Eating disorders like anorexia receive a lot of media attention. Yet they remain poorly understood. Some may believe that anorexia is a choice. After all, in order to restrict your own eating, you have to decide not to eat, right? In reality, anorexia is a much more complex condition than simply refusing to eat.

What is anorexia?

Anorexia nervosa is characterized by extremely restrictive eating habits in people who see themselves as overweight, even if they are not. Signs of anorexia include:

  • An extremely restrictive diet
  • Distorted body image
  • Extreme fear of gaining weight
  • Emaciation

If left untreated, anorexia can cause severe, even fatal, complications. People may develop osteoporosis (thinning of the bones that make them brittle and fragile), a slowed pulse, organ failure, and infertility.

It’s also important to note that anorexia can affect people of all genders and ages.

Treating Anorexia

Fortunately, people can fully recover. Psychotherapies and medications are useful tools to help treat anorexia. For example, cognitive behavioral therapy (CBT), a type of talk therapy, teaches patients how to identify and change distorted thinking patterns.

Medications like antidepressants can help because people with anorexia often also have mental health conditions. Treatment — which may involve hospitalization and extended stays at specialized facilities — may be expensive. American patients can offset some costs by accessing prescription medications from licensed pharmacies abroad through a referral service like RxConnected.

Why do people become anorexic?

It’s easy to think that the answer to this question is the media. After all, most of us are bombarded with images of thin and fit celebrities on screens and advertisements. Many of us have wanted to look better than we do, but most of us aren’t anorexic, so what makes someone anorexic?

A Plethora of Factors

The National Eating Disorders Association (NEDA) cites several factors that may contribute to a person’s risk for developing an eating disorder (ED) like anorexia. This includes social factors like the media, physical illnesses, childhood experiences (like bullying), and biological predispositions, as eating disorders can run in families.

Distorted Body Image

We all have a body image. This is the way we perceive and picture our bodies, and this perception can be heavily influenced by social standards as well as personal experiences. How we perceive our body image is mostly controlled by a part of the brain called the parietal cortex. Science suggests that people with ED have abnormal activity in their parietal cortex.

When confronted with an image of their body digitally altered to be bigger, people with anorexia respond with heightened activity in the part of the brain that controls fear. Other studies suggest that eating disorders are somewhat heritable, and that distorted body image is correlated with perfectionism.

Altered Reward System

According to NEDA, the brain’s reward system is also markedly different in people with ED. Studies have discovered that the brains of anorexic people are less sensitive to reward but are over-sensitive to punishment. Interestingly, science has also found that these differences in reward processing do not disappear even after the disorder is treated.

How to Help Someone With Anorexia

People with anorexia may initially be resistant to help, but with love, support, and patience, you can gently encourage a loved one to seek support.

Note: If the person is in immediate danger of hurting themselves or others, contact emergency medical services right away.

Do you suspect an eating disorder?

Eating disorders can be hard to spot. People who have them may go to great lengths to hide their behavior. According to NEDA, behavioral signs that someone may be suffering from an eating disorder include:

  • Social withdrawal
  • Elaborate rituals around eating
  • Being very particular around routines and behaviors
  • Disappearing to the bathroom after eating
  • Fear of eating in public
  • Excessive exercising and exercising in secret
  • Wearing baggy clothes to hide weight loss

Physical signs someone may be suffering from an eating disorder include:

  • Sensitivity to cold
  • Dizziness and fainting
  • Weight fluctuations both up and down
  • Missing periods
  • Impaired immune system; slow wound healing
  • Fine hair all over the body
  • Dental problems

Encourage the person to get help.

Talking to someone with an eating disorder and trying to convince them to get help isn’t easy. You may become frustrated and impatient. The following tips from NEDA can help:

  • Use “I” statements and statements based on visible behavior, not accusations. For example, say, “I am worried that you’ve been skipping dinner these days,” instead of, “You’re hurting yourself!”
  • Avoid giving unsolicited, oversimplified advice like “just eat.”
  • Offer to help your loved one by attending doctor appointments with them.
  • Find something the ED sufferer is more likely to agree with. For example, if the sufferer likes socializing, you can leverage the fact that avoiding meals means missing out on opportunities to be with friends.

You can’t be too pushy, but you can’t ignore the problem either. Understandably, this will require some trial and error. Don’t be too hard on yourself if you make mistakes.

Support the person during treatment.

Treatment is a journey and a challenge that will be difficult for many ED sufferers, especially if they didn’t want to get treated in the first place. Here are a few things you can do to help make the journey easier:

  • Listen, be non-judgmental, and allow the person to vent.
  • Get educated about eating disorders.
  • Offer to help them with everyday things like laundry, grocery shopping, etc.
  • Plan social events that don’t involve eating, so your loved one can participate with minimal stress.
  • Keep them accountable, but avoid being too controlling. Avoid constantly telling them what they “should” do.

Lastly, remember to set boundaries, because of your mental health matters too! Anorexia is a serious medical problem, so don’t be afraid to ask other people in your loved one’s care team to help, including doctors, counselors, family, and friends. It will be a bumpy journey, but a little patience and genuine care can go a long way.