Anorexia Nervosa | National Eating Disorders Association

Anorexia Nervosa and Related Eating Disorders - ANRED

Anorexia Nervosa: Symptoms, Causes, and Treatments

Case Vignette: Lila, a 29-year-old hotel manager, entered therapy for bulimia nervosa. She alternated between rarely eating, running 15 miles a day, and losing control by bingeing on a dozen maple bars from her neighborhood donut shop. After bingeing, she ran until her lower back ached. She was stuck in a cycle that seemed impossible to break. Lila hated her body and herself whenever she put on weight. When asked where she thought her weight obsession came from, she said her mom dieted constantly. She talked non-stop about needing to lose weight. Mom also commented on Lila’s weight, fussing over Lila’s meals and refusing to buy the treats that her friends had in their kitchen pantries. Over time, Lila vowed to achieve the perfect body thus erasing nagging self-doubts about her appearance. Within a few sessions, Lila admitted she wanted to cut back on exercise because she feared her injuries would become permanent. After a full physical, her doctor backed up this decision. We calculated that each binge contained about 8,000 calories. So if she spread out those calories in a healthier form over a four-day period, she could eat 2,000 calories a day without gaining weight. She did not believe it until her dietitian came up with a plan to allow her to run moderately, eat real food, and not gain weight. Lila was reluctant yet willing to try. But she didn’t want to stay the same weight; she wanted to lose weight. After weeks of trial and error, she ate more normally and binged less frequently. She agreed to put weight loss on a back burner and explore where she developed body hate. She noticed she felt bad about herself every day, wanting to starve or go out for a long run. But she liked how her body functioned when she ate meals. Once Lila understood the dynamics that set up her beliefs and the internal talk that reinforced it, she focused on identifying the “not good enough” feelings every time they surfaced, telling herself she feels this way and not is this way. She even had the fleeting thought that maybe her body was okay the way it is.

Santonastaso, P., Ferrara, N., and Favaro, A. (1999). Differences between binge-eating disorder and nonpurging bulimia nervosa. , 215-218.

National Centre for Eating Disorders - Bulimia Nervosa…

Currently, there is no empirical data to support treating anorexia with medications alone. Anorexia remains quite resistant to pharmacological interventions. However, once weight is restored, antidepressant medications are often used to treat depression, anxiety, obsessive-compulsive symptoms, and bulimic symptoms. A psychiatrist needs to assess whether the depression and anxiety are related to starvation prior to recommending an antidepressant (Keel and McCormick in Grilo and Mitchell, 2010).

Kaye, W.H. (2008) Neurobiology of anorexia and bulimia nervosa. Physiology and Behavior, 146: 121-135.

Need for Control. Bulimia restricts life choices and that is useful for some people. Life feels more in control when you have fewer decisions about what to do or where to go. For example, Anna claimed that her bulimia had stopped her from going to work and looking for a boyfriend. But in actual fact it had protected her from having to make a painful decision about whether to leave home or stay to care for her disabled mother.

Smith, K.A., Fairburn, C.G., and Cowan, P.J. (1999). Symptomatic relapse in bulimia nervosa following acute tryptophan depletion. , 171-176.


What is the Difference Between Orthorexia and Anorexia

Pro-anorexia (pro-ana) and pro-bulimia (pro-mia) web sites take a positive attitude towards eating disorders, encouraging the philosophy and behaviors while claiming eating disorders are a lifestyle choice not an eating disorder. Bardone-Cone and Cass found that women who viewed a pro-ana website had greater negative affect, lower social self-esteem, and lower appearance self efficacy than controls who did not view the website (2007). Photos of emaciated celebrities are used as “thinspiration” by pro-eating disorder websites in order to share strategies that encourage eating disorders (Lewis, et al., 2016).

Read story Anorexia VS Bulimia (A comparison and ..

Occupations and avocations that encourage thinness, such as elite athletics, are associated with increased risk of developing anorexia nervosa (American Psychiatric Association, 2013). A meta-analysis of 34 studies showed that female college athletes showed significantly more eating disordered patterns than non-athlete controls (Smolak et al., 2000).

Anorexia Nervosa and Bulimia Nervosa are the most ..

There is a difference between someone who exercises for fitness and an athlete who becomes compulsive. Risk factors include hyper-competitiveness, a tendency to be self-absorbed due to a focus on the mental and physical self, and a high tolerance (even enjoyment) in hunger pains associated with restrictive eating (Stirling and Kerr, 2012). One study compared the psychological profiles of athletes and anorexics and the following similarities were found: perfectionism, high self-expectations, drive, competitiveness, hyperactivity, repetitive exercise routines, compulsiveness, body image distortion, pre-occupation with dieting and weight, and tendency towards depression (Bachner-Melman et al., 2006).

Anorexia VS Bulimia (A comparison and contrast …

Screening for disordered eating behaviors, eating disorders, and related health consequences should be a standard component of participation examinations. Team physicians should be knowledgeable about criteria for eating disorders in the DSM-5 (American Psychiatric Association, 2013). Athletes with an eating disorder should undergo thorough evaluation and treatment by an experienced multidisciplinary team. Use of evidence-based guidelines to clear an athlete to return to the sport is recommended. Eating disorder prevention efforts should be aimed at athletes, coaches, parents, and athletic administrators plus a focus on healthy nutrition in support of athletic performance and health (Joy et al., 2016).