Eating attitudes test. identify the symptoms of anorexia and bulimia

Leading criteria for the disorder

The main symptom of anorexia nervosa is conspicuous thinness.
This is not a slender body at all, but an emaciated body with an imbalance of proportions. At the same time, a thin person does not mean anorexic. The cause of weight deficiency may be constitutional characteristics or a somatic disease, as well as other mental deviations from the norm. It turns out that thinness alone is not enough to diagnose anorexia nervosa. There are certain criteria for symptoms and signs that help determine the presence of a disorder:

laxatives;
diuretics;
excessive exercise;
cleansing enema;
inducing vomiting;
taking appetite suppressants.

fear

The first mention of anorexia dates back to the 17th century. Then doctor Richard Morton described an 18-year-old patient suffering from poor appetite and indigestion. The girl was depressed and looked pale. The doctor noted that the patient looked like a skeleton covered with skin, “her flesh became loose and flaccid.” The girl had been suffering from the disease for two years. She asked for help due to frequent fainting. Morton called this condition nervous consumption.

Russia learned about the disease in 1894, when the famous pediatrician A.A. Kisel described a case of hysterical anorexia in an 11-year-old girl.

Diagnosis and treatment features

The diagnosis of “bulimia nervosa” is made by a psychiatrist based on the patient’s medical history, his interview, as well as data from laboratory and other studies. The first refers to a biochemical test of the patient’s blood, which gives an idea of the state of the water-salt balance. Diagnostic studies include electrocardiography, computed tomography of the head, ultrasound of the abdominal cavity - thanks to it, it is possible to determine disturbances in the functioning of internal organs.

Treatment of this disorder is carried out by a psychiatrist and psychotherapist: the first selects medications, and the second uses certain psychotherapeutic techniques to correct the disease.

A person suffering from bulimia is taught not to eat stress, but to deal with it in other, rational ways, to avoid situations that lead to overeating, and to eat normally. Next, the thoughts are introduced into the patient’s consciousness that his own body, although it is important, there are other values. Group psychotherapy is very effective when bulimics share their experiences with each other and try to jointly find ways to get rid of a dangerous disease.

Experts believe that proper treatment of eating disorder requires not only the joint actions of a psychotherapist and psychiatrist, but also a nutritionist, and in advanced stages, also a resuscitator.

It should be noted that correcting an eating disorder is a complex matter, and it cannot be accomplished quickly. You cannot cope with bulimia on your own - only professionals can do this. First of all, the patient needs to realize that a problem exists and admit it to others. Sometimes, if in the life of such a person everything changes for the better and his self-esteem becomes higher, then the disease recedes on its own. However, this happens very rarely and requires specialist intervention.

And one more thing: it is better not to bring yourself to a state where the damage caused by bulimia to the body becomes irreversible, and illnesses will accompany you for the rest of your life. It is more advisable to clearly understand that it is impossible to live like this and contact experienced doctors in the early stages of the disease. It happens that people live with eating disorder for years, and only after 20 years of suffering do they come to the doctor with their own feet, and some are brought. Up to 80% of patients manage to correct the situation; however, their keen attention to food and weight remains, but without fanaticism.

Sources

Facts About Eating Disorders: What The Research Shows (https://eatingdisorderscoalition.org.s208556.gridserver.com)
Marilov V.V. Dynamics of anorexia nervosa within borderline states. - In the book: Problems of theoretical. and wedge. honey. developing countries. - M.: Academy, 2009. ()
Medical reference book (https://www.med.tehlit.ru)
Anna Zholobova - a girl who died from anorexia (https://fb.ru/article/320314/anna-jolobova—devushka-pogibshaya-ot-anoreksii)
I see a stranger in the mirror (https://meduza.io/feature/2017/04/27/ya-vizhu-v-zerkale-chuzhogo-cheloveka)
Korkina M.V., Tsivilko M.A., Marilov V.V. “Anorexia nervosa” (https://psychologyjournal.ru/books/nervnaya-anoreksiya-korkina-mv-tsivilko-ma-marilov-vv/)

What does this look like in real life?

All manifestations of the disease can be divided into several groups. External symptoms of anorexia nervosa include:

sudden weight loss;
haggard look;
pale, bluish and dry skin;
puffy face;
sunken eyes;
brittle nails;
sparse dull hair;
lethargic and tired appearance;
slow growth (in adolescence);
swollen joints;
Tooth loss is very common.

Psychological signs:

irritability and depression;
emotional instability;
memory impairment;
inability to concentrate for long periods of time;
appetite suppression;
constant fear of gaining weight;
low self-esteem, obvious dissatisfaction with oneself;
obsession with sports;
the desire to be perfect;
feelings of guilt and anxiety.

Behavioral signs:

reducing food portions;
Constantly counting calories and avoiding certain foods;
inducing vomiting in order to free yourself from what you have eaten;
a change in clothing preferences, a person tries to wear things that will hide his “shortcomings” as much as possible;
constant control of your weight;
regular loss of consciousness;
high level of self-criticism;
refusal to communicate with loved ones, withdrawal into oneself.

Eating Attitude Test EAT-26

The Eating Attitudes Test (EAT) is a screening test developed by the Clark Institute of Psychiatry at the University of Toronto in 1979[.

The scale was originally intended to screen for anorexia nervosa and consisted of 40 questions. In 1982, the developers modified it and created the EAT-26 scale, consisting of 26 questions. The EAT-26 scale showed a high degree of correlation with the original version. Subsequently, the EAT-26 scale became widely used in screening for both anorexia nervosa and bulimia nervosa.

Currently, the EAT-26 scale is the most widely used instrument in eating disorder research.

The EAT-26 test consists of 26 questions. Each question has the following answer options: “never”, “rarely”, “sometimes”, “quite often”, “usually” or “always”. When answering 5 additional questions, the subject chooses one of two answer options - “yes” or “no”. Sometimes the test includes 5 additional questions that have “yes” and “no” answer options.

The test is intended to be completed by the patient/subject themselves; a specialist should not be involved. Before starting the study, it is recommended to familiarize the subject with the principles of working with the scale.

All test questions, with the exception of the 26th, are scored as follows: “always” - 3; “usually” - 2; “quite often” - 1; “sometimes” - 0; “rarely” - 0; "never" - 0.

The 26th question is scored as follows: “always” - 0; “usually” - 0; “quite often” - 0; “sometimes” - 1; “rarely” - 2; “never” - 3. Scores for all items are summed up and a total score is calculated.

A meaningful analysis of the answers to each question can provide additional information.

The EAT-26 test is a screening test, i.e. It is impossible to make a diagnosis on its basis, even a preliminary one, but a high score on it means a high probability of having a serious eating disorder - presumably anorexia or bulimia (the test was created to identify precisely these disorders).

Meanwhile, a number of items are specific to some other eating disorders - for example, restrictive, compulsive, etc.

Please read the statements below and mark the answer on each line that best matches your opinion. Please remember that this test is a preliminary assessment tool and cannot be used to make a diagnosis.	Never	Rarely	Sometimes	Often	Usually	Constantly
The thought of getting fat scares me
I abstain from eating when I'm hungry
I find myself preoccupied with thoughts about food
I have bouts of uncontrolled eating, during which I cannot stop myself
I cut my food into small pieces
I know how many calories are in the food I eat
I especially avoid foods that contain a lot of carbohydrates (bread, rice, potatoes)
I feel that people around me would prefer that I eat more
I feel an increased sense of guilt after eating
I am preoccupied with the desire to lose weight
When I exercise, I think I'm burning calories
People around me think I'm too thin
I am preoccupied with thoughts about the fat in my body
It takes me longer to eat food than other people
I abstain from foods containing sugar
I eat diet foods
I feel like food issues control my life.
I have self-control when it comes to food.
I feel like people around me are putting pressure on me to eat.
I spend too much time on food-related issues
I feel discomfort after eating sweets
I like the feeling of an empty stomach
After eating, I have an impulsive desire to vomit it.
I enjoy trying new and delicious foods

Dutch Eating Behavior Questionnaire (DEBQ)

The habit of “eating” unpleasant or pleasant emotions.
Inability to fight temptations (inability to resist “sweets”).
The desire to strictly and radically limit oneself in food.

By taking this simple questionnaire, you can find out what is wrong in your relationship with food, and how you can correct the problem.

In general, the test consists of thirty-three questions, which must be answered as honestly and openly as possible. In this case, you must immediately give answers, without hesitating for a long time. For each answer “Never” you will receive only 1 point, for “Very rarely” – 2, for “Sometimes” – 3, for “Often” – 4, and for “Very often” – 5.

*For question number 31, answers should be scored in reverse order.

Add up the scores for questions 1-10 and divide by 10.
Sum up the scores for questions 11-23, divide by 13.
Add up the points for questions 24-33 and divide the total by 10.
Add the points you receive.

Do you eat less if you notice your body weight is increasing?
Do you try to consume less than you would like, limit yourself in nutrition during any meal?
Do you often refuse to eat or drink because you are worried about being overweight?
Do you always control the amount of food you eat?
Are you making food choices to lose weight?
After overeating, do you eat smaller amounts the next day?
Do you try to limit food to avoid gaining weight?
Do you often have to try not to snack between meals because you are struggling with your weight?
Do you try to avoid eating in the evening because you are watching your weight?
Do you think about your body weight before you eat anything?
Do you feel like eating when you're irritated?
Do you feel like eating in moments of idleness and laziness?
Do you feel like eating when depressed or discouraged?
Do you eat when you are alone?
Do you feel like eating after the betrayal of loved ones or deception?
Do you feel hungry when plans are disrupted?
Do you eat when you anticipate trouble?
Do worries and tension make you want to eat?
If “everything is wrong” and “falls out of your hands,” do you start to seize it?
Do you want to eat when you're scared?
Do dashed hopes and disappointments cause pangs of hunger and the desire to eat?
When you are upset or very nervous, do you immediately want to eat?
Are anxiety and fatigue the best reason to eat?
When food is delicious, do you eat large portions?
If food smells good and looks appetizing, will you eat more of it?
Do you want to eat as soon as you see delicious, beautiful food with a pleasant aroma?
Do you eat all the delicious food you have right away?
Do you want to buy something tasty while passing by retail outlets?
Do you want to immediately refresh yourself if you pass by a cafe that smells nice?
Does the sight of other people eating food whet your appetite?
Are you able to stop when you eat something very tasty?
When you eat with others, do you eat more than usual?
When you cook yourself, do you often taste the dishes?

How to recognize anorexia

With anorexia, the signs of the disease should be differentiated from the manifestations of concomitant pathologies. The success of the treatment methods depends on this. Before determining the tactics of therapeutic intervention, it is necessary to exclude the presence of other pathologies, the course of which is accompanied by a sharp decrease in weight and other similar signs.

With this in mind, it is worth considering the manifestations of only the nervous form of the pathology. Symptoms of anorexia in girls are multifaceted and manifest themselves in the form of eating disorders, mental changes and physiological problems.

Physiological signs

The first symptoms of anorexia in a girl appear in the form of a sharp weight loss. This indicator is determined taking into account the age norm. In a woman suffering from anorexia, the disease is diagnosed if the deviation exceeds 30%.

Signs of underweight (besides thinness):

decreased blood pressure;
increased fatigue;
general weakness;
decrease in body temperature;
swelling of the limbs;
frequent fainting and dizziness;
baldness;
frequent hemorrhages.

The fight against extra pounds helps reduce the concentration of vitamins and minerals in the body. Due to a deficiency of beneficial microelements, the skin becomes dry and bad breath appears, which indicates eating disorders. Lack of calcium and other minerals causes osteoporosis, in which bones break easily. At the same time, dental diseases occur.

In addition, the initial stage of anorexia is characterized by poor physical condition of the patient. This condition is largely explained by a person’s desire to reduce their own weight through vomiting. The latter causes severe dehydration of the body, which leads to impaired blood flow and many other complications.

Eating disorder

The first signs of oncoming anorexia are recognized in the form of an obsessive desire to lose weight. This desire develops into mania, in which the refusal to eat is permanent. People suffering from the disease deliberately induce vomiting after eating.

You can notice such a desire by a person’s behavior. He is afraid of gaining extra pounds and regularly counts the calories he consumes. An eating disorder manifests itself as a desire to eat small portions.

Mental changes

Signs of mental changes in people with anorexia can be replaced in the behavior of patients. Such people:

strive to perform complex physical exercises;
wear loose, baggy clothes;
unable to concentrate;
have problems sleeping;
avoid communication with the environment;
apathetic;
fanatically and aggressively defend their point of view.

Mental changes can be traced in how the patient relates to the world around him. A characteristic sign of anorexia is an obsession with one’s own problems. People mostly focus on their weight. Moreover, they refuse to accept the fact that they are sick.

The described signs of pathology are not absolute. That is, they cannot be used to determine whether a person suffers from anorexia or not. Many diseases, including cancer, provoke sudden weight loss. Therefore, treatment of anorexia must be carried out after a comprehensive examination of the patient.

Symptoms of Anorexia Nervosa

Nervous factors underlie adolescent anorexia. At the same time, girls suffer more often. Patients lose from 15% to 40% of body weight. Teenagers are dissatisfied with their appearance and actively try to change it, primarily through artificially induced vomiting, intense exercise, dieting, and the use of laxatives. In many cases, the behavior reaches the point of absurdity - the patient never sits, because he believes that standing loses significantly more energy.

Important changes are observed in the mental sphere. Against the background of denial of one’s own body and critical weight loss, a negative food reflex is formed, characterized by the appearance of vomiting even at the sight of food. In this case, the sufferer feels nausea in those cases when he himself begins to realize the need to restore nutrition.

Eating behavior in anorexia nervosa has a number of characteristic changes:

in the initial stages, an obsessive desire to lose weight arises, while the weight fluctuates within normal limits or is even reduced;
obsessions formed around losing weight lead to a narrowing of the sphere of interests (patients begin to become interested in diets, sports, count calories consumed and lose their previous hobbies);
expressed fear of obesity and excess weight gain;
meals have the appearance of rituals: patients spend a long time setting the table, cutting food into small pieces, and chewing them thoroughly;
unmotivated refusals to eat are observed (as the pathology progresses, they become associated with a negative food reflex);
patients avoid meetings and events that involve a feast or coffee break.

Eating disorders and insufficient nutrient intake lead to physiological changes:

tendency to fainting, as well as frequent dizziness and general weakness;
hair loss and its replacement with vellus hairs;
a decrease in body weight by 15% or more compared to the age norm;
decreased libido in men and menstrual irregularities in women.

Anorexia nervosa is accompanied by psychological personality changes - the development of apathy and depression, decreased mental performance, sleep disturbances and emotional lability.

An important feature of anorexia is the lack of criticism of one’s own condition. The patient does not note exhaustion or the appearance of negative symptoms from the internal organs. Talking about losing weight leads to anger and aggression. In this regard, in case of critical exhaustion, treatment is carried out forcibly with hospitalization.

The causes of anorexia can be very different: from diabetes to alcoholism and severe mental disorders. Most often, people suffering from this disease have low self-esteem, they are subject to constant stress and depression, and the development of various phobias is observed.

Anorexia can also be caused by:

Chronic diseases that are accompanied by loss of appetite.
Metabolic disorders, lack of hormones.
Diseases of the digestive tract (liver cirrhosis, hepatitis, gastritis).
Kidney failure.
Long-term use of antibiotics or other medications.

Anorexia occurs mainly in young people and also in children. The first signs of anorexia are a serious cause for concern. Examination by a specialist and immediate therapy will help avoid serious consequences.

The main symptoms of the pathology are:

too low body weight, which decreases even more over time;
reluctance to gain weight and gain weight;
complete confidence that the current weight is normal;
fear of food, regular restriction of food intake and refusal of it under various pretexts;
fear of weight gain, reaching the point of phobia;
feeling of discomfort after eating;
severe weakness, fatigue;
feeling of worthlessness.

Quiz: Do you suffer from an eating disorder?

An eating disorder (ED) is a common group of mental disorders that are associated with the process of eating. This includes the well-known scourges of society - anorexia, bulimia and others. Due to the increasing pace of propaganda of the ideals of female beauty on Instagram, there are more and more girls who want to have ideal parameters, legs from the ears and a flat stomach. Do you suffer from similar disorders? Now we'll find out!

Looking in the mirror, you consider your figure incredibly ugly, although in reality the opposite is true. People around you keep telling you to get better, but you don’t want to listen to them and go on a new diet every time. You blame yourself for every extra calorie, and an increase of 100 grams on the scale sends you into a panic attack. Perhaps it's time to seek help from a specialist?

It just so happens that you are used to eating up your problems with all sorts of harmful goodies. And everything would be fine, but after that you begin to blame yourself terribly. Remember that after this, the stress hormone (cortisol) is immediately released, which, by the way, is 100 times more harmful than a couple of hundred extra calories. So why bring yourself to a nervous breakdown? It's just food!

You've never been the type to count calories when trying to lose weight. You do not adhere to PP, but nevertheless you try not to eat at night and not to overeat. It’s worth saying that your type of eating is more like “intuitive”, and this is great, because you don’t worry, live for your own pleasure and don’t choke on lettuce leaves when meeting with friends in a cafe... Keep it up!

You eat whatever you want, whenever you want and in any quantity. We even admit that you are overweight, but it does not bother you at all, because you are happy with yourself. You feel 100% beautiful, and others, of course, notice it. If you want to lose weight, you will do it, but for now everything suits you.

Three stages of the disease

Exhaustion of the body due to chronic malnutrition and starvation causes serious illness and no less serious consequences.

Anorexia develops in several stages.

Dysmorphomaniac. Characterized by low self-esteem regarding one’s appearance, in particular, one’s figure. Constant thoughts about obesity are accompanied by decreased appetite and starvation. The first signs of anorexia are strict diets and starvation.
Anorectic stage. After some time, after prolonged dieting, a sharp weight loss is observed. A person experiences euphoria, delight from such results. He continues to exhaust his body even more.
The cachectic stage is an irreversible degeneration of internal organs. This period begins approximately two years after strict diets. A person’s weight decreases by half, the body’s water balance is disrupted, and potassium levels drop. Often this condition can no longer be treated - the functions of all organs are inhibited, which can lead to the death of the patient.

Who is most likely to suffer from anorexia?

Anorexia nervosa most often affects teenage girls. Especially those who are distinguished by increased emotional sensitivity, high anxiety, diligence and impose strict demands on themselves.

The peak incidence occurs between 14 and 18 years of age. At this age, a radical restructuring of the body occurs. Teenagers often find flaws in their appearance; the slightest criticism regarding their weight can lead to unpredictable consequences. Boys are also susceptible to anorexia, but to a much lesser extent.

The risk of developing an eating disorder increases if a child is involved in ballet, figure skating, rhythmic gymnastics or modeling. In these types of professional activities, the requirements for appearance and specifically for weight are very strict, often diverging from the physical indicators of a healthy person.

In Russia, the number of cases is steadily growing. If earlier anorexia was considered a specific disease of catwalk models, now many ordinary families face it.

Reasons for the development of the disorder

When diagnosing, the following groups of symptoms are distinguished:

innate personal qualities - increased emotional sensitivity and anxiety, a tendency towards perfectionism and behavioral rigidity;
psychological factors - lack of self-confidence, dissatisfaction with the body, a feeling of inability to control one’s life, lack of skills to regulate intense painful emotions;
physiological disorders - hormonal imbalance and features of the release of the hormone ghrelin, which is responsible for the feeling of hunger and satiety;
neurophysiological reasons - features of the functioning of brain areas responsible for receiving pleasure and satisfaction, a feeling of satiety, perception of taste;
increased activity of the area responsible for the formation and strengthening of habits;
increased sensitivity to sensations from internal organs;
hereditary factors - a number of studies show a connection between the presence of genes and the risk of developing eating disorder.

Symptoms of anorexia arise from a lack of acceptance of one’s own body. If at the same time there are conflicts, resentments in the family, or unpleasant remarks about appearance are used, then alarming concerns about weight appear.

Other factors cause sudden weight loss and impaired hunger. Appetite problems are a relatively common symptom with certain medications. Sometimes this property of drugs is used deliberately to cope with excess weight, which is drug abuse.

Separately, it is worth considering the development of exhaustion while taking antidepressants. This type of loss of appetite and weight loss is not classified as anorexia nervosa. Treatment of psychological problems should be monitored by a physician to monitor for negative side effects of therapy. In the case of depression, the detected loss of appetite may not even be noticed by the patient. Changes in appetite and weight loss are common symptoms of this disease. The patient may hide some information from the doctor, which will complicate the diagnosis.

Stages of development of anorexia

The course of the disease from its first signs to death can develop quite quickly - from two to five years. Anya Zholobova, hailed on the Internet as an “anorexia icon” and the star of the television show “Live,” began losing weight at the age of 19. After losing 20 kg, her weight began to increase again. One day, seeing the 44 kg mark on the scales, Anna attempted suicide - she jumped out of a fourth-floor window and miraculously remained alive. But, unfortunately, her life was soon cut short: Anya died in her sleep at the age of 21 from exhaustion and lack of oxygen.

A similar story happened with Margarita Aslanyan, who lost weight from 66 to 39 kilograms. Health problems forced the girl to gain ten kilograms, but this did not help. In 2011, when Rita was 20 years old, she fainted from hunger and suffocated because her tongue stuck in her throat and blocked her breathing.

Depending on the manifestation of symptoms and the patient’s behavior during the illness, three stages of anorexia are distinguished: dysmorphophobic, dysmorphomanic and cachectic.

Dysmorphophobic stage

At this stage, the patient increasingly develops obsessive ideas about being overweight. It seems to him that everyone around him is inclined to critically evaluate his appearance and note flaws in his figure. He is in constant anxiety and despondency, afraid of condemnation and ridicule from others. Eating habits change: calorie counting, avoidance of high-calorie foods and regular weight checking begin. Appetite at this stage remains stable or even increases.

Unable to cope with hunger, the patient may break down and eat at night.

Dysmorphomanic stage

At this stage, the patient is deeply convinced of the completeness and imperfection of his body. He constantly looks at himself in the mirror and complains about being overweight to others.

During this period, an anorexic patient tends to exercise diligently. When awake, he prefers to spend more time standing, even in those activities that require a sitting position: reading, writing, working at the computer, eating.

Drinks a lot of water and tries not to eat in front of others, eats in small portions, and after eating induces vomiting. The facts of refusal of food are carefully hidden from loved ones, coming up with various tricks: discreetly hiding, spitting out or giving food to pets. Before eating, he tightens his waist with a belt or corset to prevent food from entering the intestines. Strives to empty the intestines as early as possible, stimulating it with enemas. By consuming food in a larger volume than the “norm” determined by himself, or by eating a “forbidden” product, the patient experiences guilt and remorse

Against the backdrop of an obsession with the idea of losing weight, the patient becomes dependent on pharmacological drugs that speed up metabolism and reduce appetite, as well as on laxatives and diuretics. The craving for caffeine and smoking increases.

Cachectic stage

This stage is characterized by general exhaustion of the body. If measures are not taken to cure the disease of anorexia in the first two stages, the third occurs approximately a year and a half from the beginning.

Due to regular vomiting, the acidity of the stomach decreases and dystrophic disorders appear, and appetite completely disappears. The sight, taste and smell of food causes disgust, and toothpaste accidentally entering the mouth while brushing teeth is regarded as a sufficient amount of food. The skin dries out, the muscles become thinner and weaker, the teeth crumble and fall out, and subcutaneous fat completely disappears. Hair falls out, nails break, blood pressure drops and pulse slows. Anacidic gastritis develops, which is essentially atrophy of the mucous membrane, and there is no intestinal peristalsis. Prolapse of internal organs occurs, involution of the uterus and genitals occurs, and menstruation stops. A patient in the cachectic stage already weighs half as much as normal, but continues to be convinced that he is overweight.

Causes of anorexia.

Anorexia is one of three symptoms of altered body condition syndrome (that is, anorexia, sudden weight loss, and asthenia or general fatigue). This syndrome may indicate the presence of various types of diseases: from mental to oncological, and from infectious to endocrinological.

Anorexia can also be caused by:

a side effect caused by taking a number of medications or other bioactive products (amphetamines, antidepressants, antibiotics, various stimulants and others);
a side effect caused by withdrawal from certain other drugs or substances (cannabis, corticosteroids, etc.);
various reasons that are difficult to classify (physical training, altitude sickness or high-altitude hypoxia, postoperative period after removal of tonsils or adenoids, excess of vitamins A or D5 in the body, deficiency of zinc or vitamins B1, B6, B8.
natural reactions of the body aimed at self-healing (in the case when anorexia is of organic origin; if it does not last long, then it is even useful).

In any case, regardless of the cause, anorexia that lasts too long can have serious or even fatal consequences, since the body does not receive the necessary calories, as well as vitamins and minerals.

Changes in mood and emotional state

Anorexia is often accompanied by symptoms of depression, anxiety, hyperactivity, perfectionism, and impulsivity. These symptoms can cause people with anorexia to not enjoy activities that are usually enjoyable for others.

Extreme self-control is also common in anorexia. This characteristic manifests itself in restricting food intake to achieve weight loss. Additionally, people with anorexia tend to be very sensitive to criticism, failure, and mistakes.

Imbalances of certain hormones such as serotonin, dopamine, oxytocin, cortisol and leptin may explain some of these characteristics in anorexic patients. Because these hormones regulate mood, appetite, motivation, and behavior, abnormal levels can lead to mood swings, irregular appetite, impulsive behavior, anxiety, and depression.

Additionally, reducing food intake can lead to deficiencies in nutrients involved in mood regulation.

What is bulimia

In essence, bulimia nervosa is gluttony. A person suffering from it is simply delirious about food, thoughts about it completely take over him: he cannot study, work, do anything. The patient gives up everything just to eat; he may steal food or take it out of the trash. While he is eating, he does not have any internal tension, but after that the individual has a fear that he will gain weight. And then all possible means are taken to prevent this: taking laxatives, inducing vomiting in various ways, enemas, diuretics and fat-burning drugs - cleansing the stomach brings relief.

Remember how in history lessons we were told about the many-hour feasts of Roman aristocrats. To clear their stomachs full of food and continue the feast, they used peacock feathers to induce vomiting, putting it into special vessels designed for this purpose. This, of course, is very far from the problem we are considering, but it is quite appropriate to mention this fact.

The individual also begins to train intensively, and such activities are compulsive (obsessive, coercive) in nature. Excessive sports activities, according to the bulimic, make it possible to get rid of excess calories received from food, and will also allow you to eat more.

Such measures do not lead to anything good, threatening numerous health problems and loss of attractiveness:

due to the high acidity of vomiting, ulcers appear in the oral cavity, gums become sore, and teeth deteriorate and fall out due to enamel erosion;
electrolyte balance and heart rhythm are disturbed;
the body no longer has enough nutrients and minerals due to their leaching;
the esophagus is damaged;
salivation increases;
the face swells as the salivary glands enlarge;
kidneys and liver are damaged;
various diseases arise;
the psyche suffers;
women's menstrual cycle is disrupted;
frequent convulsions are observed;
the skin dries out;
bone density decreases;
hair fall out;
haunted by a feeling of chills.

Very often it all starts with another eating disorder - anorexia, in which a person tries to limit himself in food intake and goes hungry. He is driven by the desire to get an ideal (from his point of view) weight, to be slim. Moreover, quite often such an individual actually has normal body weight.

Abstaining from food leads to the fact that a person’s thoughts begin to revolve around food, and he breaks down, loses control of the amount of food consumed, absorbing it in huge quantities. In an attack of bulimia, a patient is able to receive up to 6 thousand kilocalories, when, for example, a woman from 19 to 30 years old with low physical activity needs 2 thousand kcal.

Some experts believe that bulimia and anorexia are not even “twin sisters,” but different stages of the same disease: first, fear of food due to weight gain, then obsessive thoughts about it, and again the return of the same fear. They classify bulimia as primary - independent, and secondary - a symptom of anorexia.

Forget about tact

Very often, parents miss the moment when the situation can be changed with home remedies, explaining that they are uncomfortable interfering in the teenager’s private life. If you suspect that your daughter is carried away by fasting, throw away all tact. If a girl often uses a computer, then most likely she takes part in some forums, groups and discussions where anorexia is praised. This, of course, is not very beautiful, but it is still better to check what sites the child visits. To begin with, just talk to your child, maybe they will admit to you that they are starving. But if a child has “closed himself off” from you, measures must be taken immediately; do not hesitate to contact a psychiatrist, because your child’s life is at stake!

If, due to your busy schedule, you do not have time to prepare breakfast, lunch and dinner, use the grocery home delivery service in Moscow or in your city. Don't let your child go hungry.

Parents can support their children

It is pointless to look for those responsible for the occurrence of anorexia: this disease has only victims. Psychotherapist Nadezhda Zuikova emphasizes: parents can become invaluable allies of doctors and play an important role in the recovery of their child.

Why don't parental persuasion, threats and pleas work?

Because the relationship between parents and children during puberty is too complex. Anorexic mentality pushes a teenager to manipulations that can destroy family ties. Those who hope to overcome a child’s illness with the help of promises and agreements are mistaken: they only delay the moment of providing medical care.

What happens to the body of an anorexic patient?

Metabolism is disrupted, puberty slows down to the point of amenorrhea (absence of menstruation), that is, systemic endocrine disorders occur. Significant weight loss is characterized by a decrease in blood pressure, temperature, and changes in heart rate. Swelling appears, problems with skin, nails, teeth are inevitable...

What should parents do if they find signs of illness in their child?

To begin with, consult with a psychotherapist who will determine in which direction to move. Only a comprehensive treatment program with the cooperation of nutritionists, psychologists and psychiatrists can be successful, who will guide both parents and adolescents, individually select therapy appropriate to their case, and choose a treatment strategy. Parents need to be patient, strong, and supportive of their children during the several months of treatment.

Treatment options for anorexia

" - Hello! Please help me get anorexia. I really want to lose weight!

“I really want to too, but it just doesn’t work out...”

From anonymous messages in a thematic forum

The global difficulty in treating anorexia is that patients themselves often do not recognize the fact of the disease, but, on the contrary, make a cult out of it: they communicate on numerous forums, share photos and praise each other for extreme weight loss, publicly repent of breakdowns and overeating, write motivational addressing each other. And they even want to get sick, seeing this as a solution to the problem of self-esteem and self-acceptance. Fans of the deceased Anya Zholobova, whom we talked about above, continue to communicate in the community she created, create communities of memory and “perform feats” - losing weight in her honor. In those cases when patients realize the danger of anorexia and try to eat, eating is accompanied by emotional discomfort, even panic attacks.

Since anorexia is a disease that has obvious underlying psychological problems and physiological changes - as a consequence, treatment should be comprehensive and include several areas:

medicinal and restorative treatment - aimed at improving the somatic condition and restoring microelements lost by the body, necessary for normal life (vitamin therapy, cardiovascular medications, restoring fluid levels in the body);
nutritionist control over nutrition and regimen - patients are prescribed 6-7 meals a day in small portions, followed by bed rest for at least two hours;
tube feeding - used in extremely severe cases when the patient is no longer physically able to feed on his own;
behavior modification with the help of psychology - work with determining the true causes of anorexia nervosa and changing attitudes, changing a learned behavior pattern.

One of the main goals of psychotherapy is to eliminate the fear of controlling weight change. During the process of recovery of the body, the brain itself records the loss and allows you to compensate for the lack of weight. Full recovery is a very long process, you should be patient and not lose hope even in cases of relapse.

Errors in the actions of others that can be fatal for the patient

Mistake #1.

Parents and relatives are under no circumstances recommended to put pressure on the patient’s psyche and force him to eat - this can only aggravate the situation.

A successful outcome of therapy is possible only when the patient himself is aware of the problem and wants to solve it. The task of conveying to the patient the danger of the consequences of anorexia and the need to treat it should be taken on by a competent specialist - a psychologist. Mistake #2.

It is impossible to recover from anorexia without the help of specialists - you need to accept this as a fact. There are many tips on the Internet on how to cure anorexia yourself at home. The number of such requests is terrifying. The patient can stay at home most of the time during the treatment period, but only at the initial level of exhaustion (dysmorphophobic and early dysmorphomanic stages) and subject to the constant presence of a loved one, close cooperation with doctors and psychologists and compliance with all their recommendations.

Prevention of anorexia in children and adolescents

The best prevention of the disease is to instill adequate self-esteem in children and in oneself. Watching and discussing documentaries, reading scientific articles and books will help a teenager develop an understanding that excessive weight loss is a life-threatening problem. Set priorities: convey to your child the idea that there is nothing more important than health and you should not chase ideals inspired from the outside.

Article information

This article was co-authored by. Trudy Griffin is a licensed psychotherapist in Wisconsin. She received her master's degree in clinical psychotherapy from Marquette University in 2011.

Category: Weight loss

In other languages:

English: Recognize Signs of Anorexia in Young Girls, Español: reconocer los signos de la anorexia en chicas jóvenes, Bahasa Indonesia: Mengenali Gejala Anoreksia pada Remaja Perempuan, Français: reconnaitre les signes d'anorexie chez les jeunes filles, Deutsch: Die Anzeichen von Anorexie bei jungen Mädchen erkennen, Italiano: Riconoscere i Sintomi dell'Anoressia nelle Ragazze più Giovani, العربية: التعرف على أعراض فقدان الشهية عند الفتيات الصغيرات, Português: Reconhecer Sinais de Anorexia em Adolescentes, Tiếng Việt: Nhận biết chứng chán ăn ở thiếu nữ , Nederlands: Signalen van anorexia herkennen bij meisjes

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Consequences of the disease

Anorexia nervosa is fraught with very serious consequences. Here are some of them:

Disturbances in the functioning of the cardiovascular system.
Pathological disorders in the endocrine system against the background of decreased production of triiodothyronine and thyroxine (thyroid hormones) and sex hormones. As a result of this, not only do menstruation stop, but reproductive function also decreases, i.e., the girl may subsequently not have children.
Brittle bones due to calcium deficiency in the body . Such people systematically suffer from various fractures.
Inflammation of the esophagus and deterioration of tooth enamel due to the effects of stomach acid, which is released when vomiting is constantly provoked.
Disorder of the psycho-emotional sphere - such people are constantly depressed, irritable, and emotionally unstable.
The worst consequence of anorexia is death , which can happen if you do not pay attention to this problem in time and let the situation take its course.

Anorexia in children

Most parents are very concerned about their child's appetite. Everything is delicious, everything is healthy - but the child, as luck would have it, refuses. Games of catching up with a spoon or feeding during a cartoon begin, which only makes the situation worse. There are often cases when a mother, suspecting anorexia in a child, tries to stuff as much food into him as possible, which causes hatred and aversion to food in the baby, independently programming the disease.

In fact, a child’s refusal to eat can be quite justified - the baby is sick, tired, he doesn’t like the food... When a child refuses food for a long enough time, then it’s time to “sound the alarm.” It should also be remembered that signs of anorexia in adolescents are accompanied by growth retardation. It is best to visit a specialist if you notice symptoms.

First signs

In the early stages, pathology manifests itself only in changes in the behavior of the teenager. The first signs of anorexia in girls and boys are characterized by refusal to eat, the child says that his stomach hurts or that he has already eaten. Against this background, the teenager constantly talks about diets, counting calories, he can actively help cook, but he will not eat the food. At the same time, food becomes a favorite topic of conversation. Clinical first signs will appear in the form of the following symptoms:

rapid fatigue;
weakness, fainting;
puffy face;
brittle and dull hair;
arms and legs take on a bluish tint due to poor blood circulation.

Due to exhaustion of the body and lack of fatty tissue, girls stop having periods; the patient is always cold because the body is not able to produce energy to keep warm. The body tries to retain heat, so a layer of fine hair appears on the skin. Next, osteoporosis develops (failure of calcium metabolism in bone tissue), disturbances appear in the digestive processes, the functioning of the heart and the central nervous system.

Anorexia and its varieties

The name “anorexia” itself is borrowed from the Greek language and literally translates as “no appetite.” It manifests itself in a complete refusal to eat, which leads to rapid weight loss and entails mental disorders and nervous disorders, the main manifestations of which are phobia of obesity, manic desire to lose weight, unreasonable anxiety about weight gain, as well as a false painful perception of one’s physical health. forms.

Approximately 80% of anorexia sufferers are teenage girls between twelve and twenty-four years old. The remaining 20% are women and older men.

The worst thing is that this disease leads to very sad consequences and in 20% of cases ends in death, the vast majority of which are suicide. Anorexia is considered an occupational disease in models, where it accounts for approximately 72% of cases. Timely qualified medical care leads to a complete recovery of patients in only 40-50%.

Unfortunately, this disease has become so deeply ingrained in everyday life and has become so widespread among the population that in some countries it is legally prohibited to give jobs to overly thin models or anorexic models with unhealthy thinness.

There are several varieties of this disease.

According to the mechanism of development, anorexia occurs:

neurotic – when refusal to eat is caused by a strong negative emotional background, pathologically affecting the cerebral cortex;
neurodynamic - when the decrease and loss of appetite is caused by the impact on the brain of strong non-emotional stimuli, such as severe and intense pain;
neuropsychiatric - in other words, neurological, nervous, psychogenic anorexia or cachexia, which occurs against the background of a purposeful and conscious refusal to eat and is considered as a severe mental disorder - one of the types of self-destruction, classified in several degrees of severity.

Based on causative factors, anorexia is divided into:

true anorexia - mental anorexia, in which refusal to eat is caused by severe endocrine, mental or somatic disorders, caused by disturbances in the functioning of the digestive center in the cerebral cortex;
false anorexia - more similar to nervous one, when refusal to eat is due to a critical attitude towards one’s own appearance, a conviction of one’s own inferiority and imperfection.

Childhood types of anorexia:

primary – a disease caused by failures and disturbances in the baby’s nutrition;
secondary – anorexia, provoked by disturbances in the functioning of the digestive organs or any other systems.

Recently, scientists have identified another type of anorexia - senile, when completely healthy elderly people begin to refuse food, become despondent, apathetic, and rapidly lose weight. It turns out that this is due to biological changes in the body caused by an increase in the level of certain hormones. However, senile anorexia is just as dangerous as nervous anorexia - the privilege of the younger generation.

Types and reasons

“Mannequin disease,” as anorexia is often called, has become a global scourge over the last 30-40 years. The abundance of glossy publications, television programs, photographs of successful people with beautiful figures, their popularity and demand for them, force girls from 14 years old, women up to 35 and even more, and even some men, to resort to extreme measures to be very thin.

This disease can also develop during stressful situations and hormonal imbalances.

There are different types of anorexia, each of which depends on specific causes:

• mental.

• symptomatic.

• nervous.

• medicinal or medicinal.

Having considered the reasons for the appearance of these types of dangerous illness, you can understand what causes anorexia. The rarest of them is a mental form that develops as a result of mental illnesses such as depression, paranoia, and schizophrenia. As for the symptomatic and medicinal type, they are based on the following physiological factors:

1. Abuse of medications (antidepressants).

2. Changes in the normal level of brain hormones - norepinephrine, serotonin, cortisol.

3. Diseases of any organs.

The most common form of anorexia is nervous, its causes lie in human psychology:

1. An irresistible desire to meet the standards imposed by society and the media.

2. Any violence - sexual and physical.

3. Striving for ideal – perfectionism.

4. Psychological trauma.

5. Strict control of your life. 6. An inferiority complex instilled in childhood.

Not only young girls with complexes who have no prospects and are in conflict with their parents suffer from anorexia. Among celebrities, well-established, famous and rich people, there are also many of them: Victoria Beckham, Angelina Jolie, Rachel Zoe, Mary-Kate Olsen.

Disguise

As soon as the disease begins, an anorexic girl begins to choose loose clothes to hide her body.

She comes up with all sorts of excuses not to sit down at the table - she’s sick, she overslept during dinner, she’s already had lunch with a friend, she’ll eat later.

The girl does this not for pleasure, not out of calculation, but rather in order not to hurt her loved ones. She realizes that she can hurt them - although she doesn't really understand why - and tries to protect them.

However, it is very difficult to maintain a balance between what is happening in her inner world and in the real world. These efforts exhaust her internally.

Consequences of bulimia

The consequences of bulimia are disruption of the stomach, exhaustion and, as a result, hospitalization

Overeating and immediate vomiting lead to serious problems, among which the following conditions are especially important:

neurasthenia;
disruption of the gastrointestinal tract;
violation of metabolic processes;
acute heart failure;
general exhaustion of the body;
drug addiction;
deterioration of the condition of teeth, hair, skin.

Real signs of anorexia

And there are signs of anorexia that are not advertised by popular culture. And therefore they are often not noticed for a long time, and due attention is not paid to them.

Height without weight gain

Body types vary, the concept of “normal weight” for teenagers can vary greatly, everyone develops according to their own, unique scenario... Yes, all this is true. But despite this, there are several objective indicators that will tell you that the child has some problems.

At the same time, compared to her peers, your daughter may still not look super skinny. And you may not notice that she neglects food. If desired, novice anorexics can hide their increasingly meager diet with amazing virtuosity.

Insistence on eating alone

There is, of course, such a thing as demonstrative anorexia, when people ostentatiously refuse to eat.
But much more often it happens differently - individuals susceptible to this illness try their best to hide it. Because deep down they understand that this is unhealthy and wrong. Because they are afraid of being judged. Sudden things that definitely need to be done during a family dinner. “I already ate at my friend’s.” Unexpected lack of appetite due to fatigue, malaise, or bad mood. Artistic spreading of vegetables on a plate if you end up at the same table. If something like this happens suspiciously regularly, this is a reason to think about it.

Unexpected interest in cooking

There are different hypotheses why this happens. They write that anorexics are afraid that the same thing will happen to their loved ones as to them, and they “insure themselves.” Others insist that girls thus get a thrill from realizing how strong their will is. There is also a version that the process of preparing food deceives the brain, and it no longer so insistently demands that its owner eat as soon as possible.

Whatever the reasons, a fact is a fact. Girls caught in the grip of anorexia often demonstrate an unexpected love for cooking.

Red thread on the wrist and other symbols of the pro-ana subculture

Anorexics have their own subculture with its own slang, symbols, traditions, and groups on the Internet.
A red thread on the wrist is the most obvious outward sign of belonging to a community. They say that such groups have a very friendly atmosphere. A teenager who worries that no one fully understands him, doesn’t take him seriously, doesn’t love him, literally blossoms in such an environment. And therefore he can seriously accept for himself the ideology of the subculture that comes his way.

Each of these signs taken separately may mean nothing. But if you notice several of the listed points in your daughter at once, this is a serious reason to contact a specialist.

Prepared by Nadezhda Lukashova, 07/11/19

about teenagers, diet, Weight loss, symptoms and diseases

How to save a loved one

As already mentioned, people suffering from overeating do not want to admit their problem, hide it, and thereby harm themselves. The task of relatives and loved ones who notice the symptoms of bulimia is to gently push the patient to the decision to visit a doctor. The following will help you gain trust and explain the need to consult a specialist:

Study as much information as possible about eating disorders, its manifestations and dangers, in order to fully and clearly convey it to the bulimic.
The patient may strongly dislike the fact that you have found out his secret; he is capable of showing aggression. You need to be patient and try to build trust.
You cannot put pressure on a person, and if at the moment he does not want to talk, postpone the conversation until he gathers his strength and wants to listen to you.
Convince the patient that you do not want to humiliate him, but simply to help.
Encourage the bulimic to express emotions about their life and condition.
Focus the conversation on the fact that it is very difficult for any person to admit to addiction, so your interlocutor is great if he can do this.
Promise the patient that you will not tell anyone about his illness. However, this can be done if he is ready to turn to specialists.
Convince the bulimic that if he decides to undergo treatment, he will definitely succeed.

When communicating with such a patient, you cannot say that you are nervous about him, putting your feelings above his, manipulate, or behave as if you know everything. Under no circumstances should you say to him the following words: “Can’t you stop eating so much? Eat normally, you’re not fat.” This devalues the problem.

What is anorexia

Anorexia (in English “anorexia”) is a special type of neuropsychiatric disorder characterized by a person’s refusal to eat. This condition is combined with an obsessive desire to lose weight.

Provoking factors

To understand how to treat it, you need to understand what anorexia is. The appearance of the disease is mainly due to psychological problems. The latter make a person want to change his appearance through weight loss. Nervous or psychological anorexia develops under the influence of many factors (often a combination of them):

Poor family environment

This is one of the first signs that doctors pay attention to when working with anorexics. An unfavorable family climate occurs due to increased irritability of one of the members, depression, alcoholism and other factors. Low self-esteem

It often develops against the background of family problems. Due to low self-esteem, mental dysfunction occurs. The patient develops a persistent rejection of himself. In an effort to improve his own appearance, a person refuses food, believing that a slender figure will change the attitude of those around him. Problems in your personal life. The obsession with losing weight comes from the patient’s desire to please others.

Despite the fact that the disease is considered a weight loss disease, anorexia develops under the influence of many factors.

Anorexia nervosa

In previous cases, lack of hunger and appetite was one of the symptoms of some pathology, but there is anorexia nervosa, which is an independent disease.

On the one hand, it seems like a normal desire of any person, but in this case the desire to reduce one’s weight becomes absurd.

Anorexia nervosa is rare in men; it is more often a problem of young girls who suffer from complexes about their appearance. First, they go on a diet, induce vomiting after eating, then their appetite and feeling of hunger disappear. Having reached a certain weight, which initially seemed ideal to people with anorexia, they do not stop and lower the bar.

Stereotypes of modern industrial society, combined with mental characteristics, have become the main cause of this disease. No matter how much weight decreases, people with anorexia still consider themselves not thin enough. If you conduct a test and ask them to draw approximately their outlines on the wall, then they are much wider than the true size of girls and boys suffering from this mental disorder.

In addition to almost one hundred percent refusal to eat and unnatural thinness, there are other symptoms:

Denial of the problem. Patients believe that they are striving for an ideal and that others simply do not understand them or are jealous.
No matter how much weight a patient with anorexia loses, he is still fat in his eyes. Moreover, a phobia (fear) of gaining at least 100 g is formed.
Sleep disturbance and depression. All cells, including the brain, experience pathological starvation.
With all this, there is often an increased interest in cooking. Anoreticians prepare grand dinners for loved ones, but do not sit down at the table themselves.
A feeling of resentment because, again, they do not want to recognize their body as ideal.
Isolation, distance from loved ones and friends. The desire for loneliness.
Bouts of euphoria, probably associated with low blood glucose levels.
Girls experience amenorrhea.
Constant weakness, fatigue, fainting.
Cardiac arrhythmia.

At first, a person, due to a feeling of inferiority, begins to try diets, gradually reducing the amount of food. On the second, when the weight is reduced by approximately 25%, euphoria sets in, which potentiates the tightening of ideal weight criteria with a subsequent reduction in food consumption. Having reached the third stage, organ dystrophy develops, which is almost irreversible.