Those people who suffer from anorexia feel a real fear of getting fat and have a distorted picture of both the dimensions and shape of their body. Therefore, they cannot maintain a normal body weight. Many adolescents with anorexia restrict food intake by dieting, fasting, and even excessive physical exercise. They hardly eat at all, and the little they ingest becomes an obsession.
Other people with anorexia resort to later binge eating and purging: they eat large amounts of food and then try to eliminate calories by vomiting, taking laxatives, excessive physical exercise, or a combination of these actions.
In some cases, people with anorexia simply begin to try to lose some weight or get in shape. But the need to eat less, purge or overexercise becomes "addictive" and is very difficult to control.
There are some signs that may indicate that a person has anorexia. Anorexic people can:
be socially isolated, especially to avoid meals or parties where food is served
feeling depressed, low energy and often cold
Eat only certain foods and avoid dairy, meat, wheat... (although many people are allergic to certain foods or vegetarian).
Lose a lot of weight, become fragile or scrawny.
Obsession with eating, food and weight control.
Weigh oneself repeatedly.
Meticulously count or ration food.
Fill up with water when visiting a professional for weighing.
Overexercise.
Feel fat.
Family factors. The nature of overprotection, the high level of aspirations, the rigidity, the prolonged duration of conflicts, etc., favour the development of anorexia.
Social and cultural factors. Together with the psychological ones, they will be decisive in the development of the disease. The increase in the number of cases is due, in large part, to the fact that in our culture there is much emphasis on the importance of a "healthy" diet, understood as such a low-calorie diet, low in fat and sugars and without seasoning. On the other hand, body image and thinness are overrated. In our environment, being thin and having a slim figure are considered very positive personal values.
Perpetuating factors. Along with the unresolved individual factors and, of course, with the existing socio-cultural pressure, the main perpetuating factor is the presence of psychopathological alterations (consequence of continued malnutrition).
Restrictive or typical type: Weight loss occurs through diet, fasting, or excessive exercise.
Compulsive/purge type: During the episode of anorexia nervosa, the sick person regularly resorts to binge eating and then, to compensate for possible weight gain, induces vomiting or abuses laxatives, diuretics, or enemas. This group also includes patients who induce vomiting even if they have only ingested small amounts of food.
Cardiovascular disorders. Heartbeats decrease and blood pressure decreases; this sometimes results in dizziness and arrhythmias (alterations of heart rhythm) that can lead to cardiac arrest and, consequently, death. The blood circulation in the periphery of the body diminished favors that
arms and legs are cold and bluish.
Gastrointestinal disorders. Nausea, vomiting, diarrhea due to the abuse of laxatives, constipation,
feeling of early satiety due to slow digestion and abdominal pains are the usual alterations.
Blood alterations. Anemia due to lack of iron and folic acid in the diet.
Hormonal alterations. Many are secondary to thinness and recover when weight increases. Altered secretion of ovarian hormones and low weight lead to loss of menstruation.
Bone alterations. Bones are weakened because bone mass decreases and can easily fracture. If the onset of dietary restriction occurs before puberty, it will result in short stature.
Kidney alterations. Dehydration.
Psychic disturbances. Many patients suffer from affective disorders, anxiety and obsessive-compulsive symptoms. Obsessive traits are often very intense and focused on food issues. Sometimes, strong feelings of guilt and despair when they are unable to control their weight provoke ideas, and even attempts, of suicide. Sleep decreases in quality, quantity and depth.
Once the diagnostic parameters described above have been evaluated and other psychiatric and organic pathologies have been ruled out, the patient is treated and monitored. The treatment process for anorexia nervosa is multidisciplinary, requiring coordinated action from family doctors, psychiatrists, psychologists, endocrinologists and gynecologists. The main points of treatment are:
Modification of the patient's eating habits: a "re-education" of the patient's eating habits is required. For this purpose, it begins with a relatively low calorie diet (1,000-1,500 calories/day) and increases progressively until the patient's calorie needs are met, always respecting the personal space to avoid putting pressure on him/her, but not allowing him/her to eat alone, and watching that he/she makes the five essential daily meals.
Regular weight control: weekly gains of 250-500 grams should be detected when weighing the person naked or in underwear (avoids the tare weight of clothing and possible deceitfulness of the patient).
Restriction of physical exercise: initially completely eliminated and reintroduced very gradually.
Regular analytical controls to avoid organic complications.
Pharmacological therapy: focuses primarily on the depressive or anxious component of anorexia. It is an individualized treatment and constrained to the patient's requirements and psychological situation.
Psychological therapy: Behavioral, psychoanalytic, interpersonal and group therapy is used alone or in combination.
Follow-up treatment of anorexia can be done in combination between the primary care physician and mental health unit. In the event that outpatient follow-up has failed, and provided that the patient has good family support, a good predisposition towards treatment and tolerates group therapy, therapy can be attempted in day hospitals, being a totally contraindicated option if the patient shows a tendency to suicide, substance abuse or severe medical complications.
The patient may be hospitalized in case of manifest risk for his or her life, very serious psychological disturbance (suicide, other psychiatric alterations, etc.), or if the family situation is very unfavourable. Once treatment has begun, the prognosis is highly variable, although the patient's capacity for early acceptance of the disease, the appearance and short-term diagnosis of the disease, good family support, and the absence of a psychiatric history in the family are considered indicative of good prognosis.
CONCLUSION
Today's teens shouldn't worry about their physical appearance, but their health, because anorexia can destroy your life.
You don't have to listen to other people's criticisms and be who you are.
It begins with someone commenting on you and ends with anorexia nervosa and confined in a hospital, and there are cases that go as far as death.
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