Anorexia
Anorexia is a familiar illness in modern society. This self help page aims to help you understand anorexia - the causes, symptoms and treatments available.
What is anorexia?
Anorexia nervosa is a relatively rare eating disorder in which you starve yourself, often becoming dangerously thin.
What causes anorexia?
Research has shown that your genes and your family's attitude towards food can make you more likely to suffer from anorexia. Depression, anxiety, low self-esteem, loneliness and emotional distress can also contribute to anorexia.
Eager to please and fearing failure, sufferers hide their inner fears and anxieties and, as a result, use food to control their feelings. A difficult experience such as the death of a loved one, being abused, a family upheaval or starting college may trigger anorexia.
Who gets anorexia?
Anorexia affects both men and women, at any age, but it's most common in young women between the ages of 14 and 25.
What are the symptoms?
Not everyone will have the same symptoms, but the most common are:
- severe or significant weight loss;
- limiting the amount you eat and drink, sometimes to a dangerous level, to control your body weight and shape;
- exercising more than normal in an attempt to burn off the calories you have eaten;
- focusing on food to try to cope with, and bring a sense of control to, your life;
- strong feelings of 'fatness'; and
- loss of menstrual periods and sexual feelings.
The long-term effects of anorexia
Over time, you may develop physical and psychological side effects including:
- infertility in women;
- brittle bones, heart and kidney problems;
- extreme tiredness and exhaustion due to starvation;
- chemical changes in your brain, making rational decisions difficult;
- depression, anxiety and suicidal thoughts; and
- feelings of self-harm and suicide.
The long-term effects of anorexia can be severe, even fatal, with 10% to 20% of sufferers dying from anorexia and its effects. Fortunately, with regular nourishment and treatment, many effects are reduced.
How does anorexia affect family life?
Anorexia affects the whole family. Loved ones often find it hard to understand that an eating disorder is actually about feelings and coping, rather than food. This can lead to misunderstandings and arguments, particularly at meal times.
Can I recover from anorexia?
Even after many years with the illness, you can recover and go on to live a full life. But you must want to recover and understand that it can take years, possibly with some relapses to begin with.
How is anorexia treated?
Anorexia needs specialist help to treat both the psychological causes and its physical effects.
Contacting your GP is often the easiest way to get help and further treatment. He or she may offer you psychological counselling or dietary counselling, or refer you to a specialist for further assessment. This may lead to outpatient treatment or, if more serious, day or inpatient treatment. As a day or inpatient, you might be offered relaxation and body acceptance therapy.
If you're worried about talking to your GP, you can:
- consider writing down your concerns and questions;
- take a friend or family member with you;
- see another doctor in the practice; or
- join a new GP practice.
The type of professional support offered will depend on the services that are available in your area, and the arrangements that your primary care trust (PCT) has with other health authorities or private providers. Specialist treatment for eating disorders is also available privately through the Priory Group.
Family and friends can also help through their support and care. It is particularly helpful for relatives to understand that your eating problems are your way of coping with emotional difficulties, and that you may have mixed feelings about changing your eating pattern.
Therapies used to treat anorexia include dietary counselling, psychotherapy, family therapy and cognitive behaviour therapy (CBT). CBT has become more popular over the past few years and can reduce symptoms by identifying, challenging and changing unhelpful thinking patterns that create unpleasant feelings and dieting behaviours.
If you're dangerously thin, you will need to gain weight with the help of a dietary plan designed to restore your physical health and a normal eating pattern.
Family support
Most families benefit from family help aimed at supporting and managing any difficult relationships. Family work is helpful and encouraged, depending on your ability to cope.
When will I have to go into hospital?
When you lose a great deal of weight, the effects of starvation can affect your ability to think clearly and you will become more and more at risk. In extreme circumstances, if your life or health is at serious risk, you may have to go to hospital under the Mental Health Act.
Body mass index (BMI) is a helpful way to assess a healthy weight and is a useful guide to both risk and recovery in adults. It is less useful in children. A healthy BMI for an adult is between 20 and 25. However, if it's less than 17.5 then it's likely you're anorexic (if you do not suffer from any other physical illness causing weight loss).
We work out your BMI by taking your weight (in kilos), and then dividing it by your height (in metres) squared. The lower your BMI, the more likely it is that you will need to go into hospital.
Self help
Self help may be useful as the first stage of treatment or alongside other treatments. There are also many different self help publications available, and you need to find the right one for you.
Self help groups, like those supported by the Eating Disorders Association, can be a useful support but they do not replace professional treatment. However, they can help sufferers and families understand that they are not alone, and offer valuable support and practical advice.
The National Institute for Clinical Excellence (NICE) guidelines for treating eating disorders are the basis for treatment in England and Wales (for more information: www.nice.org.uk). NICE also publish information for patients and their carers. At the moment there are no equivalent guidelines for treatment in Northern Ireland or Scotland.
Finding help
If you feel that you or a close relative are developing anorexia and would like help or more information, you can speak to your GP or contact any of the following organisations:
Eating Disorders Association
0845 634 1414 (www.edauk.com) helpmail@edauk.com
NHS Direct (England and Wales)
0845 4647 (www.nhsdirect.nhs.uk)
NHS 24 (Scotland)
08454 242424 (www.nhs24.com)
National Institute for Health and Clinical Excellence
0207 067 5800 (www.nice.org.uk)
Priory
0845 2 774 679 (www.priorygroup.com)
If you suspect you've got a problem with eating, call 0845 2 774 679 to find out how Priory can help. Lines are open 24 hours a day, seven days a week.
Why should I choose Priory?
Our service
At Priory, our committed and professional staff provide the highest standards of care, understanding and service for everyone. This service brings hope and confidence, allowing our patients to take control of their lives within a safe and secure environment.
Expertise and innovation
As Europe's leading independent provider of specialist mental-health, neuro-rehabilitation and special education services, we bring experience and an excellent reputation. Through our close links with the public and private sectors, we've developed the expertise and innovation to offer consistent and successful treatment.
We admit patients 24 hours a day, seven days a week.
For more information on Priory eating disorder services please click here.
Specialist Priory eating disorder units
Treatment for adults over 18 years old
Treatment for children under 18 years old
This document has been edited by Dr Alex Yellowlees, with support from the Eating Disorders Association (www.edauk.com) and Plain English Campaign (www.plainenglish.co.uk)