Anorexia - Causes, Symptoms and Therapy

Anorexia nervosa or anorexia
Anorexia nervosa, anorexia, is a disease based on a disturbed body image. Anorectics have an extreme need to lose weight by overworking and refusing food.

contents

• Unique symptoms are:
• hyperactivity
• causes
• The story of Anorexia Nervosa
• The main types of eating disorders
• causes
• risk factors
• The behavior of anorexics
• Sociocultural causes
• Effects of anorexia on the brain
• Effects of anorexia on the heart
• The treatment of anorexia
• References:

Unique symptoms are:

- Continuous circling to lose weight

- the compulsion to deprivation

- a distorted image of your own body

The death rate is high. Nevertheless, many sufferers benefit from treatments in special clinics for eating disorders.

False self-image: Anorexics see themselves in the mirror "fat", although they are objectively emaciated. The self-image is disturbed. Image: RioPatuca Images - fotolia

hyperactivity

Besides food deprivation, physical hyperactivity is another piece in the anorexic puzzle. Laypersons often do not take this overactivity seriously, or even consider it positive, according to the motto: If you do so much sport, you can not be sick. However, this symptom plays a central role in the clinical picture and the progression of self-destruction.

Not all anorexics are hyperactive, but the hyperactive ones show poor healing rates, they are longer and more frequent in clinics and are energetic. Experts now regard hyperactivity as an essential psychopathology of anorexia.

The reason for the hyperactivity is the same as for the refusal of food. Sufferers feel imperfect and try to discipline their bodies in this distorted perception - ultimately fatal.

Their idea of ​​being deficient does not result from real physical deficiencies: very few anorexics previously suffered from severe obesity, in which eating less and exercising more would make sense.

Her pathological urge for perfection, on the other hand, is a mental disorder. Not real weight problems, but a wrong perception of yourself is the cause.

Anyone who does a lot of sports, instead of having a proper breakfast, only 10 kilometers running, then cycling, and in the evening, instead of sitting in the pub to go to the gym, in this society is not considered sick - on the contrary, the performance ideal.

Anorexics often have a particularly ambitious and successful outlook on outsiders - these are desperate people who need help.

causes

The causes of the disease vary from person to person; the known causes include genetic dispositions as well as a combination of environmental, social and cultural factors.

The exact causes are still unknown and mechanisms that cause the disorder are poorly understood. Advances in techniques that depict nerve reactions are becoming increasingly important in understanding anorexia.

One thing is clear: Anorexia Nervosa is spreading in the developed capital states and many sufferers are compulsively trying to live up to the guiding ideologies of turbo-capitalism.

The core features include a compulsion to perfection. Many anorexics strive to be the best in every area. No matter what they do, whether they are politically active, graduate, graduate, or engage in sports: they are the ones who wake up two hours earlier to study for the exam; they train in their free time when they only became second at the 1000 meter run; if they are politically active then they will not miss an event.

For outsiders, this involvement is often not pathological because it also extends to free time: Anorexics dance the night away at parties, or go on extreme trips beyond the limits of their physical performance.

Young anorexics often act responsibly to an extent that is inappropriate for their age. In layman's terms, their behavior only becomes apparent when the traces of the disease can no longer be denied - the fingers are reminiscent of skeletons, the larynx comes out, or the thighs have the thickness of wrists.

When addressed, sufferers usually deny their illness; For example, they tell of a thyroid malfunction or gastric hyperacidity.

Generally, anorexics are perfect in not showing any weakness to the outside, and this behavior is both a symptom and a cause of their illness. They often learned early on that they felt they were lacking, if they did not perform well in every area.

First, they suffer from this, but secondly, they are unable to criticize the misanthropic achievement ideal. So instead of advocating conditions in which people can unfold their lives without conforming to a physical ideal, they pathologically work off the constraint they suffer from on their own bodies.

Unconsciously, there is often a desire behind this de facto self-destruction to free oneself from social constraints. An anorexia, for example, said when she was 28 kilograms in intensive care: "I feel free as a ghost, released from the shackles of the body."

Not refusing food and rape the body at the same time to maximum performance, not accidentally reminds us of the ascetic practice in religions, so the failure to pre-programmed attempt to escape the company by tormenting their own body.

Many anorexics logically have a sadomasochistic personality. Masochistic, because they torture their own body instead of putting their suffering into social action. Sadistic, because in their disturbed perception they look down on the "normals" trapped in their "shapeless bodies".

Empirically barely proving, but obviously, they unfettered by a propaganda that is standard in neo-liberalism, namely, the fairy tale that the one who "thinks positively" and works harder, a "winner" is.

This social Darwinism selects between "winners" and "losers" and denies the social conditions in which every human being is involved. Many anorexics show the enmity of this ideology on their own body; they solidify and try to be the "best" to the logical extreme.

Defining oneself from the "normal" by tormenting one's own body leads them into a vicious circle. When friends, relatives or professionals criticize their "lifetsyle", it only confirms that they are tormenting themselves even more intensely. However, as conditions do not change as a result of this "self-sacrifice," they are increasingly destroying themselves.

The story of Anorexia Nervosa

William Gull, a personal physician to Queen Victoria, gave her name to Anorexia Nervosa in 1868, and Charles Lasgue first described it in 1873 as Lánorexie Hysterique.

William Gull wrote about a disease that particularly affected young women between the ages of 15 and 23, with the characteristic of extreme malnutrition. Men did not show up in his investigation, and he saw the disorder associated with the "hysteria" that was then considered a specifically female disorder.

He suggested that the patients be separated from their families because he saw them as a "vampire" sucking the "blood of healthy people in the social environment".

These early descriptions contain a true core. The "female hysteria" in the Victorian era appears socially produced under sociological magnifying glass and from a historical distance. Bourgeois and noble women then lived in a prison of rigid norms that codified the image of women, and irrational outbreaks were one of the few ways to escape this corset.

The anorexia of the time can also be classified in this environment: as a failed attempt to escape control and, at the same time, to draw attention to the psychological suffering: those who refuse food refuse to cooperate.

Seeing the sufferers as energy vampires also coincides with the experience that today's loved ones often have with anorexics. No food, whether from parents, siblings or friends, is often a signal to show, "I am not one of you." One's own suffering is often used consciously and unconsciously to punish the social environment.

What is wrong is the idea that anorexics are starving to force their relatives to take care of them. On the contrary, they deny their illness and suggest offers of help. Therapists break their teeth on them, because those affected usually know the condition more accurately than the attending physician and still carry on.

The disease is therefore too complex to see those affected generally in a moral guilt.

Anorexia can already be detected in ancient Greece and begins with religious fasting, which extends into the Middle Ages. The medieval practice of "getting sick of hunger" by women in the name of religious purity can no doubt be classified as anorexia. Even today's anorexics often imagine their disruption as a service for a higher purpose - whether it is the "road to God" or capitalist barbarism does not matter.

In the 19th century, anorexia was a form of melancholy (now depression) in which self-aggression drives libido.

Today, anorexia is considered a result of various factors. The media and Western obsession with slimming play as well as dysfunctional dynamics in families. Therefore, today's experts are discussing in particular how parents transmit eating disorders to the children.

This is not only true for anorexia, but also for eating-nausea and eating addiction. To put it simply, the bum semitics eat what they are suffering from inside themselves, make a good face for the evil game and strangle it secretly; the Ess-addicts eat a protective armor to cover their injuries with this armor. The anorexics are the "consistent" among the eating-disturbed. They refuse the food and thus the connection to the family and expose themselves at the same time to a murderous achievement ideal, in order to escape the constraints of their Lebenswelt.

Eating is an elementary social ritual, and the family system is defined by food: with whom do we eat where, what do we eat, how much do we eat, who gets what, do we eat meat or vegetarian, German-bourgeois or international? This expresses how we define ourselves socially.

In the family, the food ritual characterizes the social hierarchy: The teenager, who is a doner kebab after school instead of sitting with his mother at the table, demonstrates his independence; The mother keeps her dependent and overweight daughter in a double bind by constantly telling her "look how fat you are" and giving her the thickest piece of cream pie at the same time. Anorexics demonstrate, "I'm not part of the system."

Anorexia women still suffer from teenage and adolescent adolescence, and many studies see it as a method of refusing sexuality: as a result of anorexia, the female hormone balance collapses, and in many people the period continues out. Some of them call this absence of bleeding "salvation".

The main types of eating disorders

There are three main types of eating disorders.

People with anorexia nervosa have a disturbed body image that makes them feel overweight, even if they are critically malnourished. They often refuse to eat in the presence of others, they lose a lot of weight, and even starve to death.

People who suffer from bulimia eat in quantities, then take laxatives and vomit what they have eaten. They usually act in secret, they despise themselves and are ashamed of their illness, in addition to negative feelings, when they have emptied their stomach. Bulimia is accompanied by an obsession to control weight and self-image and is often accompanied by depression. Since those affected despise their "lack of consistency", the suicide risk is high in severe cases.

So-called "binge eaters" suffer from food cravings in which they uncontrollably swallow food. Unlike bulimia sufferers, they do not consistently burn excessive calories. Binge eating is less well defined than bulimia and anorexia, so little generality can be seen.

Control binge eating and immediate breaking out of food. Image: Photographee.eu - fotolia

Affected individuals often report feelings of "inner emptiness", feel isolated in social relationships, feel that they have missed the "essentials of life" or "never reach what they want to achieve in life". They often suffer from extreme guilt, stress and self-contempt.

In addition there are eating disorders that can not be classified exactly, but can have just as bad effects as bulemia or anorexia. They range from people who compulsively consume harmful foods such as sweets or energy drinks in excess to sufferers who refuse food that played a special role in their family.

For anorexia, bulimia, and binge eating, the sooner relatives recognize the symptoms, the better. Anorexia, such as choking addiction, is very common in puberty. The teens submit to strict diets and pay close attention to weight loss.

Responsible parents should look at every diet of their children to see if it is in a "healthy setting" and if the motive is psychological. It is irresponsible, however, to discriminate against a 14-year-old daughter, who has a bit of bacon on her ribs, and secondly to praise her because she has become "so pretty slim."

Firstly, such parents often struggle with their own weight and secondly, they usually express much worse accusations with their "criticism". Subliminally they tell the teenager: "As you are, you are not okay." With the (supposed) overweight they denounce an alleged lack of discipline or laziness of the child.

These accusations often strike just as the teenager takes the first steps of self-development, and the parent blocks them. The adolescents do not know where they are going, but they suggest that every step into the world is wrong.

Strict diets are sometimes a destructive attempt to be "right." In these cases, the blame for the eating disorder of teens parents. Unfortunately, such parents are often resistant to advice. When the patients get into a therapy, they often say, "I think she has the wrong girlfriends," "that was just such a fashion at school," or "she became very funny in puberty" ... but they're rock solid to have done everything right. Experienced therapists in these cases recognize the narcissism of the parents as the core of the problem, and the disorder of the teenager as a symptom of a system that ensures the parent's rule - at the expense of the child.

But it's not always the family's fault. Fascistoid selection, such as Heidi Klum's "Germanyś next topmodel", explains girls as "unworthy of life" who do not conform to the body ideal of a skin-covered skeleton. In the labor market, women, and increasingly men, are experiencing that a properly starved body shape is needed for careers - empathic parents need to work hard to counteract this barbarism.

It's about showing your kids that parents love them, whether they're a little bit thicker or thinner. At the end of the day, if eating habits have a destructive impact, trained therapists are in demand. Many psychologists in Germany today specialize in eating disorders.

In general: A formed anorexia like bulimia is a vicious circle from which those affected hardly ever come out without help.

causes

Nonetheless, genetic predisposition plays an important role in the genesis of anorexia, according to recent studies. Accordingly, a gene in the vicinity of the chromosome 1p is involved in the risk of developing anorexia.

Another "suspect" is dysfunction in the hypothalamus, which regulates certain metabolic processes. An imbalance of the neurotransmitters characterizes people who also suffer from anorexia.

Eating problems of a child, a general biography of malnutrition and depression of the mother are considered as risk factors. A high degree of negative feelings and perfectionism characterizes the persons concerned.

Basic social problems provide the breeding ground for a disorder that often begins with the pressure to be thin and "attractive". A bad self-image increases the problem. This self-image can have a variety of causes: bullying in elementary school, violence by classmates, special interests that the "others" do not share, or sexual failures in early puberty.

People who suffer from eating disorders are often victims of sexual abuse in childhood, and bulimia and anorexia are both ways of refusing sexual experience.

The factor family is currently hotly debated in the professional world. While some physicians still regard dysfunctional families as a major cause of all eating disorders, other experts, especially those on anorexia, are opposed to empirical findings that show that even members of harmonic families develop the disease.

The question of whether "first the chicken was there or the egg" can hardly be answered comprehensively. For example, an afflicted person loathes eating food and, as adults, promiscuously lives their sexuality, but does not enter into a close relationship at eye level. Her mother is suffering from bipolar disorder and her parents wanted to get a divorce when the person was 14. Are the eating disorders now a reaction to the family system, or was the genetic disposition crucial?

risk factors

Gender and age are related to anorexia. Only ten percent of all those affected are men. Essentially, eating disorders spread among teenagers and young adults.

Family studies have shown that people with disabilities who are also disturbed are far more likely to be at risk for their entire lives than those without family responsibilities - the risk of first-degree relatives being particularly acute is particularly clear.

The good intentions of doing sports and losing weight fail with bulimia and anorexia. A systematic education about harmful extreme diets, especially for teenagers, is therefore a high priority. Serious experts today agree that crash diets have fatal consequences. Instead, they recommend a long-term change of diet, which means not to starve.

The behavior of anorexics

Anorexics permanently find ways to lose weight, even to death. They stand out with a high sense of duty and moralism and a fanatical notion of independence.

At the onset of the disease, they work hard to prepare low-calorie foods, weighing up to four times a day and following exhausting diets. After a while, they glide to the next level, where their behavior is constantly changing, and the family begins to recognize the problem. But the perpetrators refuse to talk about their illness. Quarrels are commonplace, and often those affected now isolate themselves from their relatives, which aggravates the problem.

The interest in hobbies that have nothing to do with weight loss is dwindling. The ability of those affected to concentrate is lost as well as their sexual activity.

Although the patients sometimes behave hyperactively, the physical consequences of the deprivations also cause lethargy, emotional instability and a "standing side by side".

Sociocultural causes

Sociocultural theories emphasize the role of society: According to them, those affected suffer from the expectations that are placed on the appearance of women. An indication of this thesis is the group of the main victims: not men who are not exposed to slimming terror to the same extent, not even old women, which are not only measured by their shell and secondly come from a generation in which the women's movement " Beauty "norms attacked - but young women.

These young women are constantly confronted in Internet, advertising, tabloid press and TV with unreal images of perfect bodies, which hardly a living person can do justice. These images are also edited by Photoshop, celebrities and porn actresses look completely different after hours of cosmetic work than in real life and often have "beauty" operations behind them.

Advertising models in the 1990s were on average 10 kilos lighter than in the 1950s and 1960s. This ideal try to emulate young girls. Grotesquely, this does not at all correspond to what potential sexual partners of the opposite sex find attractive. Empirical studies show that men prefer female curves to emaciated bodies.

Anorexia often begins with the onset of sexual identity. A virtual ideal of beauty here opposes social reality. Girls who are sexually unattractive anyway are put in a negative loop because they focus on an ideal that does not appeal to the actual boy.

Because their perception is already distorted, the girls are increasingly getting into isolation. While the unrestrained classmate with bacon at the hips is swarmed by the boys, the hungry sees himself alone in the corner.

Effects of anorexia on the brain

Our physical and mental health, our relationships and our everyday lives are all affected by disturbed eating habits in the clinical sense. If someone suffers from a eating disorder, there is a risk of contracting brain damage.

Disturbed eating behavior adversely affects food processing; The brain does not get the nutrients it needs to function well. This is especially important in adolescents, as their brains develop intensely until early adulthood - anorexia can interfere with elemental periods of brain growth.

Brains of people who had or have anorexia do not respond to food or pictures of food - unlike non-sufferers. When they consume sugar, even people who overcame their anorexia show less brain activity than people who like sugar and never have an eating disorder. Researchers conclude that anorexia patients draw less enjoyment from food than non-affected people - and in the biological-brain chemical sense.

The reason anorexia sufferers can continue their diet until death is because their brain does not urge them to eat. Whether the brain of the patient does not react sensory or does not transmit the right signal for food remains unclear at present.

Effects of anorexia on the heart

Heart disease is the most common medical sequelae for people with severe anorexia. In patients with long-term anorexia, the heart walls are thin and weakened, while the ventricles expand. The heartbeat decreases and with it the blood pressure. Organs that are very sensitive to blood pressure and blood flow as kidneys and liver begin to fail. Fortunately, these damages often heal with weight gain and the intake of important vitamins and minerals.

A number of abnormal heart rhythms may be associated with anorexia. First, the slow heartbeat, in the vernacular Bradycardia. This problem usually affects people with weak heart muscles. When cardiac function weakens, the heart increases the number of beats per minute to keep blood flow constant. With anorexia, however, the energy stores in the heart are so damaged that the heart rhythm can not rise to strengthen a weakened heart - blood pressure drops rapidly and organ failure develops rapidly.

Another problem of anorexia sufferers are abnormally fast heart rhythms. Particularly affected by this complaint are sick, in which cravings and vomiting alternate. This results in a dangerous loss of sodium, potassium and magnesium. But the heartbeat depends on these electrolytes. As their levels drop, chaotic patterns develop in the lower chambers of the heart.

Other consequences of anorexia include cognitive damage. In Bulemia, the teeth suffer from constant contact with acid during vomiting, the hair becomes brittle in eating disorders due to mineral deficiencies, iron deficiency leads to drowsiness, bulemia and anorexia patients suffer from drowsiness and irritation.

The treatment of anorexia

Anorexia is difficult to treat. Sufferers deny the disease, are ashamed, or, conversely, see themselves as standouts who are above the "needs of the carnal world." Then some of them play with their therapists; they know the symptoms of their illness better than psychiatrists and trick them.

Single or group therapies have been proven to be beneficial. Image: Photographee.eu - fotolia

For example, they pretend to be successful in therapy, even pretend to relatives that they are eating and in fact go on starving. However, reintroducing normal eating habits is necessary to restore the patients' health.

Two goals are in the foreground of the therapy: First, to ensure a stable diet and to achieve a normal body weight. Second, it is necessary to change the pathological eating behavior so that the body weight can remain at a healthy level.

Most of the time the therapy is outside of clinics. But for clinical conditions such as dangerous underweight, heart problems, suicide or psychosis, hospitalization is inevitable.

Mostly a mixture of behavioral and supportive psychotherapy promises the best results. Those affected can learn to adapt their behavior and break the life-threatening patterns. The advantage of behavioral therapy is that it does not force the sick. To analyze their "disturbed personality" - but "only" to control their behavior with the aim of restoring a normal way of dealing with food.

Medicines show no success against anorexia.

The most common treatment for anorexia is psychotherapy, which usually takes a long time - almost always issues such as sexual abuse, substance abuse, relationship problems or suicide risk. In contrast to behavioral therapy, psychotherapy can and should not only address the symptom of disturbed eating, but also the emotional well-being. The focus is on discussing the emotional and cognitive causes behind the disturbed eating habits.

Often, family therapies help. The eating disorder applies here as an expression of a disturbed family system, which in turn involved all close relatives. Their success largely depends on whether the family is willing to join in and members change their behavior.

When families get involved and learn how to support and catch those affected, this therapy promises the longest chance that the patients will not fall back into self-destruction. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)

References:

• http://www.medicinenet.com/anorexia_nervosa/page3.htm
• https://www.emilyprogram.com/blog/how-eating-disorders-affect-the-neurobiology-of-the-brain
• http://www.everydayhealth.com/columns/jared-bunch-rhythm-of-life/for-both-men-and-women-anorexia-nervosa-is-increasing-and-the-effects-on-the- heart-can-be-severe /
• http://www.hsj.gr/medicine/contribution-of-social-and-family-factors-in-anorexia-nervosa.pdf
• http://www.psychology4all.com/eatingdisorders.htm