• Weight Management

Exploring the Causes of Anorexia Nervosa

Medically reviewed and edited by Dina Whiteaker, APRN

Behind society’s facade of perfection lies various challenges – including anorexia nervosa: a complex battle of mind, body, and self-perception. This eating disorder knows no boundaries and can impact individuals from all walks of life.

The National Association of Anorexia Nervosa and Associated Disorders (ANAD) estimates that 28.8 million people in the U.S. will be affected by an eating disorder in their lifetime.

Anorexia nervosa may begin with something as simple as trying to lose weight by decreasing your calorie intake, but it can quickly turn into something more sinister.

To protect yourself and others from developing an unhealthy relationship with food or an obsession with your body shape, we’ve put this article together to help you understand anorexia nervosa.

Remember, there are always healthier ways to lose weight than extreme behaviors associated with eating disorders. If you’re feeling overwhelmed, visit LifeMD. A team of experts can also assist you with your weight loss efforts.

What is Anorexia Nervosa?

Anorexia nervosa is a complex eating disorder that often impacts both physical and mental health.

Those living with this condition typically engage in severe food restriction, often eliminating entire food groups or consuming insufficient quantities.

Several psychological, biological, and environmental factors contribute to the development of anorexia.

The National Institute of Mental Health outlines specific characteristics to identify individuals with anorexia nervosa, including:

• Intense preoccupation with weight: A pervasive obsession with weight, coupled with an overwhelming fear of gaining weight, dominates the individual's thoughts.

• Distorted body image: People with anorexia typically perceive themselves as overweight despite being underweight due to their distorted body image that influences their eating habits and self-assessment.

• Lack of insight: A major hurdle in treating anorexia is the individual's lack of awareness of their condition's severity, often not acknowledging the negative health impacts. This can complicate recovery.

What are the different types of anorexia?

Anorexia nervosa can take different forms, each with distinctive behaviors and patterns.

Understanding anorexia types is important to ensure accurate diagnosis and effective treatment.

The two primary forms of anorexia are:

Restrictive anorexia

In restrictive anorexia, individuals severely limit their diet, often omitting whole food groups, and may engage in excessive exercise. This can lead to major nutrient deficiencies and serious health complications.

Binge-purge anorexia

The binge-purge subtype of anorexia features a harmful cycle of excessive eating followed by purging through self-induced vomiting or misuse of laxatives, enemas, or suppositories.

This cycle causes significant physical and psychological stress, which could lead to serious health issues and may even be fatal.

What are the Causes of Anorexia Nervosa?

Anorexia nervosa is a complex eating disorder with various factors contributing to it.

In some cases, individuals might experience anorexia simply by taking a diet to an extreme level or missing a few meals.

While no exact cause for anorexia has been identified, several conditions, disorders, and factors are frequently associated with its development.

What are the Risk Factors of Anorexia Nervosa?

As mentioned above, the reason why anorexia develops is unknown, but the presence of certain risk factors can significantly increase your chances of developing it.

The more risk factors an individual has, the greater their likelihood of experiencing anorexia nervosa.

The National Eating Disorders Association (NEDA) has identified three main categories of risk factors for anorexia:

Social risk factors

• Verbal harassment, bullying, or teasing: Being ridiculed or shamed about one's body can contribute significantly to the development of a poor body image or even body dysmorphia. This negative perception of oneself can be a trigger for anorexia nervosa.

• Buying into misrepresentation in media: Exposure to idealized body images in the media can foster feelings of inadequacy and drive individuals toward unattainable body standards, heightening their risk of anorexia.

• Exposure to stigma associated with weight: The societal stigma that links increased weight with attributes like poor health and laziness can also be a risk factor. This negative framing around weight can pressure individuals to conform to certain body standards, potentially leading to disordered eating behaviors.

Biological factors

• Family history of eating disorders: The likelihood of developing an eating disorder increases in individuals with a family history of such conditions. The Centre for Eating Disorder Assessment, Recovery, and Support (CEDARS) notes that people who have family members with an eating disorder are 11 times more likely to develop one than those who don’t.

• Family history of mental health disorders: A background of mental illness in the family can also increase the risk for eating disorders, indicating a potential genetic or environmental influence in their development.

• Type I diabetes and eating disorders: The relationship between Type I diabetes and eating disorders is particularly notable.

Research has shown that disordered eating patterns — including conditions like anorexia nervosa and bulimia nervosa — affect up to 20% of people with diabetes.

Psychological factors

• History of substance abuse: Research indicates a strong correlation between past substance abuse problems and the development of eating disorders.

Research shows that 27% of people with anorexia nervosa have also struggled with substance abuse. This suggests a possible shift from addiction to drugs or alcohol to unhealthy eating habits.

• Prior mental health diagnoses: Approximately 35% of individuals with eating disorders have a history of mood disorders, such as depression, anxiety, or social phobias, often diagnosed before the onset of their eating disorder.

This suggests a significant link between these mental health issues and the later development of disordered eating behaviors.

• Challenges in emotional regulation: Challenges in managing emotions can lead to eating disorders, with individuals using food or dieting as a control mechanism to cope with emotional distress, signaling deeper psychological issues.

Who is most at risk of developing anorexia nervosa?

Data collected by the Office on Women’s Health indicates that anorexia nervosa affects girls and women more frequently than boys and men. It’s especially prevalent among younger females.

Research indicates that women are three times more likely than men to develop anorexia.

What are the Symptoms of Anorexia Nervosa?

Anorexia nervosa may be overlooked in its early stages and is often only recognized when it becomes severe.

Key signs that an individual may have anorexia nervosa include:

• Unusual weakness

• Being severely underweight

• Low self-esteem, particularly related to body image and a drive for perfection

• Intense fear of weight gain

• Preoccupation with dieting and food restriction

How is Anorexia Nervosa Diagnosed?

Anorexia Nervosa is formally diagnosed based on criteria outlined in two key medical references: the ICD-10 (International Classification of Diseases, 10th Edition) and the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).

These criteria provide a framework for healthcare professionals to identify and diagnose this eating disorder accurately. Key diagnostic criteria include:

• Intense fear of gaining weight: Individuals with anorexia exhibit a profound and persistent dread of weight gain, which significantly influences their eating habits and perception of self.

• Distorted self-perception: A skewed interpretation of their own body and weight is common. Despite being underweight, individuals with anorexia often perceive themselves as overweight or are extremely critical of their physique.

• Restrictive dieting leading to health risks: A hallmark of anorexia is engaging in extreme dietary restrictions that deprive the body of essential nutrients, resulting in an unhealthily low body weight relative to the individual's age, sex, developmental trajectory, and height.

How is Anorexia Nervosa Treated?

There are several aspects of anorexia treatment. It may include a combination of psychological, medical, and nutritional strategies.

Your doctor will work with other healthcare professionals and tailor your treatment to address both the mental and physical aspects of the disorder.

Psychotherapy

Engaging with a mental health professional is essential for addressing underlying issues, boosting self-esteem, and fostering healthier coping strategies, offering a safe environment to explore the emotional and psychological causes of the disorder.

Cognitive behavioral therapy (CBT)

This is a key therapeutic approach that aims to change destructive behaviors and thought patterns. CBT helps patients identify and alter negative beliefs about body image and food, and develop more positive and healthy behaviors.

Medical care and monitoring

Regular medical checkups are essential to monitor the physical health of individuals with anorexia. This includes assessing vital signs, electrolyte balance, and overall physical condition to address any immediate health risks.

Nutrition counseling

A dietitian plays a vital role in providing guidance on healthy eating habits and devising a plan to safely increase food intake. This counseling helps individuals understand the importance of nutrition and assists in gradually restoring a healthy relationship with food.

Medications

While there are no specific medications to cure anorexia, certain drugs can be prescribed to treat underlying mental health conditions that contribute to the disorder.

These may include antidepressants, antipsychotics, and mood stabilizers. These medications can help manage symptoms like depression or anxiety, which often occur alongside anorexia.

How Long Does it Take to Recover from Anorexia Nervosa?

Recovery time from anorexia nervosa varies for each individual and it’s influenced by the severity of their condition, their participation in treatment, and their response to therapy.

While it can be effectively managed, a complete cure is challenging, with a continuous risk of relapse, similar to chronic conditions like alcoholism.

Research indicates that a structured approach can significantly reduce the likelihood of relapse compared to navigating recovery without professional guidance.

This highlights the importance of ongoing support and adherence to treatment strategies for long-term management.

Where Can I Learn More About Anorexia Nervosa and Other Eating Disorders?

If you feel like your weight loss journey has impacted your mental or physical well-being, LifeMD can help.

A team of healthcare professionals can provide guidance and support to help you manage anorexia and other eating disorders.

Book your appointment to reclaim your health and happiness.

Dina Whiteaker, APRN

Dina earned her MSN from the University of Nebraska Medical Center before becoming a Family Nurse Practitioner. She has 10ᐩ years of telemedicine experience. Dina is board certified and is a member of the American Academy of Nurse Practitioners.

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