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Anorexia Nervosa - Articles, Links and Resources!

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A good article on anorexia: sweek/page/3/

Please see the rest of the post for more information on Anorexia and support.

Edited Nov 15 2007 13:13 by nycgirl
Reason: 6/28/07 Updated Hyperlinks, 11/15/07 updated thread title
44 Replies (last)
All In Her Head

(Jan. 20, 2005) --Anorexia ?? the most deadly mental illness ?? is definitely not just about looking thin.

"She didn't choose anorexia. I know that now, but that doesn't make it any easier to watch her starve herself, and fade away into nothing.

It's like a nightmare where you see the boogeyman and you know it's going to kill her so you warn her, but she can't see it, so she doesn't believe you, and then she dies.

But anorexia's a slow suicide. And although anorexia accounts for more deaths than any other type of mental illness, she says she's okay, she says she's healthy. Her brain has shrunk and she's losing her cognitive skills.

She's says she's not like other anorexics. She's in denial. She's moody and angry and depressed a lot of the time. She thinks her mind and body are just fine. But her heart has shrunk, too, and its resting rate has fallen to 49 beats per minute (60 to 80 beats per minute is considered healthy) and she's seen doctors for problems with her kidneys, stomach and other organs.

When she's sleeping, her heart rate will fall well below the "critical" rate of 45 beats per minute, and she may not wake up again.

It's difficult not to feel angry with her because she's hurting herself and all of the people who love her. But she's not just a skinny, stubborn, vain girl who won't eat. She's sick, with a mental illness, and she didn't choose this any more than someone chooses cancer.

A few days after Christmas, she is hospitalized. She's in treatment now, although most of the time she doesn't want to be there and she insists she can get better on her own. I try to tell her that no one looks forward to chemo, either. I don't know if she hears me or not. There are millions of other women ?? and men ?? like her in the US, walking skeletons, dying to be thin.

"Why won't she just eat the sandwich?" asks Dr. Cecily FitzGerald, an emergency physician who also treats patients with eating disorders. "She can no more eat that sandwich than you can eat that shoe.

"It's important to stress that it's not about the food, because parents, spouses, loved ones ?? they always feel it's just about the food. It's really not about the food."

The National Association of Anorexia and Associated Disorders says the problem has reached epidemic levels in America, and affects everyone ?? young and old, rich and poor, women and men of all races and ethnicities. Their statistics say seven million women and one million men are sick with an eating disorder. More than 85 percent of victims report the onset of their illness by age 20.

There are still a lot of misunderstandings about the disease, however, even among health professionals. Treatment is hard to find ?? few states have adequate programs or services to combat anorexia nervosa and bulimia ?? and it's also very expensive.

Inpatient treatment can cost about $30,000 a month, and outpatient treatment, including therapy and medical monitoring, can reach $100,000 per year or more.

"The treatment should be multi-disciplinary," FitzGerald says. "Therapy, a nutritionist, and a physician. Those are the minimum requirements ?? you can add to that physical therapy or art therapy. You can add as much as you see fit. But the bare-bones is the therapist/psychologist, a physician and a nutritionist."

Anorexia ?? as all eating disorders ?? is a complex disease. There's not one single, simple cause, although new research has revealed that anorexia and bulimia are inherited conditions ?? one needs to have a genetic predisposition for them.

"But that doesn't mean that everybody who has that gene does have, or will develop, an eating disorder," says Kirstin Lyon, a marriage and family therapist in Carmel Valley who is also a certified eating disorder specialist.

So-called environmental factors can also trigger, and worsen, the disease: our society's obsession with thinness, puberty, dieting, going away to college, a traumatic world event or a more personal one, like a breakup.

"There are usually about 10 other reasons why people get eating disorders," Lyon says, "and they all come together: control issues, perfection issues, also addiction. When all these things come together, it forms this way of coping. It's not about the food."

While most people who develop anorexia do so when they hit puberty, both Lyon and FitzGerald say they see patients of all ages. They say they treat 10 girls for every one boy.

First, it looks like body dissatisfaction. "I want to go on a diet," Lyon quotes her patients. "Or food pickiness ?? I want to be a vegetarian."

Sometimes it's even encouraged ?? "dieting and exercising are good for you; thin is beautiful," or so we are told every day.

"We live in a culture where we look at anorexically thin models and call that normal, call that attractive," FitzGerald says. "We have lost our high level of suspicion for someone who is at low weight."

By the time the disease is discovered, much damage has already been done. Hair falls out. Skin turns orange, or yellow. Teeth and gums erode. Menstruation stops. Bones become weak and brittle. The heart, kidney, liver, stomach and other organs become seriously damaged and start to shut down. The brain shrinks.

And those are only the physical repercussions. Words don't adequately describe what the disease does to her self-esteem, how badly it damages her relationships and how much it hurts the people who love her.

"Weight restoration will return most everything to normal," FitzGerald says.

About one third of anorexics recover, Lyon says. Another third may relapse and remain symptomatic. The final third are chronic.

"Their life expectancy is shorter, or they will die," Lyon says.

The ones who recover can't do it overnight. It usually takes between two and nine years. Both Lyon and FitzGerald had eating disorders. Both recovered, and want to help other people become well.

"There were so many times when I didn't want to go [to treatment]," Lyon says, "but I just had faith that things can change. If they can for me, they can for anybody."

And both Lyon and Fitzgerald rail against the unrealistic body images on TV, in magazines and on the runways.

"It's very important for all of us ?? parents, teachers, men and women ?? to be accepting of our bodies," FitzGerald says. "I think this whole obesity epidemic is really dangerous; the amount of press that obesity is getting is leading to so much press for diets and it's such a dangerous, dangerous place to go. People need to eat what they want, when they want, and stop when they are satisfied."

It's also extremely important for parents to model body acceptance for their kids, she says. "Then they aren't so susceptible to the media, to diets. It's important for parents to point out all the ways that our culture gets women to be unhappy with themselves. Don't say, 'Do these jeans make me look fat?' or, 'I can't have dessert; it will go straight to my hips.' It's that kind of stuff that children just can't hear. They need to know that they don't need thin thighs or a flat stomach to love their body."

FitzGerald talks to her daughter about airbrushing; in fact, the two have made a game out of it.

"We go through magazines and pick out where we think the model has been airbrushed. You take a woman who is already beautiful, and even the model can't achieve this level of perfection.

"Parents, teachers, babysitters, sisters, we need to all stand up and say, 'We are happy with ourselves, our bodies, the way they are.'"

I hope she makes it to that point, and someday, will be able to say she's happy with her body and really mean it. She's begun to take the first steps, at least. But right now she's angry much of the time. She's angry at her doctors and her parents because they are forcing her to eat and attend therapy sessions. I hope someday she will be able to realize that they saved her life."

Source: Monterrey Weekly
Defining characteristics of Anorexia Nervosa: Individuals with anorexia nervosa are unwilling or unable to maintain a body weight that is normal or expectable for their age and height (most clinicians use 85% of normal weight as a guide). Individuals with anorexia nervosa typically display a pronounced fear of weight gain and a dread of becoming fat although they are dramatically underweight. Concerns and perceptions about their weight have a extremely powerful influence and impact on their self-evaluation. The seriousness of the weight loss and its physical effects is minimized or denied (women with the diagnosis of anorexia nervosa have missed at least three consecutive menstrual cycles).

Diagnostic criteria of anorexia nervosa include two subtypes of the disorder that describe two distinct behavioral patterns. Individuals with the Restricting Type maintain their low body weight purely by restricting food intake and increased activity (i.e. compulsive exercise). Those with the Binge-Eating/Purging Type usually restrict their food intake but also regularly engage in binge eating and/or purging behaviors (i.e. self-induced vomiting or the misuse of laxatives, diuretics or enemas). Binge-Eating/Purging Type of Anorexia Nervosa is also frequently associated with other impulse control problems and mood disorders.

People who suffer from anorexia often have low self-esteem and a tremendous need to control their surroundings and emotions. The eating disorder is often a reaction to external and internal conflicts (i.e. anxiety, stress, and unhappiness can be leading factors).

Profile: Anorexia Nervosa The person suffering Anorexia is generally extremely sensitive about being fat, or has an intense fear of becoming fat, and of losing control over the amount of food he/she eats. This hyper-sensitivity is accompanied by the desire to control his/her emotions and reactions to these emotions. Low self-esteem and the constant need for acceptance leads to obsessive dieting and starvation as a way to control not only weight, but also feelings and actions regarding their emotions. Many anorexics feel they are not deserving of life's gifts and pleasures. They often deprive themselves of situations that offer pleasure. Starvation or restriction, obsessive exercise, calorie counting, a constant obsession with food and health issues, self-induced vomiting, the use of excessive amounts of laxative, diuretics, and/or diet pills, and a persistent concern with body image can all be some of the physical indications that someone suffers from Anorexia Nervosa. People suffering with Anorexia may also go through periods of Bulimia (binging and purging) as well.

There are numerous ways a person with Anorexia can exhibit their disorder. The anorexic attempts to maintain strict control over food/caloric intake. Periods of starvation, obsessive counting of calories, compulsive exercising, and/or purging after meals are among the most common symptoms. In some cases, an anorexic will seem to eat normal meals with only periods of restriction. They use diet pills to control their appetite, or laxatives to attempt to rid their body of food, both of which are dangerous and useless in producing weight loss results. Anorexics will deny hunger, make excuses to avoid eating, will often hide food they claim to have eaten, or attempt to purge the food away with self-induced vomiting, or by taking laxatives.

Diagnostic Criteria: Anorexia Nervosa The following definition of Anorexia Nervosa is used to assist mental health professionals in making a clinical diagnosis. The clinical criteria is not always representative of what one living with anorexia feels. Please note, you can still suffer from Anorexia even if one of the below signs is not present. One can not simply read the criteria and think "I don't have one of the symptoms, so I am not Anorexic" or "I don't have a problem with food."

1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).

2. Intense fear of gaining weight or becoming fat, even though underweight.

3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

4. In postmenarcheal females (the absence of at least three consecutive menstrual cycles.

Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

Binge-Eating Type or Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating OR purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

Definition/Review of Anorexia Nervosa: Anorexia Nervosa is an eating disorder effected by a complex mixture of social, psychological and physical problems.

Characteristics are:

A. An intense drive for thinness
B. An intense fear of gaining weight or becoming fat
C. A disturbance in body image
D. In women- a cessation of the menstrual cycle for at least three months
E. In men- a decreased sexual drive

Facts About Anorexia Nervosa:

A. There are two types of Anorexia Nervosa:
     1. Restrictive type
     2. Binge eating/purging type.
B. 90-95% of individuals with Anorexia Nervosa are female.
C. It affects about 1 in 2400 adolescents.
D. It typically develops in early to mid-adolescents.
E. Psychological problems are displaced onto food.
F. It is usually preceded by dieting behavior.
G. Unusual food behaviors are practiced.
H. Need to vicariously enjoy food by cooking it, serving it, or being around it is common.
I. Preoccupation with body weight and image.
J. Dieting becomes increasingly important.
K. Denial of the condition can be extreme.
L. Body image disturbance (misperception of body size and shape) is common.
M. Pronounced emotional changes are common.
N. One-third of anorexics subsequently develop Bulimia Nervosa.

Common purging behaviors include:

A. Self-induced vomiting
B. Diuretic abuse
C. Laxative abuse
D. Emetic abuse
E. Excessive exercise
F. Fasting

Both Anorexia and Bulimia Eating disorders are very complex emotional issues. Though they may seem to be nothing but a dangerously obsessive dietary concern on the surface, for most men and women suffering with an eating disorder there are deeper emotional conflicts to be resolved.

Source: g_Disorders/who_gets.asp
Articles, Links and Resources: sweek/page/3/ tr.htm g_Disorders/index.asp rexia+Nervosa

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Here are some links to pictures of what Anorexia Nervosa might look like:

(WARNING: DISTURBING AND GRAPHIC CONTENT) ml 6.html 4.htm ?month=200511 idasaudavel/00003911_anorexia_f3.adp

Some of these photos are exaggerations. Please see the rest of the post for more information on Anorexia and support. Thank you.   

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EDIT: ADDED 3/20/07

Here are my notes from Googling the term "Thinspo" inspo&btnG= Google+Search&ie=UTF-8&oe=UTF-8&s a=N&tab=gi inspo&btnG= Google+Search&ie=UTF-8&oe=UTF-8&s a=N&tab=wg sonstostare.htm l _content&ta sk=view&id=154&Itemid=27 ealthinspo.html 2f28%2f2006+14% 3a12%3a19.277&direction=n

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Thanks for all the great info.  I have never understood why someone would want to do this to their body!  I know its a disease but man I just don't get it!  Thanks for posting it.
Thanks, Ix.  Maybe people won't get so mad at eachother anymore with these resources.  It's so hard to try to be understanding towards someone we don't actually understand at all. 
Edited Mar 09 2007 00:52 by lollipopfairy
Reason: Member's real name removed by request
No problem. I was working on putting all this information together, because I wanted to get a clearer understanding as to why those who starve themselves get so darn snarly sometimes! I find it helps to try to understand someone's perspective, if you have information regarding what they are going through. The pictures were a huge motivation for me to make sure I get at least 1200 calories per day.
way to go ix - proactive and factual.
Edited Mar 09 2007 00:52 by lollipopfairy
Reason: Member's real name removed by request
good lord those pictures are gruesome
Yeah, sorry... I suppose I should put up a disclaimer... (EDIT: Done!)
"She can no more eat that sandwich than you can eat that shoe. "

wow that line just really made me realize what's in their heads. I also could never understand how someone could do that to their body but I guess if I believed all food was like eating a shoe, I probably wouldn't eat either! Thanks ix!
Edited Mar 09 2007 00:52 by lollipopfairy
Reason: Member's real name removed by request
Sure, no problem. My pleasure. I thought it was a really great article. This one is a really great one too, just too long to copy and past: sweek/page/3/
wow.  hard to read.  very informative.  thank you for taking the time to gather all of these resources and information.
Just so you all know, a large proportion of those photographs appear to have been photoshopped for effect. In fact, some of the photos on the last link are actually identified as being fake, if you read the Portuguese captions. I'm not saying that anorexia isn't dangerous, or that the results aren't often equally scary, just that a lot of those particular photos are fakes, and so should probably be considered "artist's conceptions" instead of photo-documentation.

Very thought-provoking article, though.
good info.  thanks for all the hard work.  You are a great researcher. 
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you left me a message on my thread so i checked this out

thank you for showing others that an ed is not a choice

everyday i struggle thank you for supporting me.
I noticed that some of the photos could have been faked, I was wondering why some of the women were fashion models.
disturbing. gross. sick. sad. That's what I think
...not really the most deadly mental illness.
Ballison - why isn't it the most deadly mental illness?  It is deadly and many persons die due to its complications - maybe its not that widely mentioned in the media and doesn't seem to get the attention other mental illnesses get.  I mean recently it made the headlines when the Brazillian model died, but before that I think the last time I heard on the news of someone dieing from the disease was Karen Carpenter and how many eons ago was that?  There are some celebrities who have tried to get the word out on its dangers, but I think it is one of those diseases that just doesn't get the attention it needs to to help the sufferers and help family and friends to get these people the help they need and to see the signs and warnings.

I see some folks post on this site that I pray will get help - and I pray they have family or friends who will intervene and get them the help they need.
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