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Anorexia Nervosa

Anorexia NervosaIn a society that lives by sayings like “You can’t be too rich or too thin,” extreme dieting is usually applauded. But no one can overlook the seriousness of anorexia nervosa, an eating disorder that has become one of the most common chronic illnesses among adolescents. The mortality rate for anorexia is higher than any other psychiatric condition — as high as 20 percent, according to the Eating Disorders Coalition.

But getting help for someone with anorexia can be extremely difficult. Until dieting turns pathological and weight loss becomes severe, anorexia nervosa often goes undetected.

If you’re frustrated by your own ability to stop dieting, or you care about someone who’s in danger of starving herself to death, it’s important to know that there’s help available. You shouldn’t have to face the fear and despair of handling anorexia alone. With the right treatment and ongoing support, recovery from anorexia is possible. The sooner the illness is identified and treated, the greater the chances of making a successful recovery.

Diagnosing Anorexia Nervosa

“Anorexia” literally means a loss of appetite for food. The lack of desire to nourish yourself can occur as a result of a severe physical illness, such as cancer, but it can also occur as a result of a psychiatric disorder. This condition, called anorexia nervosa, is defined by several key characteristics, which are outlined in the Diagnostic and Statistical Manual of Mental Disorders-IV, published by the American Psychiatric Association:

Key Characteristics:

  • Insistence on maintaining a body weight that’s 15 or more percent below normal
  • A distorted body image that makes you perceive yourself as overweight, even if you’re extremely thin
  • An obsessive fear of gaining weight
  • Missing three or more periods (in females who have started to menstruate)
Not everyone who suffers from anorexia will meet all of these criteria at every stage of the process. The condition usually doesn’t develop overnight; it often starts with a simple, healthy diet that gets out of control. A teenage girl who’s mildly overweight may start to diet in order to lose a few pounds. As she receives attention and praise for losing weight, she may take the diet to a more extreme level, especially if she has a low sense of self-esteem.

Meanwhile, the effects of severe dieting and malnourishment on brain chemistry may perpetuate the distorted body image, perfectionism and obsessive thinking associated with anorexia. The Harris Center at Massachusetts General Hospital notes that low levels of serotonin, a neurotransmitter linked with mood, emotions and the appetite for food, contribute to the anxiety and obsessive behavior of anorexia.

Eating DisorderYou don’t have to be a psychiatrist or an eating disorder specialist to know when your dieting has gotten out of control, or when someone you love is losing too much weight. Once you’re aware of these telltale signs of anorexia, you can respond more quickly to a potentially life-threatening situation:

  • Constant preoccupation with dieting and weight loss
  • Taking up highly restrictive diets that allow no more than 1,000 calories per day or limit foods to fruits and vegetables, etc.
  • Practicing strange new eating habits, such as slicing food into tiny cubes
  • Making up reasons not to eat in front of the family
  • Exercising to the point of exhaustion at the expense of any other activities
  • Obsessing over images of food, studying recipes and preparing elaborate meals without actually eating anything
  • Displaying the physical symptoms of anorexia, such as a layer of fine body hair on the arms and legs, constant fatigue, weakness, dry hair and dark circles under the eyes

The complications of anorexia aren’t limited to excessive weight loss or the absence of a menstrual period. Malnourishment and dehydration can cause dangerous electrolyte imbalances, which can cause heart or kidney failure, even in the young. The use of stimulant diet pills, laxatives and diuretics can cause heart problems and rob the body of precious nutrients. Nutritional deficiencies like anemia and osteoporosis can make the body weak and frail. Eventually, every vital organ in the body is adversely affected by self-starvation. Sadly, one of the greatest risks of all among people who suffer from anorexia is suicide. The International Journal of Eating Disorders estimates that the rate of suicide among anorexics may be even higher than current clinical studies indicate, and that it is definitely higher than the general population.


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Types of Anorexia

Types of AnorexiaEating disorder specialists have identified two basic subtypes of anorexia: the restricting type and the binge eating/purging type. Anorexics of the restricting type impose severe limitations on their food intake and engage in complicated eating rituals such as:

  • Counting calories obsessively
  • Limiting their meals to specific types of food
  • Cutting portions into tiny pieces
  • Chewing each bite of food a certain number of times

The binge eating/purging type of anorexia includes behaviors that compensate for food intake. Someone with this type of anorexia may make herself vomit if she feels she’s eaten more than she should, or exercise compulsively to work off a few extra calories. She might use laxatives, diuretics or enemas to flush unwanted calories from her body. An anorexic who practices only restrictive behavior might begin to add purging behavior to her regimen if she feels that she’s not losing weight quickly enough, or if she feels guilty for eating too many calories. Both vomiting and intensive exercise release endorphins that create a temporary sense of well-being, which can provide valuable relief for someone who’s chronically tired and depressed. Understanding the behaviors associated with anorexia nervosa makes this condition easier to identify and to treat.

Who Is at Risk?

Up to 90 percent of those who develop anorexia nervosa are adolescent females, estimates the National Alliance on Mental Illness. But that doesn’t mean that the disorder doesn’t affect boys, men or women over the age of 25. People in all of these groups have been diagnosed with this eating disorder. It’s never safe to assume that someone doesn’t have anorexia based simply on their age or gender. Self-consciousness, low self-esteem, a history of abuse and a conflicted home environment are some of the factors that contribute to anorexia nervosa. Young girls who are in the process of developing sexually may use anorexia as a way to control a body that is maturing at a scary rate. Teenagers who are sexually or psychologically abused might starve themselves as a way to become smaller and less physically attractive. By making themselves thinner, they feel more childlike and secure. At Risk for Anorexia Healthy sports and activities like running, gymnastics, acting or dancing can contribute to eating disorders. Coaches or teachers may inadvertently encourage extreme dieting by criticizing young people for gaining weight. Activities that promote body awareness, like ballet or modeling, may lead to an unhealthy preoccupation with looks, which often sets the stage for pathological dieting in teenagers who are overweight. Although anorexia is often associated with young females, a woman who’s been treated for the disorder may relapse into extreme dieting and strenuous exercise years after graduating from rehab. A professional woman who loses a job, a new mother who’s trying to lose pregnancy weight or a married woman going through a divorce are vulnerable to anorexic behavior, especially if they’ve lived with the disorder in the past. Increasingly, eating disorder specialists acknowledge that anorexia is a chronic psychiatric illness that can reappear later in life, especially in times of severe stress.

Co-Occurring Disorders

Anorexia nervosa usually doesn’t occur in a vacuum. The human psyche is complicated, and when one disorder appears, others are likely to be discovered. Alterations in brain chemistry caused by extreme dieting can set the stage for depression, suicidal behavior and substance abuse. Some of the conditions and disorders that accompany anorexia include:

  • Depressive disorders
  • Generalized anxiety
  • Obsessive-compulsive disorder
  • Body dysmorphic disorder
  • Drug or alcohol addiction

Co-occurring disorders can be treated successfully if each condition is addressed during treatment. From the initial evaluation stages to the aftercare phase of rehabilitation, it’s important to work with professionals who have been trained in treating eating disorders, addiction and mental health disorders.

Hope for Anorexia

Hope for AnorexiaWhen someone you love is literally starving herself to death, it’s natural to want to see results quickly. You want to enjoy family meals with your loved one, to hear her laugh again and hold her healthy body in your arms. You want to see her return to her former self as quickly as possible. But making a full recovery from anorexia takes time and patience, and treatment can’t be rushed. The National Eating Disorders Association recommends that when you’re looking for treatment for anorexia, it’s crucial to find the right level of care. Outpatient, inpatient and long-term residential treatment are available for anorexia nervosa. Intensive residential care is often advised for clients who need a structured, supportive setting where they can receive the dedicated care they need to restore healthy eating habits and build a strong self-image. Relapse rates in anorexia are high, and programs that are too short or that don’t address co-occurring issues will probably not be effective over the long term. The more comprehensive the treatment plan, the more recovery tools you’ll have to face this baffling, life-threatening disorder. In addition to in-depth work with a psychotherapist, you should have the opportunity to participate in self-help groups, meet with nutritional counselors and take advantage of holistic therapies. At Futures, we provide a multidisciplinary approach that encompasses several effective treatment strategies. Our team members are dedicated to supporting you throughout the treatment process, from your first private consultation to the day you graduate and beyond.

What We Treat


Futures offers an integrated multidisciplinary approach for treating those suffering from drug or alcohol addictions as well as those with addiction and underlying co-occurring disorders.

How We Can Help


  • Personalized Care
  • Safe and Comfortable Medical Detoxification
  • Comprehensive Introduction to Adherent DBT
  • Intensive Clinically Based Program
  • Luxury Accommodations and Amenities
  • Experienced, Educated and Compassionate Staff
  • Extensive Continuing Care
  • Experiential and Cognitive Therapies
  • 24 – Hour Medical Care
  • Private Bedrooms / Private Baths
  • A Healing, Process-Oriented Family Program

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