Anorexia: what causes it and what can help?

What is anorexia and what causes it? What additional consequences are associated with anorexia? Find out more about anorexia, the chances of recovery and how to overcome anorexia.

16.01.2024 Imke Schmitz 5 minutes

What is anorexia?

Anorexia is an eating disorder. It often starts in puberty and impacts not just eating behaviours but also self-image and body perception. But what exactly is anorexia? Those affected are not capable of building and maintaining a healthy relationship with food. They are afraid of gaining weight and have a distorted image of their body: they consider themselves overweight, even though they are not. Anorexia can have long-term developmental effects in children and adolescents who are still growing.

The difference between anorexia and bulimia

The difference between bulimia and anorexia is that people with bulimia are generally of normal weight or overweight, while people with anorexia usually become underweight as the illness progresses. However, the central mechanism of both eating disorders is the same: a constant preoccupation with one’s own body weight and body shape.

People who have anorexia achieve their extreme weight loss through severely restricted food intake, forced vomiting and purging, and excessive physical activity. If anorexia is at an advanced stage, anorexia-cachexia syndrome occurs. Those affected suffer severe loss of muscle mass due to long-term malnutrition. This combination of anorexia and cachexia makes them feel increasingly weak and sleepy.

People with bulimia use the same weight loss strategies as those with anorexia. It primarily involves self-induced vomiting and is accompanied by extreme cravings and subsequent binge eating.

Anorexia: what are the symptoms?

Anorexia can be identified by a number of symptoms. Possible physical signs include:

  • Severe weight loss or a very low body weight for the respective age and height
  • A fear of gaining weight or being perceived as overweight
  • A distorted perception of one’s own body, constant dissatisfaction with figure and weight
  • Irregular or absent menstrual periods

In addition to the physical symptoms, there are typical behaviours associated with anorexia. These are often the result of fear of weight gain. Those affected

  • check their body weight very frequently;
  • eat secretly or lie about food intake;
  • withdraw from social activities, especially if they are related to food;
  • eat very slowly, crush the food or avoid meals;
  • obsess over the topics of calories and nutrition;
  • do an excessive amount of sports, even when sick;
  • avoid certain food groups or follow extreme diets.

Do you suspect that your child has anorexia? Try to talk about it, be empathetic and offer your support. If necessary, seek professional advice and support from a doctor or therapist on anorexia nervosa in teenagers and children.

What BMI is classed as anorexic?

17.5 kg/m2 is the maximum BMI (Body Mass Index) in anorexia nervosa. A level of 14.5 kg/m2 or less is life-threatening. Since BMI is age-dependent, these specific values do not apply to anorexia in adolescents and children. Generally speaking, BMI is not the only criterion for diagnosing anorexia. This is due to the fact that it only takes into account weight, height and age. However, this does not allow any direct conclusions to be drawn about body composition, such as muscle or fat percentage. BMI does not take into account individual differences in physique either.

Anorexia: what are the root causes?

Anorexia is a complex condition that can be caused by various factors. Psychological aspects can play a role, for example a perfectionist attitude, a strong need for control, low self-esteem or difficulties in dealing with emotions. Those affected will then resort to controlling food intake and body weight to cope with stress or negative emotions.

The causes of anorexia may also include social factors: the pressure to conform to certain beauty ideals can promote the development of anorexia in some people. Children and young people in particular are exposed to such ideals, for example when they use social media. Family dynamics and interpersonal relationships can also have an impact. Conflicts, unreasonably high expectations or a lack of emotional support increase the risk.

In addition, genetic and environmental factors, psychological susceptibility and certain life events can have an impact on the risk of anorexia. Stressful life circumstances, such as a change of school, parental separation or bullying, can be a trigger. Such events often lead to a sense of helplessness and despair, especially among younger people. Sufferers then try to achieve emotional stability by controlling their diet and their weight.

Does anorexia also occur in men and adults?

Anorexia can affect people of different ages and genders. Although anorexia often occurs during puberty, people can also develop it at other stages of life – regardless of their gender.

Anorexia in children usually manifests itself differently than anorexia in adults. Children are still growing. In addition, they are less able to talk about their feelings and thoughts, making diagnosis more difficult. In many cases, anorexia doesn’t present itself in the form of severe weight loss, but in a lack of weight gain or growth. Many people associate anorexia with girls and women, but anorexia can also be an issue in men. But since this is less common, the disease often isn’t detected in men or only detected late. 

Anorexia: what are the chances of recovery?

When it comes to anorexia, the earlier the illness is detected and psychotherapeutic treatment is initiated, the better the chances of recovery. The speed of the recovery process depends on the severity of the condition, the duration of symptoms, and the support people receive.

How do you overcome anorexia?

Treatment for anorexia usually consists of a combination of psychotherapeutic support, nutritional counselling and medical care.

Psychotherapy often takes the form of cognitive behavioural therapy. In the process, those affected learn to recognise and change unhealthy thought patterns. In nutritional counselling, individuals impacted and their families receive support to promote balanced eating behaviour. Some cases require additional medical treatment – especially if the anorexia has led to physical symptoms.

Specific measures for dealing with anorexia may include:

  • A recovery meal plan: a recovery meal plan can aid recovery from anorexia. It is adapted to the individual needs of those affected and can help them to plan regular and balanced meals.
  • Self-help and support groups: engaging in conversation with other sufferers can be very valuable. The groups offer support, understanding and practical tips from those who have experienced anorexia. A psychotherapist accompanies the participants.
  • A diary: recording thoughts and feelings in a diary creates structure. This can help those affected to gain awareness of their own patterns and triggers.
  • Relaxation techniques and mindfulness: methods like yoga, meditation or mindfulness for stress reduction can help people affected to cope with stress and create a deeper connection to their own body.

Anorexia: what are the consequences?

Anorexia can have various consequences, including long-term effects. The most common include:

  • Osteoporosis (bone loss)
  • Cardiovascular disease
  • Renal dysfunction
  • Impaired concentration
  • Frequent infections
  • Water retention
  • Infertility
  • Growth and development disorders in children and adolescents
  • Other mental health problems like depression or anxiety disorders
  • Withdrawal, neglecting social contact and interests

Just like other illnesses, the sooner anorexia is treated, the better. Both sufferers and family members should be cautious and take any potential signs seriously.

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