Anorexia Nervosa, A Jarring Reminder

The other day I walked into one of my favorite coffee and bagel establishments and found a note next to the cash register informing customers of the untimely death of one of the workers. When I inquired about what happened I was given information about the tragic death of a young woman. She died of the effects of chronic Anorexia Nervosa. In addition to the tragic nature of the news and the loss it represented to customers and workers alike, the irony of starving to death in a food establishment really struck me hard. I was also reminded of the fact that these eating disorders continue to be a dangerous and deadly disease.

What Is Anorexia Nervosa?

Anorexia Nervosa is an eating disorder. It that causes people to obsess about their weight and the food they eat. They attempt to maintain a weight that is far below normal for their age and height. To prevent weight gain or to continue losing weight, people with Anorexia Nervosa starve themselves and exercise excessively.

This dreadful eating disorder afflicts mostly women. It can start anywhere between the ages of 13 to 25 and even older. There are a small but increasing number of young men who become anorectic as well.

The person wit Anorexia Nervosa does not see how skinny they have become. They look at themselves in the mirror and see only fat even as they waste away.

The profile of the person with anorexia is of someone who is a perfectionist, obsessive compulsive, depressed, anxious and very intelligent. Despite how much they control what they allow into their bodies, they will drink and use drugs. Oddly, they refuse anti depressant medications because they do not want to put anything that is not natural into their bodies.

Recently, it has been emphasized that families do not cause anorexia. I agree. At the very same time, families unwittingly conspire to help maintain this eating disorder. For example, it is not unusual for family members to not see the incredible weight loss in their daughter. Once someone, especially an MD points it out, it comes as a shock. It is also true that eating disorder tend to run in families, indicating that their may be a genetic factor at work here.

The utter denial of the eating disorder is what makes treatment so very difficult. The anorectic patient continues to deny the existence of a problem. Because they are so intelligent, it is very difficult to reason with them. For every argument presented they have a counter augment and that becomes enormously exasperating for loved ones.

This is the reason why a team approach is recommended for the patient with Anorexia Nervosa. On an outpatient basis, the team often includes a psychiatrist, nutritionist, psychotherapist and group therapy. This approach makes it more difficult for the patient to maintain denial, especially when there are weekly weigh-ins and food diaries that are kept. Even with all of this, the anorectic will often attempt to strictly maintain the absolute minimal weight allowed.

If left untreated, this disease leads to physical illnesses and, ultimately, death.

If you have a loved one who shows symptoms of anorexia, do not hesitate to point it out to them but without getting into a losing debate over the issue. Get them to the MD where treatment usually begins.

In extreme cases, the illness can result in hospitalization where a full treatment program is started. There are hospitals that have department specializing in treating these patients on both and in and out patient basis.

What are your experiences with Anorexia Nervosa? When you respond to this you are also helping other people who face similar problems. Please post your comments and opinions.

Allan N. Schwartz, PhD

  • Ben

    I had someone very close to me succumb to anorexia.I tried to reason with her and to make her see how irrational her beliefs were without insulting her intelligence.But I always hit a brick wall.No matter what I told her,she saw a fat girl in the mirror(even at 78lbs at 5'4")I knew she was messing up her electrolytes and harming her heart with dieting,the laxatives,the exercise.But I could do nothing.Even with treatment,she would do better only for a short period and go right back to her self-destructive behavior.Me and everyone else around her felt helpless.All we could do was support her and love her while we waited for her to die.And finally she did.We found her laying on the bathroom floor nude after showering.She apparently went into cardiac arrest shortly after.

  • Fiona Place

    The blame game when it comes to eating disorders is ultimately futile. While parents may wish to see an eating disorder as a brain disorder and not 'their' responsibility this belief is not very useful - why not? Because as the post shows - young men and women die - and it is precisely this 'it is not my fault' attitude that allows this to happen. Forget about fault and act responsibly - make sure you set limits and boundaries. Or at least try. Fault is irrelevant.

    Fiona Place

    Author of Cardboard: A woman left for dead

  • Allan N. Schwartz, PhD

    Hi Fiona,

    You are correct about the blame game being futile, especially since we have no idea of what causes eating disorders. Families of anorectic children need to put blame aside. Instead, they need to recognize that they have someone with an eating disorder and begin getting that person to go to treatment.

    The challenge is for us to find ways for family members and anorectic patients to break through the denial so that everyone can work on recovery.

    Dr. Schwartz