetic factors. Linkage analysis of genes in no loci found within the genome for a broad diagnostic category anorexia nervosa, but analysis pedigrees of at least one pair relatives with a restrictive type anorexia nervosa identified clutch with chromosome 1p34. Striving for thinness and obsession are most closely related with anorexia nervosa, causing new genetic loci on chromosomes 1 for the mixed indicator and 13 for striving for thinness.
Research on connection studies are focused on study of genes related to specific neurochemical factors eating behavior. One of these candidate is the HTR2A gene for serotonin 5-HT2A receptor. Brain gene neurotrophic factor (BDNF) also involved as a susceptibility gene to anorexia nervosa. This protein is involved in the regulation of eating behavior level of the hypothalamus, including regulation of serotonin levels, the decline of which causes depression. Probably genetic vulnerability lies in the predisposition to a certain type of personality, to a mental disorder (affective disorder or anxiety disorder) or dysfunction of neurotransmitter systems. Therefore, the genetic predisposition and vulnerability appear in adverse conditions, such as an unhealthy diet or after emotional stress.
Biological factors - overweight and early the onset of the first menstruation. Except Moreover, the cause of the disease may lie in dysfunction regulating food intake behavior of neurotransmitters such as serotonin, dopamine, norepinephrine.
Research has clearly demonstrated dysfunction of all three of the above mediators in patients with disorders eating behavior. Nutritional deficiencies Zinc deficiency plays a role in anorexia but is not the cause of the disease. There is evidence that it may be factor that deepens the pathology anorexia. At 1994, randomized placebo study showed that zinc (14 mg per day) doubled the rate weight gain compared to placebo patients.
Family factors are more likely to occur eating disorders in those who has relatives or friends, suffering from anorexia nervosa, nervous bulimia or obesity. In the presence of family member or relative suffering depression, alcohol abuse or drugs or addiction them, also increases the risk of disorders.
Personal factors - to psychological factors risk include perfectionist-obsessive personality type, especially for restrictive type of anorexia nervosa. Low self-esteem, feeling of inferiority, uncertainties and inconsistencies requirements are risk factors development of anorexia nervosa.
Cultural factors - these include: accommodation in an industrialized country and an emphasis on harmony (thinness) as the main sign of feminine beauty. stressful events such as the death of a loved one relative or friend, sexual or physical abuse can also be risk factors for the development of the disorder eating behavior.
Age factor - from the point of view of psychologists national pathopsychological school age is one of the most important predisposition conditions to anorexia nervosa. risk group is teenage and youthful age. In recent decades there has been a decline in age disease manifestations.
Anthropological factors - from the point of view of the doctor medical sciences, psychophysiologist Vadim Rotenberg, anorexia nervosa is associated with human search activity.
Anorexia | Tervisliku toitumise informatsioon
Anorexia ( anorexia nervosa ) is an eating disorder in which a person tries to achieve the lowest possible body weight.
Despite dangerously low weight, a person feels fat and is afraid to gain weight.
The disorder manifests itself in malnutrition and associated mental and physical complications. As a result of this disease, a person eats low-calorie, often monotonous foods to avoid weight gain. The focus is on weight, appearance, nutrition. Often this becomes the main activity, negatively affecting all other important areas of a person’s life. Violated close relationships, deteriorating ability to learn and work.
Anorexia usually develops in early adolescence. Most often, young girls get sick. Anorexia occurs in 1% of women and 0.1% of men. The genetic predisposition for anorexia is higher than for other eating disorders. The influence of heredity on this disease is estimated at 40-60%. The presence of a close relative with anorexia increases the risk of the disease by 11 times. As with all eating disorders, biological factors and the environment play an important role.
Symptoms of anorexia:
- underweight - significantly lower than should be for age, sex and height diarrhoea, abuse of appetite suppressants or laxatives
- a distorted view of the body, a perception of being larger than one actually is.
- Fear of weight gain, very strict weight restrictions
- Concomitant hormonal, metabolic, physical complications
- Normal physical development is disturbed in children and adolescents, developmental delay occurs
Complications of anorexia:
- , osteoporosis)
- amenorrhea or absence of menstrual bleeding
- damage to the cardiovascular system, arrhythmias, palpitations, decreased performance
- kidney, liver and pancreas disorders
- gastrointestinal disorders which may be associated with constipation or diarrhoea, bloating, abdominal pain
- damage to nails and skin, thinning hair
- chronic fatigue, weakness and loss of strength, decreased exercise tolerance, dizziness, shortness of breath, fainting
- difficulty concentrating, memory problems
- Anorexia is often associated with affective and anxiety disorders, sleep disorders
Anorexia treatment options
Treatment of anorexia is often time-consuming and complex.
