Anorexia is an eating disorder that means that you try to starve to lose weight, even though you weigh less than what is healthy for your height and age. Anorexia can be life-threatening if you do not receive treatment. Most people who receive treatment become healthy.

Here you can read about anorexia or anorexia nervosa that the disease is called in medical language. If you are a parent or relative of someone who has an eating disorder, you can read more here. 

How do I know I have anorexia?

It can take time to develop an eating disorder, and sometimes it can be difficult to know when it has become a disease. You may have anorexia if you have any of these disorders: 

  • You constantly think about what you should or should not eat.
  • You are very afraid of gaining weight.
  • You often get comments that you are too narrow.
  • You think you are too thick no matter what others say.
  • You have constipation and stomach pain.
  • You freeze a lot, have a hard time falling asleep and rarely wake up rested.
  • You have lost the desire for most of what you used to think to do.

If you have anorexia you may find it difficult to see for yourself that you need help. Often, people in your area react to losing weight. 

If you recognize in the descriptions above, you may have an eating disorder or be at risk of developing an eating disorder. Then it is important that you seek professional help. The earlier you seek care, the better. 

What is Anorexia?

Anorexia is a form of an eating disorder that means you eat so little that you starve yourself. In the medical language, the disease is called anorexia nervosa. The disease usually starts with losing a lot of weight for a short period of time. You may get anorexia regardless of gender and age, but what is most common is that you become ill in your teens. 

Unlike bulimia, which is usually not noticed outward, anorexia is usually seen and suspected by the surroundings. Often, people around you react first, and then the reactions can become stronger the more you lose weight. If you have anorexia, do not share your concerns about your weight. Instead, you are focused on having control over your body and reducing weight. That task feels vital. 

Two types of anorexia

There are two types of anorexia. One means that you are starting to lose weight. 
The other means that you starve to lose weight, while sometimes you eat or feel that you have to get rid of the food you have eaten by, for example, vomiting or using laxatives.

Fear of gaining weight 

If you have anorexia, you feel that you are thick, although you are slim. You feel that you are doing well and do not notice that you are affected by starvation, both physically and mentally.

You usually feel hatred for your own body and are very afraid of gaining weight. The image you have of yourself is different from how others view you. The distorted picture you have of yourself belongs to the disease.

Need for control

In order to gain control of your inner mood, eating disorders become a way to dampen your emotions rather than deal with them. In the short term, anxiety can be stopped by weight control, but in the long run, your problems worsen because you have no contact with your emotions. It will then be difficult to orientate yourself to life and find a guideline in relation to life’s various challenges.

Self-feeling is affected

If you have anorexia, your self-esteem is highly dependent on body shape and weight. You are often dissatisfied with yourself. Thoughts constantly revolve around food, your concentration ability is affected and you sleepless. 

Often you have high demands on yourself and want to perform well. You can switch between hopes of finally being able to take control and being happy with yourself, and a sense of hopelessness when you think it will never happen. 

Common with mental illness

If you have anorexia, you are usually anxious, depressed, or depressed. As your behavior makes you more and more isolated, you can have an increasingly negative self-image. It is common for you to have obsessions, phobias or hurt yourself. You can also get suicidal thoughts.

Excessive exercise together with a strict diet – “orthorexia”

Exercising in a compulsive way with a strict diet is common if you have an eating disorder. It is sometimes called “orthorexia”, for example in various news media. Although many may recognize the description of orthorexia, it may be good to know that it is not a formal eating disorder or psychiatric diagnosis. The term orthorexia also has a slightly different meaning when used internationally.

The problems can still be serious for the person concerned. When seeking treatment, you may be diagnosed with anorexia, OCD – Obstructive Syndrome or some form of anxiety instead of orthorexia. Whatever the diagnosis is called, you can get treatment for your problems.

What happens in the body?

How your body is affected depends on how long you have had your eating disorder and how fast you have lost weight. A very rapid weight loss can be significantly more harmful than a slower reduction that is easier for the body to adapt to.

The signal system is disrupted

Experiences of hunger and satiety are controlled by a signal system in the brain. Digestion is affected by what you eat and how much you move. Your body weight will then automatically adjust to the life you live. 

Anorexia disrupts that signal system. Instead, you develop obsessive-compulsive thoughts and behaviors that make it hard for you not to listen to what your body needs.

Lack of important topics

If you give the body too little nutrition and energy, the body will settle on hunger by reducing energy consumption. Substance turnover decreases. If you are still growing, the disease can affect your length growth and lead to osteoporosis.

If you avoid certain foods for an extended period of time, you may be deprived of various substances and salts that your body needs. It can be harmful to the heart, for example. 

Stomach pain and iron deficiency

It is common for you to get stomach upset, constipation, gas or other stomach and intestinal problems. Anemia due to lack of iron can make you tired.
If you have menstruation, it may disappear or become irregular. 

Most of the side effects of anorexia disappear when you start eating regularly again and regain a healthy weight in relation to your height and age. 

The body settles on starvation

If you have anorexia, you can lose weight so much that your body is unable to perform its biological functions. The condition is called starvation. 

The threshold for when starvation begins is often considered to be at the point when body weight is less than 85 percent of the bodyweight that can be expected by people of the same sex and age. 

If you have been ill for a long time

If the body is in starvation for a long time, additional things happen. To save energy, the body begins to turn off important functions. Then the following happens:

  • Your heart rate goes down and your body temperature drops.
  • You get low blood pressure, which allows you to become dizzy and faint. 
  • Blood circulation gets worse, can cause you to freeze and become cold and blue about feet and hands.
  • You may have problems with osteoporosis, which can make you more easily exposed to bone fractures.
  • Your muscles become weakened.
  • You can get a thin hair, so-called lanugo hair, in the neck and on the arms and legs.
  • Your hair can become frizzy and you may get dry skin and acne.
  • Your heart and kidneys may start to work worse.

If you are affected by self-aggrandizement for an extended period of time, your brain can also be affected. You can then get what is called brain atrophy, which can affect how well your brain works.

When and where should I seek care?

To find out if you have anorexia, you need to seek care. Sometimes there may be bodily illnesses that cause symptoms similar to eating disorders. Therefore, it is important that you get a proper investigation. 

If you are under 18 years of age

You who are under 18 can contact a health care center, a  youth clinic, student health or child and adolescent psychiatry, bup. At some bup-clinics, you need a  referral from the health center.

If you are over 18 years of age

If you are 18 years of age or older, you can book time at a  health care center, psychiatric clinic or occupational health care if you work. You who are up to 20-25 years can also contact a youth reception.

The age limit varies between different youth centers. You who are studying can contact student health if the problems are related to the studies of the university. 

Special receptions

More and more county councils have special eating disorders. At some clinics, you need a  referral from the student health or medical center, but in several places, you can contact yourself.

Try again if the help didn’t work

If you have previously received help somewhere but do not think it worked, try again somewhere else.

Talking to different people can work well. It is also different from how it feels during different periods. Sometimes it may take time before it feels right to receive help.

What can I do for myself?

You can start by finding out as much as possible about anorexia and how it is treated. This can be a first step towards seeking help.

Start talking to others

There are various associations on the net that offer support and assistance via telephone, chat or email. You can also start by talking to a friend or someone you trust, so you don’t have to be alone with what’s difficult. 

If you have questions about anorexia or other eating disorders, you can contact the National Association for Eating Disorders, Healthy, and Free. They have local associations in several locations and can help you answer questions and refer you further. You who identify as a girl and are between 10 and 25 years can also email or chat with a volunteer at the  Eating Disorder Zone.

Another association that is knowledgeable in both eating disorders and self-harm behavior is  SHEDO. At  SHEDO.se  you can read more, chat or email to tell and get support and help. 

Dare to talk about difficult feelings

You are worth feeling well and feeling happy with who you are. It is important to socialize with people who help you appreciate and develop yourself. 

To start talking about what you have held for yourself and ashamed of can feel both difficult and a relief. You can react in a way you did not expect. Everyone reacts differently, and there is no right way to feel. 

Get new perspectives

When you start talking to others, you will automatically start to think and feel differently, because you are no longer alone with your thoughts. Often thoughts about weight, body, and food have taken a lot of space. Maybe you’ve forgotten what other things you think are important in life? 

By talking to others, you can gain new, healthier perspectives than if you go along with your thoughts. 

Find out what you need

Pictures of seemingly perfect bodies in advertising and social media can increase the press and cause us to lose touch with our own bodies. When am I really hungry? May I be hungry? What does it mean to me to feel good? The answers to these questions can give you insights on what you need to feel good.

You may need to learn more about healthy eating,  exercise and sleep, and what your body needs to feel good. You can learn to trust your body and distinguish between hunger and sweetness. Sometimes relaxation and exercises in mindfulness can help.

Here you can get temporary support from the Helpline.

What can I get for the treatment of anorexia?

If you have anorexia, you need help both to break the hunger and to find ways to deal with your emotional difficulties. The treatment of anorexia you receive is primarily psychotherapy, either individually or in groups. The therapy is about changing your way of eating and processing other difficult feelings. Sometimes antidepressants are also included in the treatment.

Investigation consisting of interviews

In order to plan the right treatment of anorexia, a thorough investigation is first done. You get to answer questions about your eating behavior and about how you feel about life in general. This is done in several interviews done by a psychologist or curator. Sometimes you have to fill in different questionnaires.

You can also go through a general body examination, weigh yourself and submit different samples. If you are under 18, parents are also usually interviewed.

Changed eating habits and help manage emotions

To remedy anorexia, you first need help with the damage that has occurred as a result of self-starvation and help to change your eating habits in the long term, and you need help dealing with difficult feelings and psychological problems.

To do that, you usually have to go into some form of psychotherapy. Here you can read more about psychotherapy as a treatment for eating disorders.

At least six months of treatment of anorexia

How long the treatment of anorexia lasts and how it is designed varies, but often it is usually a therapy session per week for six to nine months.

Depending on how you are feeling and what problems and difficulties that have emerged during the treatment period, you may need to continue in therapy even after you have resolved the eating disorder problem itself.

Information and group meetings

Many specialist clinics arrange group meetings for both those who have anorexia and for those close to them. There you and your relatives can get information about eating disorders, food and how to eat better.

At some receptions, there are daycare activities where you cook and eat food together, and discuss various problems related to eating.

Sometimes you can get medicines

If you have depression at the same time with an eating disorder, you may be treated with antidepressants. If you receive such drugs, they should not be the only form of treatment but always combined with psychotherapy.

If you still live at home, family therapy may be an option. Then parents and possibly siblings also participate.

Most do not need to be entered

If you are severely affected by anorexia, you may need to receive hospital care because of how your body has been affected by self-aggression.

Most people who have anorexia do not need to be hospitalized. However, if you are severely affected by starvation, such as having very low body weight, low heart rate or low body temperature, you may need hospital care.

The goal of hospitalization is to get the biological functions of the body up and running. You can get nutritious meals or nutritional drinks, liquid drops and monitoring.

Relapse

There is a risk that you will relapse after treatment, especially when you are exposed to stress or new challenges. Even if you do not relapse into anorexia, you may develop bulimia.

Many specialist care units organize follow-ups or special calls to counter relapse.

Here you can read more about what it is like to receive temporary support from the Helpline.

Pregnancy and breastfeeding

Even if you have been free from an eating disorder for several years, negative thoughts about food and your body may come back during pregnancy or after you have had a baby. It is not uncommon for you to fear the weight gain that is necessary when you are pregnant.

Important to tell about the eating disorder

If you have an eating disorder and become pregnant, it is important that you tell us about the eating disorder for the midwife at the maternity care center so that the pregnancy can be followed in the best possible way. The body has a natural tendency to protect the fetus by, for example, ensuring that the fetus receives nutrition in the first place.

At the same time, if you develop an eating disorder in connection with pregnancy, it will be a great stress for you and the child. There is some increased risk of miscarriage if you have anorexia. Therefore, it is very important that you get professional help early.

Most will be fine again

When you are sickest, it may feel like you will never get well and feel happy again, but it doesn’t have to be. There are treatments that help against anorexia.

The road back can be long and difficult, but even if you have lived with anorexia for many years you can get better or completely healthy. If you seek help, through healthcare or in a support group, you increase your chances of becoming well.

Ehtisham Nadeem

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