What causes anorexia?
An eating disorder has no single cause. A wide range of factors have been identified that can be considered possible “causes” of anorexia. These can be grouped into family, social and personal factors. People who exhibit a number of these are considered to be at a higher risk of developing an eating disorder than others.
Family patterns, such as a family history of:
- eating disorders
Social factors, such as:
- society’s emphasis on thinness
- society’s intolerance of fatness
- pressure to achieve.
Personal factors such as:
- having low self-esteem
- being overly sensitive to opinions of others
- being a perfectionist
- having poor problem solving skills
- being anxious
- being self-critical
- being very self-conscious.
Signs to look for (symptoms)
One of the clearest symptoms is anxiety around food. This could include the person:
- refusing to eat with others
- having rituals around eating, such as counting mouthfuls, eating from a particular plate only, or taking only tiny mouthfuls
- lying about eating ("I've already eaten")
- constant preoccupation with food
- being moody or angry when asked about dieting.
Other early signs of anorexia include:
- unusually thin appearance (for that person)
- increasing concern about weight and disgust with body shape
- wearing only baggy or concealing clothing
- exercising too much
- repeatedly weighing themselves
- frequent checking themselves in the mirror
- complaining about being fat, bloated or feeling full
- difficulty concentrating
- restlessness and hyperactivity
- changes in personality and mood swing
- obsessive compulsive behaviour.
As weight drops various changes occur in the body:
- The body’s functions slow down so as not to use up too much energy. A sign of this is the lowering of body temperature so the person feels cold.
- For women with anorexia, their menstrual periods stop.
- Blood flow to the arms and legs reduces, making the fingers and toes blue and cold.
- Fine hair may grow on the back, arms and face.
- With further weight loss, vital organs such as the brain and heart may be affected.
- Starvation of the brain causes loss of concentration, difficulty in thinking clearly, depression and irritability.
- Starvation of the heart muscle leads to heart failure or disturbances in heart rhythm, which can lead to sudden death.
How the doctor determines if you have an eating disorder (diagnosis)
If anorexia is suspected the doctor will run a number of tests and examinations to make sure there is no medical reason for the weight loss.
To be diagnosed with anorexia, a person must:
- have an intense fear of gaining weight or becoming fat, even when they are underweight.
- refuse to keep weight at what is considered normal for their age and height.
- have a body image that is very distorted, be very focused on body weight or shape, and refuse to admit the danger of weight loss.
- have not had a period for three or more cycles.
Psychoeducation (providing education)
Education can be extremely important to help you and your family. Your health professional will give you information about the disorder, suggest different ways to handle it, and discuss any complications that may occur.
There are also numerous self-help books available in book shops that some find to be a useful first stage in getting help.
They can teach you about some of the ways of dealing with your eating disorder and they can also get you used to reading about or discussing problems that you have previously kept completely to yourself. They are generally written by medical experts but draw on the experience of people who have eating disorders.
There are no drug treatments that are of established benefit in the treatment of anorexia. There are a few that may help deal with some of the associated problems, and these are prescribed from time to time. These include antipsychotic and antidepressant medications.
If you are prescribed medication, you’re entitled to know the names of the medicines; what symptoms they are supposed to treat; how long it will be before they take effect; how long you will have to take them for and understand the side effects.
If you are pregnant or breast feeding no medication is entirely safe. Before making any decisions about taking medication at this time you should talk with your doctor.
Complementary therapies may be used in addition to psychosocial treatments and prescription medicines. Any health-related practice that increases your sense of wellbeing or wellness is likely to be of benefit.
In general, mindfulness, hypnotherapy, yoga, exercise, relaxation, massage, mirimiri and aromatherapy have all been shown to have some effect in alleviating mental distress.
Complementary therapies can include using a number of herbal and other medicinal preparations to treat particular conditions. It is recommended that care is taken as prescription medicines, herbal and medicinal preparations can interact with each other.
Hospitalisation may be suggested where there is extreme weight loss and concerns about your physical health. There are only a few places in New Zealand that have a specialised hospital programme for anorexia.
These units all aim to restore your weight to an acceptable level as well as to begin psychotherapy. Hospital stay tends to be between three and 12 months but this can vary a lot.
Thanks to Janet Peters, Registered Psychologist, for reviewing this content. Date last reviewed: October, 2014.
Resources & Links
Eating Disorders Association of New Zealand
Offering support, practical advice and understanding so you can help your lov...
Eating Disorders Foundation of Victoria
We connect those who are affected by eating disorders with the services, people and hope they need for recovery.
The Royal Australian & New Zealand College of Psychiatris...
Eating disorders: Clinical practice guidelines and associated resources.
ANRED: Anorexia Nervosa & related eating disorders
Information about anorexia nervosa, bulimia, binge eating disorder, and other...