Anorexia

The causes of the disease have not yet been clarified; psychological problems often play an important role. The sooner the eating disorder is recognized and treated, the better the chances of recovery. The family environment, especially for young patients, can also make a positive contribution.

Overview: What is anorexia (anorexia nervosa)?

Anorexia nervosa is a psychiatric-metabolic disorder that mostly affects young women.

Diagnostic criteria for AN according to ICD-11:

• BMI ≤ 18.5 kg/m2, not due to another disease or lack of food supply.
• Broad pattern of behaviors that make weight gain impossible, usually accompanied by fear of gaining weight.
• Disturbed perception of one’s own body / body weight or excessive importance of the body / body weight on self-esteem.
• Anorexia nervosa (AN) with significantly low weight → BMI 14.0 – 18.5
• AN with critically low weight → BMI < 14.0

Despite being extremely underweight, those affected often do not feel ill. They often perceive themselves as too heavy and try to reduce their weight further. This can have dangerous and even life-threatening consequences. This makes it all the more important for those affected to seek treatment in good time. The sooner the therapy takes place, the greater the chances of regaining a normal body weight and healthy eating habits.

Anorexia - frequency and age

In Switzerland, around 1.2% of women and 0.2% of men suffer from anorexia. These values are identical in other western industrialized countries.

In most cases, anorexia develops during puberty or in early adulthood. Accordingly, many of those affected are between 15 and 25 years old.

Anorexia nervosa (anorexia): Causes and risk factors

Anorexia can have various physical and psychological causes, which manifest themselves differently in everyone. Often the disease cannot be traced back to a specific or individual trigger.

Discovering the causes of anorexia is also the subject of research. One speaks of “multifactorial causes”. It is assumed that this disease arises from an interaction of genetic and environmental factors. Scientific studies with twins indicate that hereditary predisposition plays an important role in the development of anorexia. If one twin suffers from anorexia, the other twin usually suffers from it too. This phenomenon – also called concordance by researchers – occurs particularly frequently in identical twins whose genetic material is identical.

Anorexia often begins during puberty. A time characterized by many changes in a person’s life, such as leaving the family, building relationships, choosing an education and career, entering the world of work. Eating disorders, in particular anorexia, not only have a major impact on the person affected, but also on the family and society.

Symptoms: Anorexia (anorexia)

Despite the psychological distress, sufferers are often unable to recognize their own behaviour as pathological. They often try to hide the illness from friends or family members. Nevertheless, there are some typical and sometimes clearly visible symptoms:

• Those affected eat very little (restrictive eating behavior). It also happens that they eat normally and then vomit or use other measures to lose weight. Those affected often avoid eating with other people.
• Despite being underweight, those affected suffer from the fear of putting on weight.
• Patients with extreme anorexia usually perceive their own body as normal or even too fat.

Anorexia (anorexia nervosa): Diagnosis with us

Being severely underweight can indicate anorexia. However, this can also be a concomitant symptom of another illness. This is the case, for example, with depression or serious physical illnesses. Therefore, the diagnosis can only be made after careful clarification.

Self-help groups

Exchanges between those affected can be a great support in coping with an illness. You can get advice on finding a suitable self-help group from Selbsthilfe Zürich. They and the University Hospital Zurich are cooperation partners in the national project “Health literacy thanks to self-help-friendly hospitals”.

Anorexia nervosa (anorexia): Prevention, early detection, prognosis

Parents can help children to develop a positive body image and healthy eating habits. The following points are important:

• Be considerate of your child’s feelings of hunger and fullness and do not force them to eat.
• Make sure the atmosphere at mealtimes is as pleasant as possible so that everyone in the family can relax.
• Avoid talking critically or disparagingly about the eating habits, figure and weight of family members. Show him that you love him regardless of his appearance.
• Strengthen the child’s self-esteem and self-confidence. This makes it less susceptible to external influences.

Course and prognosis of anorexia (anorexia)

The prognosis for anorexia can vary greatly. The earlier the disease is recognized, the earlier the treatment can take place and the better the chances of recovery. However, relapses can also occur. The disease is often accompanied by other mental health problems, such as depression, obsessive-compulsive disorder and anxiety disorders.

The longer the anorexia persists and the more pronounced the underweight, the greater the risk of consequential physical damage. Severe underweight affects many organs and organ systems. Cardiac arrhythmia, missed periods, low blood pressure, impaired temperature sensation and digestive problems are common consequences. Malnutrition often causes a high risk of bone fractures (osteoporosis) during the course of the disease.

Severe cases of the disease can take a chronic course. Around five percent of those affected die from the physical consequences of being underweight, and rarely commit suicide.