Anorexia nervosa (or psychogenic) primarily affects young women, and normally starts during puberty. Parental, psychological, family and social factors all play a role in its onset.
In anorexia nervosa there is a voluntary restriction of the intake of food, leading to a significantly reduced body weight.
At the same time there is a strong fear of increasing weight or allowing fat to accumulate on the body. This fear concerns the deposition of fat and weight overall on the body, or in certain areas. Due to intense fear, the person suffering from anorexia nervosa is persistently seeking to reduce body weight, even if this is already very low.
The individual’s perception of body weight and shape is distorted. This means that the body is considered to accumulate excess fat, even though it is pathologically thin. What others objectively observe, i.e. the obviously very low weight, is not recognised by the person suffering from this condition.
Body weight and shape become the cornerstones of the individual’s own self-esteem and self-worth. Keeping weight low is a target of utmost importance. If there is any "departure" from the target, then the person feels like a failure. A feeling of failure and fear leads to an even greater restriction of food intake, or to the use of medicines such as laxatives and diuretics, or even vomiting (a characteristic symptom of bulimia nervosa, when the vomiting is recurring).
Events at school, in the family or within the circle of friends during the vulnerable period of adolescence, where rejection and recognition by others play a central role, may trigger the onset of the disease. For example, a comment of the type "you’ve put on weight” or a comment to the opposite effect, such as "you’ve lost weight and look gorgeous" may decisively affect a person -who has other risk factors- in developing the disease.
The diagnosis is based on the above characteristics. Early diagnosis correlates with clearly better rates of treatment success.
Therefore, if anorexia nervosa is suspected based on clinical characteristics, assistance should be sought from a specialist experienced in the management of nutritional disorders. In recent years cognitive behavioural therapy has been shown to generate very good results, especially if implemented in time.
The family usually needs to work with the therapist, especially if the person is young. A nutritionist may need to be brought in to train the affected person and to plan a diet, especially during the refeeding phase.
Anorexia nervosa is accompanied by many severe acute and chronic medical complications and requires concurrent monitoring by an internal medicine specialist who works as part of a team with a psychologist, psychiatrist and nutritionist.