Understanding Anorexia Nervosa

What is Anorexia Nervosa?

Anorexia nervosa is a potentially life-threatening psychological disorder characterized by obsession with weight loss or difficulties in maintaining a weight appropriate for one’s age, height and stature.

Many people with the condition also have a distorted body image. People with anorexia nervosa generally work to restrict the number of calories and/or the types of foods they eat each day.

This serious mental health disorder can affect people of all ages, genders, races and social backgrounds. However, most people with an anorexia nervosa diagnosis develop the disorder during adolescence.

Recovering from an eating disorder, such as anorexia nervosa, can feel like a long and challenging process. Eating disorders do not develop overnight and cannot be cured on a timeline.

However, with the right aftercare steps in place and a good support system, individuals who have been diagnosed with a serious mental health disorder, such as anorexia nervosa, can achieve recovery.

For those interested in finding a comprehensive anorexia nervosa recovery center, it is important to consider the different step-down or post-treatment options each program offers.

If you feel you may suffer from anorexia nervosa, don’t worry, there are steps you can take to get out. This guide will help you navigate this complicated disorder so you can get the help you need. Stay strong!

What Are the Warning Signs of Anorexia Nervosa?

While each person is different, some of the most common warning signs of anorexia nervosa include:

• Refusal to eat certain foods or implementing a highly restricted diet in an effort to control weight
• A general preoccupation with food, dieting, exercise, counting calories, etc.
• Cooking meals for others without eating
• Refusal to eat meals around others; hiding or hoarding food
• The inability to maintain a body weight appropriate for one’s age, height and general build
• Menstrual irregularities or the loss of periods altogether
• Muscle weakness and dizziness
• Dental issues that may include cavities, enamel erosion and discolored teeth
• Consistently finding reasons to skip meal times or social situations that involve food

Benefits of Early Intervention for Individuals with an Anorexia Nervosa Diagnosis

Early intervention for someone with an anorexia nervosa diagnosis could mean the difference between life and death.

Eating disorders have the highest mortality rate of any known mental health condition and, when left untreated, can lead to a number of physical and psychological health risks.

If parents or loved ones notice early signs of anorexia nervosa, they should speak with the individual and seek professional help as soon as possible.

As families choose the right anorexia nervosa recovery center for their loved one, it is important to look for a program that offers a comprehensive treatment plan, including state-of-the-art medical and psychological care.

What is Atypical Anorexia Nervosa?

Most people are familiar with anorexia nervosa, an eating disorder in which a person avoids eating and other caloric intake in an attempt to lose weight, even though they may be severely emaciated already.

Normally, when asked about the symptoms of anorexia nervosa, the common reply will describe a person who is thin, ill and malnourished. However, recent studies are revealing that there’s another kind of anorexia nervosa.  Atypical anorexia nervosa mostly involves adolescents who have lost a significant amount of weight but are not thought to be medically underweight.

Although it’s not well-known atypical anorexia nervosa is indeed an eating disorder, teenagers who’ve developed the disorder often do not show outward signs of serious medical complications related to anorexia nervosa and other eating disorders. Because of this, medical tests like bloodwork should be performed to ensure physical complications are addressed as well as emotional and psychological ones.

Atypical anorexia nervosa (AAN) is also known as a subtype of Other Specified Feeding or Eating Disorder (OSFED). These subtypes of other major eating disorders are listed in the DSM-V. These OSFED disorders include AAN, low-frequency bulimia nervosa, limited binge eating disorder, purging disorder and night eating syndrome, among others.

What Are the Symptoms of Atypical Anorexia Nervosa?

The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (the aforementioned DSM-5) lists AAN as an eating disorder which matches the criteria for standard anorexia nervosa except for that significant weight loss. The dietary restrictions and other disordered behaviors seen in people with atypical anorexia nervosa don’t result in the severe weight loss or emaciation found on more traditional anorexia nervosa.

Additionally, adolescents with AAN will display the same types of cognitive distortions and disordered behaviors associated with mainstream anorexia nervosa. Physical complications experienced by AAN patients are similar to complications diagnosed in anorexia nervosa sufferers, but not as extreme and often less obvious. It’s not unknown for adolescents with atypical anorexia nervosa to be considered medically overweight, although their nutritional balance is skewed.

This unexpected symptom, among others, has led clinicians to apply the “atypical” tag to this disorder.

In cases of anorexia nervosa, as well as bulimia nervosa and other commonly-known eating disorders, it’s extremely common for the individual to deny they have an eating disorder. This is the case for AAN as well.

When the subject of an eating disorder is raised, people with AAN might flat out deny the accusation, try to represent it as a “normal” diet, lash out at family and friends for picking on them or blame stress for their eating disorder (i.e. relationship, career, school). A direct confrontation may backfire, as AAN sufferers who’ve been confronted may go to great lengths to conceal their eating disorder.

Can AAN Be Diagnosed by a Doctor?

The friends and family of teenage AAN patients, and the individuals themselves, often do not realize they have a serious eating disorder because of the absence of severe weight loss normally related to anorexia nervosa. Because they aren’t emaciated or malnourished, they may not think there is any significant problem. Lack of knowledge about a typical anorexia nervosa can prevent parents and teens from seeking out professional anorexia nervosa treatment.

Since significant weight loss is not the defining factor for AAN, laypeople may have difficulty noticing that there’s a problem. However, most family doctors are capable of determining if further investigation, or a psychiatric or psychological assessment, is necessary.  They might be able to make the initial diagnosis themselves.

Once the possibility of the disorder has been raised, there are anorexia nervosa treatment centers that specialize in making a full diagnosis, including AAN, bulimia nervosa, binge eating disorder, and orthorexia nervosa. If you observe obsessive-compulsive behaviors involving food restriction, counting calories, counting fat grams, or other disordered behaviors like food rituals during meals, you should consider reaching out to your doctor and a local treatment center to get started on recovery.

Building a Support System Following an Anorexia Nervosa Diagnosis

A diagnosis of an eating disorder like anorexia nervosa is a terrifying situation. It’s a deadly disease and treatment can be complicated and time-consuming. Eating disorders don’t suddenly appear overnight, and they don’t suddenly disappear, either.  The anorexia nervosa treatment process takes thorough planning, with a support system of loved ones and therapists in place when the individual moves on to aftercare.

Anorexia nervosa is difficult to overcome; however, people with the disorder can enjoy long-term recovery with help during and after treatment.

While the program for treatment a person chooses to attend is crucial, what they do following recovery is just as important.  When seeking out an eating disorder recovery center for your loved one, make sure you take into account how comprehensive their aftercare and support programs are.

First, Let’s Define the Symptoms of Anorexia Nervosa

Anorexia nervosa, which is the most dangerous form of behavioral disorder, is a potentially life-threatening mental health disorder defined by extreme restriction of caloric intake, severe weight loss, body dysmorphia (flawed or distorted body image), and sometimes excessive exercising and diet pill abuse.

People with anorexia nervosa, in most cases, make great efforts to restrict the number of calories they ingest in an effort to avoid being “fat.” They may also engage in excessive or compulsive exercise, beyond the point of self-injury.  Although it’s considered by the general population to be a disorder that only targets young women, this mental health disorder can affect people of all ages, genders, races and social backgrounds.

What Are the Warning Signs of Anorexia Nervosa?

Although every case of anorexia nervosa is different, some of the most common red flags and symptoms of anorexia nervosa include:

• Refusal to eat certain foods (also associated with ARFID)
• Frequent, extreme dieting
• Avoiding public meals or finding excuses not to eat
• Obsessing over the number of calories taken in
• Obsessing over body weight
• Refusing to eat meals around others
• The inability to maintain a medically appropriate body weight
• Changing or stopping of the menstrual cycle
• Low energy
• Sleeplessness or insomnia
• Consistently finding reasons to skip mealtimes or social situations that involve food

Act Quickly – Early Intervention Is the Key

Early intervention when someone you love has received an anorexia nervosa diagnosis could mean the difference between life and death. Even including widespread disorders like depression and PTSD, anorexia nervosa has the highest mortality rate out of any known mental health condition. If it is ignored or goes untreated, the health risks can pile up and become insurmountable. The psychological risk factor is high as well – anorexia nervosa patients have a much higher incidence of suicide than the general population.

That’s why it’s essential for recovery that families reach out to medical and psychiatric professionals when there’s an indication that anorexia nervosa or another serious eating disorder is developing. As the patient’s support system is helping to locate the right anorexia nervosa recovery center for their loved ones, it’s important to look for a program that offers not only psychiatric, medical and therapeutic care modules but also a well-planned aftercare program that involves the patient’s support system.

Connecting With Yourself; Spirituality and Eating Disorder Recovery

Recovering from an eating disorder is complex and multifaceted; in addition to treating the physical manifestations such as malnutrition, bone disease, tooth decay, and low blood pressure, there are also psychological and psychiatric issues at stake. Added into the mix is the recovering individual’s sense of self and connection to their wellbeing.

The last bit may be the hardest part of eating disorder recovery.

One of the complicating factors of recovery from any kind of mental health disorder, from substance abuse to anxiety to treatment for an eating disorder like bulimia nervosa or anorexia nervosa, is designing a comprehensive plan which involves medical health, emotional wellbeing, and spirituality as part of a unified method of treatment.

Because the medical, therapeutic, and psychiatric aspects of recovery have the benefit of established, evidence-based and scientific methodologies honed over decades, there is a road map for treatment that can be to some degree used for a variety of individuals. On the other hand, spirituality is a personal journey for every individual.

Spiritual Emptiness – How It Can Trigger Eating Disorders

With a baseline of proper medical and psychological treatment ensuring the individual’s safety and the beginnings of recovery, eating disorder treatment centers can go beyond simply treating the symptoms presented by the eating disorder, and instead concentrate on their entire wellbeing.

Therapists and psychologists working with eating disorder clients have noticed a common factor in eating disorders’ development – a feeling of spiritual emptiness. This is filled by obsession over body size and shape, as well as compulsive behaviors such as binging and purging. There are comparisons to be drawn between religious obsessions such as atonement and a person with anorexia nervosa’s obsessive quest to achieve “perfect” thinness or weight loss.

People of every race and culture have a need to understand their place in the world. If that understanding is missing, they may turn to religion or another spiritual group.  However, a spiritual search for meaning can focus on anything that fills the hole they feel spiritually, even if that means transferring those feelings to an unhealthy obsession.

This is often compounded by the ways we are mediated – the constant barrage of images and video of thin, beautiful models on TV and Instagram can influence people who are feeling spiritually empty and provide them a “goal.”

Wellbeing experts in the eating disorder treatment field generally agree that the disordered behaviors imposed upon themselves are often a result of people’s desire to reach these unattainable beauty standards. Essentially, the part of each of us that needs a sense of spiritual connectedness can be corrupted by distorted weight and body goals.

Spirituality Is Both Personal and Universal

Eating disorder treatment centers that include spiritual well being as part of their curriculum do not normally associate themselves with any one organized religion. Although religious, faith-based healing programs have had some success, most modern quality ED recovery programs allow for the wide variety of personal understandings that meet clients’ spiritual needs. Of course, individuals in treatment who have religious faith are encouraged to maintain that faith as a part of their spiritual recovery,

Spirituality is a personal journey that everyone takes part in, in which you discover your connection to yourself and what your place in the world is. Because it’s a universal journey that is yet also deeply personal, it has to be part of a comprehensive eating disorder recovery.

As a metaphor – if someone was being treated for high blood pressure, would the doctor simply prescribe a pill and call it a day? Or would he also recommend a combination of exercise and sodium reduction to treat the overall causes of the disease?

Since a spiritual emptiness can lead to disordered behaviors and is often a complicating factor in their treatment, any quality eating disorder treatment center will incorporate spiritual awareness as a central part of the treatment process.

Anorexia Nervosa Aftercare: What Do Families Need to Know?

Before a patient discharges from an anorexia nervosa recovery center, they should have a complete aftercare plan set in place.

Returning home without a solid aftercare plan could set the patient up for failure, with much greater odds for relapse. The outside world provides many different triggers to someone recovering from anorexia nervosa. A simple act, such as browsing the internet or shopping at the grocery store could suddenly trigger eating disordered thoughts and behaviors.

Making a commitment to an aftercare plan is the best way to slowly transition back into day-to-day life after being discharged from treatment. Patients have the option for continued eating disorder counseling through day treatment services, group counseling sessions, family-based therapy and more.

About the Author: Carrie Hunnicutt

With 20 years of behavioral health business development experience, Carrie combines world-class marketing, media, public relations, outreach and business development with a deep understanding of client care and treatment. Her contributions to the world of behavioral health business development – and particularly eating disorder treatment  – go beyond simple marketing; she has actively developed leaders for her organizations and for the industry at large.

About Shannon Clark

Shannon holds a degree in Exercise Science and is a certified personal trainer and fitness writer with over 10 years of industry experience.