If one were to ask the general public what anorexia nervosa is, many would be able to speak to the generalized definition of the diagnosis, noting behaviors around starvation. Fewer would be able to articulate its resemblance or even correlation to that of a mental illness.
Understanding Anorexia Nervosa
Known as one of the deadliest eating disorders, anorexia nervosa is often diagnosed when an individual’s life is impeded due to their behavior around food restriction (which leads at times to starvation), a constant obsession over body image and negative feelings associated with these matters. Anorexia nervosa is documented to impact roughly 1% of women in the United States, however, these numbers may fluctuate due to underreporting in marginalized communities, including larger women who are often misdiagnosed. Anorexia nervosa is also typically diagnosed in concert with other mood disorders or mental illness such as depression and anxiety, strengthening its credence as a mental illness of its own and highlighting why recovery is something that should be holistic.
The Connection Between Anorexia Nervosa and Mental Illness
A mental illness is characterized by feelings or thoughts that inhibit an individual from living their lives daily due to its decrease in quality. When these two characteristics are happening simultaneously, there is a plausible cause to diagnose someone with a mental illness or mood disorder.
Considering the psychological impact of anorexia nervosa, it is hard to deny the parallels. Priming the brain with thoughts that lead to behaviors restricting how an individual can thrive is associated with anorexia nervosa, which may start out innocent but spiral out of control as the disorder intensifies. Something as simple as following a model for inspiration or choosing a certain food out of preference, can over time turn into an obsession that restricts one from only eating a particular food or looking similar to a person once admired. In this space, it is one’s thoughts or feelings that drive behavior.
Additionally, low self-esteem is also known to be one of the main causes of anorexia nervosa. These feelings often trigger individuals to obsess over how their bodies look to others, another symptom listed under the disorder. Experiences of low self-esteem may also stop individuals from wearing certain clothing, accepting certain employment opportunities, being seen in public and hindering how they carry out daily tasks. This ultimately has a negative effect on their quality of life, correlating with the same behaviors that constitute a mental illness.
Psychotherapy and the Importance of Social Support in Anorexia
Once in recovery, individuals who have suffered from anorexia nervosa may find themselves in treatment that not only includes nutrition but also psychotherapy. Due to the pervasiveness of eating disorders like anorexia, individuals may find through recovery that over time, they actually started to program their mind to react or participate in certain habits that fueled their disorder. In order for recovery to last, identifying these triggers and unlearning them will be essential.
Nica Stepien, LMHC, NCC has written about dialectal behavioral therapy (DBT), used to assist individuals who may feel triggered during their recovery from anorexia nervosa on how to cope. According to Stepien, triggers are part of the recovery process. They are to be managed, not avoided. Moreover, steps are provided through DBT that allows those in recovery from anorexia nervosa to participate with friends or loved ones, highlighting the importance of social support in eating disorder recovery.
Because so much of the behaviors and thoughts participated in by those suffering from anorexia nervosa happen in isolation, those in recovery often seek to reconnect to supports offered by family, friends, practitioners and their environments. In a qualitative study conducted by Linville and colleagues in 2012, outcomes pointed to support systems being crucial in eating disorder recovery. Through interviews, those in recovery expressed the importance of supportive friends, reconnection and relationships with loved ones as being both motivation to continue to recover from anorexia nervosa and any comorbid mental illnesses and to seek help. In these cases, their support system not only helped to spur different behaviors in opposition to their disorders, but they also were empathetic in listening, helping to offer insight that changed the thinking of those in recovery.
Recovering from Mental Illness & Anorexia
In conclusion, anorexia nervosa can be considered a mental illness as much as an eating disorder. Through research and accounts of clinicians, anorexia has been found to alter both the body and mind of those are impacted by it. Individuals who suffer from anorexia nervosa have also been found to suffer from other mood, behavior disorders or mental illness lending credence to the interconnectedness of the disorder with the body and mind.
Although anorexia nervosa can affect an individual’s whole person, it should not be assumed that recovery is not possible. Through the use of different psychotherapy options, social support and nutrition services, anorexia nervosa can be treated, giving those who once suffered at its hands a new lease on life.
Symptoms a loved one may be suffering from anorexia nervosa include:
- Fear of fatness or pursuit of thinness
- Pre-occupation with body weight
- Distorted perception of body shape or weight, for example, the person thinks they are overweight when actually they are underweight
- May underestimate the seriousness of the problem even after diagnosis
- May tell lies about eating or what they have eaten, give excuses about why they are not eating, pretend they have eaten earlier
- Not being truthful about how much weight they have lost
- Finding it difficult to think about anything other than food
- Strict dieting and severe weight loss
- Lack of sexual interest or potency
- Difficulty sleeping and tiredness
- Feeling dizzy
- Stomach pain
- Constipation and bloating
- Feeling cold or having a low body temperature
- Getting irritable and moody
- Difficulty concentrating
- Low blood pressure
- Counting the calories in food excessively
- Missing meals (restricting)
- Avoiding eating with other people
- Hiding food
Joy Cox, PhD is a body justice advocate using her skill set in research and leadership to foster social change through the promotion of fat acceptance, diversity and inclusion. She currently sits as the Chair for the Association of Size Diversity and Health (ASDAH), and hosts the podcast, Fresh Out the Cocoon which focuses on the lived experiences of Black fat women.
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