A guide to understanding Anorexia, creating an appreciation for the toll it takes, and developing compassion for those who suffer from it.

Woman with arms outstreched on a beachEating disorders can seem intimidating and overwhelming, scary, and mysterious, daunting, and confusing. The truth is, they are! Another truth, the most important truth is that behind every eating disorder is an individual deserving of attention, kindness, and respect. Learning about eating disorders, what differentiates them, how to identify them, and ways to treat them are all important in removing the stigma and shame that continues to surround them. It is never anyone’s intention to dive headfirst into an eating disorder and remain in its rapture for the duration of one’s life. Although there are certainly events, instances, and situations that can quietly nudge an individual in a particular direction, the road to Anorexia development is unclear. There is no one event, moment, or choice that ultimately dictates who suffers from and who doesn’t. You are not wrong if you have Anorexia, and you are not right if you don’t. Anorexia Nervosa is menacing and manipulative, very sneaky, and very controlling. When described this way, it becomes clear that developing Anorexia Nervosa is not a choice. What is a choice though, albeit a hard one, is choosing to abandon Anorexia and slowly, intentionally, and relentlessly work towards a state of recovery. Describing the road to anorexia recovery as easy, linear, or smooth unfairly discredits the tireless work completed by those who are in a healthy, happy, and stable state. Above all else, a healthy, happy, and stable life is possible for all, the future can be bright, and your past does not need to determine your future. The resources are bountiful, and the help can be endless.

What is Anorexia?

Anorexia nervosa is an eating disorder with its primary tenants being extreme and intense restriction to avoid and prevent weight gain. Restriction is often paired with exercise and an obsession with movement to burn or work off anything that is reluctantly consumed. Anorexia takes a massive toll on one’s emotional state as this ED is associated with an overwhelming fear of gaining weight, leading to a powerful desire to perpetually restrict. Anorexia devours the mind and body, creating a toxic environment of debilitating fear and an insatiable need for control. Those with anorexia often have a distorted perception of their own weight and state of health, living in a state of denial.

What are types of Anorexia?

There are two types of Anorexia: Anorexia Nervosa categorized by strict restriction and Bulimia Nervosa categorized by a cycle of restricting, binging, and purging. Both eating disorders share similar states of restriction, but the differences are anorexia is linear; those who suffer from this ED eat less and less, painfully resisting food at every turn whereas Bulimia is cyclical; a restriction leads to a binge, which leads to a purge, which lead to restriction, which leads to a binge, etc. A major similarity is the overwhelming fear of weight gain which contributes to those with anorexia to restrict and those with Bulimia to purge and restrict. 

What causes Anorexia?

The cause of Anorexia ultimately, is unknown. There is no identifiable root or reason as to why any individual develops Anorexia. It is never okay to make anyone feel like they have done anything wrong or bad for having an eating disorder, that it is their fault, or they are deserving of the state they are in.

There are, however, some shared commonalities that may provide some insight as to how and why the development of Anorexia has happened at all. They are as follows, however not limited to:

  • Genetics
  • Family history such as alcohol abuse or substance abuse
  • Personality types such as perfectionism or obsessive tendencies
  • History of trauma
  • Other mental health struggles such as anxiety or depression

How to diagnose anorexia?

Early signs of Anorexia can easily be masked by common behaviours we see frequently from friends, family, and acquaintances. A smaller portion here, a skipped meal there. Early signs are not always indicators that a full-blown diagnosis is coming but, eating disorders are not an overnight progression, they start small and gain momentum swiftly. Anorexia can be formally diagnosed by a licensed practitioner however it is important for the individual’s network to recognize when behaviour patterns change, moods shift, and when rigidity, anxiety, and a need for control are undeniable. 

Signs & Symptoms of anorexia

Signs of anorexia may start small, but they are loud and relentless, continually developing until Anorexia is in the driver’s seat and the patient is simply a passenger. Common signs that are recognizable in most individuals with Anorexia are as follows:

  • Significant weight loss
  • Intentional weight loss
  • Isolation from friends, family, loved ones
  • Avoiding eating in public, avoiding eating at all
  • Obsessing over one’s weight, body size, body statistics
  • Wearing oversized baggy clothing to hide one’s body
  • Rigid exercise routine, engaging in high cardio exercise sometimes multiples times a day
  • Erratic moods and intense anxiety, powerful desire to control all controllables 

Health risks of anorexia

The health risks associated with anorexia are at best severe, and at worst, life threatening. They are not to be scoffed at or taken lightly. The more serious anorexia becomes the more complicated the patient’s health is. Health risks associated with anorexia are below, however not limited to:

  • Decreasing body weight, potentially stunting growth, and development
  • Decreased heart rate and low blood pressure
  • Dizziness or fainting
  • Thinning hair and hair loss
  • Feeling constantly chilled
  • Interrupted sleep or insomnia
  • Interrupted menses or complete loss of menses

Anorexia treatment

All practitioners and staff at EatWell subscribe to a holistic approach to treating anorexia. As the causes are not finite or acute, it is our belief that it is critical to create a well-rounded approach to treating the psychological and physical impacts of the eating disorder. There are three general steps to treating anorexia. They are:

  1. Refeeding – This is done in a medically supervised facility when the patient is in a dangerous physical state and cardiac arrest is potentially on the horizon. Refeeding is a way to stabilize the patient’s physical condition.
  2. Outpatient Transition – Transitioning to an outpatient facility and care team is critical to achieving a state of recovery. It is imperative that the patient find a safe space and place to begin the healing journey. Finding a therapist that the patient connects with is important in creating a sustained and trusting relationship.  
  3. Continued Therapy – Acknowledging that recovery from an eating disorder requires work, time, patience, and above all, self love, and forgiveness is paramount. Setting up a supportive network that is also engaged and willing to do the work is strongly encouraged and advised. It is always important to remember that you are never alone! 

FAQ

Q: Do anorexics need more sleep?

A: Those with anorexia may feel more tired or lethargic than the average individual of the same age. Those with anorexia are constantly starving their body and thus depriving it of critical vitamins, minerals, and sustenance which can lead to low energy. 

Q: How many calories do anorexics need to maintain?

A: Counting calories is a dangerous and fruitless exercise. Unless otherwise specified for specific and intentional high intensity training for high performance athletes, counting calories can and will contribute to disordered habits and may be the gentle push an individual needs to develop an eating disorder or sustaining and already existing one.

Q: Why do anorexics struggle to sleep?

A: Individuals with eating disorders are in a constant state of deprivation which interferes with normal and natural hormone production and functioning. To have healthy sleep patterns, your body’s hormones must be in alignment. However, those with anorexia have altered their internal functioning and processing, thus impacting sleep.  

Q: How common is anorexia?

A: Anorexia is the most common eating disorder, impacting as many as 4% of all Canadian women.