Understanding Anorexia Nervosa 

Anorexia nervosa (AN) is a serious and potentially life-threatening eating disorder that affects individuals globally. The prevalence of AN is unknown, but it is generally estimated to affect: 1% of females and 0.1-0.2% of males worldwide.

In this blog, we aim to explore the nature of AN, its signs and symptoms, associated comorbidities, and treatment options. Our goal is to provide insight and support, and demystify common stigmas associated with AN.

What is Anorexia Nervosa? 

Restrictive eating habits, an intense fear of gaining weight, and a distorted body image characterise AN. Individuals with AN often perceive themselves as overweight, despite being significantly underweight. There is a stigma that AN only impacts young women. However, individuals of all genders, sexualities, ages, races, ethnicities and backgrounds can develop it.  

What are the different types of AN?

Clinicians broadly categorise AN into two subtypes: the restricting type and the binge-purge type. 

Restricting Type: Individuals may engage in extreme calorie restriction, excessive exercise, or both, to lose weight or prevent weight gain. Individuals consume significantly fewer calories than the body needs to maintain a healthy weight, adhere to strict dietary rules and avoid foods perceived as high in calories.

Binge-Purge Type: this involves episodes of binge eating followed by compensatory behaviours to prevent weight gain, similar to bulimia nervosa. Individuals with this subtype may restrict their food intake, but they also experience periods of consuming large amounts of food  

Identifying the subtype of AN is crucial for developing effective treatment plans for effective recovery. At TBITC, we focus on understanding the individual beyond their clinical symptoms and focus on the individual and their unique difficulties.

What comorbidities are associated with AN?

AN often co-occurs with other mental health conditions, including: 

1. Depression: Major depressive disorder occurs in 50-70% of individuals with AN. This is characterised by persistent sadness, hopelessness, and loss of interest in previously enjoyed activities. 

2. Anxiety disorders: Studies suggest rates of 24% and 71% in individuals with restricting and binging/purging subtypes, respectively. 

3. Obsessive-compulsive disorder (OCD): Studies suggest rates of 35% and 44% in individuals with restricting and binging/purging subtypes, respectively.

4. Substance abuse: The lifetime prevalence rates of substance abuse in individuals with AN highlight the risk of using substances as a coping mechanism. 

How does AN impact day-to-day life? 

Living with AN extends beyond dietary restrictions. It profoundly affects mental and physical health, as well as social interactions and daily functioning: 

Here’s how it impacts different areas: 

• Relationships: AN can strain relationships, which may lead to isolation and misunderstanding from family and friends. This may occur if individuals are unable to attend social situations due to fears about food, or if frustrations mount when individuals are unable to engage in recovery despite putting their health at risk. 

• Impaired fertility: Fertility in both men and women may be impacted by inadequate levels of essential hormones. Men may experience reduced sperm production, reduced libido and erectile dysfunction. Women may experience amenorrhea (absence of menstrual periods) and a reduced sex drive. 

• Brain function: AN can impact brain function by affecting neurotransmitter levels and brain structure. Sadly, this may cause cognitive impairments such as difficulties with concentration, memory, and decision-making.  

• Cardiovascular risks: Cardiovascular complications are a serious concern in AN due to malnutrition. This may cause weakening of the heart muscle and lead to potentially life-threatening conditions.  

• Weakened immunity: A lack of nutrients e.g. vitamins and minerals may impact the body’s ability to fend off disease. This may make individuals more susceptible to infections and illnesses.  

• Skin and hair: A lack of nutrients, including essential fatty acids, may cause dry, flaky skin, lanugo (fine hair growth), and hair thinning.

• Bone health: AN can impact your bone density, resulting from a lack of nutrients to produce hormones essential for strong bones. Moreover, this can cause an increased susceptibility to bone breaks and fractures, and lead to osteoporosis at a younger age than normal.  

• Gastrointestinal issues: AN can slow metabolism, cause electrolyte imbalances, and disrupt blood sugar levels. Consequently, this may also lead to gastric problems like constipation and delayed gastric emptying due to inadequate food intake. 

What are the recommended treatments for AN?

Effective treatment for AN typically involves a multidisciplinary approach tailored to the individual’s needs. At TBITC, we find a treatment approach that suits our patient’s individual needs, challenges and requirements. However, NICE guidelines for AN suggest the following treatment options: 

• Cognitive Behavioral Therapy (CBT): CBT focuses on identifying and challenging distorted thoughts and behaviours related to food and body image. It helps individuals develop healthier coping strategies and address the underlying issues contributing to their eating disorder. 

• Maudsley Anorexia Nervosa Treatment for Adults (MANTRA): MANTRA is a specialised form of therapy tailored for adults with AN. It integrates cognitive, behavioural, and psychoeducational approaches. The aim is to address the cognitive and emotional aspects of AN to develop a more balanced approach to eating and body image. 

• Specialist Supportive Clinical Management (SSCM): SSCM provides a structured therapeutic environment focusing on nutritional rehabilitation, medical monitoring, and psychological support. It emphasises a supportive therapeutic relationship and helps individuals stabilise their eating patterns, improve physical health, and address psychological issues related to AN. 

AN is a complex eating disorder that requires understanding, support, and specialised treatment. At TBITC, we provide compassionate care to individuals struggling with AN and other eating disorders. Our team of experienced professionals offers comprehensive treatment options aimed at promoting physical and mental well-being. 

If you or someone you know is affected by AN, remember that recovery is possible with the right support. Visit our Eating Disorder Support page to learn more about our services or contact us directly to start your journey toward recovery.