Anorexia nervosa is a severe eating disorder with psychological components, characterized primarily by an extreme fear of weight gain, distorted body image, and extreme dietary restriction. This condition not only affects physical health but also leads to multiple psychological and social dysfunctions. According to data from the World Health Organization, its prevalence is higher among adolescent females, but cases among males and transgender individuals have been increasing in recent years.
This disorder is often associated with societal pressures for an ideal body image, with patients frequently attempting to control their weight to cope with emotional issues or seek validation. It is important to note that diagnosis and treatment of anorexia nervosa require a multidisciplinary medical team, including psychologists, dietitians, and internists. Early detection and prompt intervention are crucial for improving prognosis.
The etiology of anorexia nervosa is complex, involving interactions among biological, psychological, and social environmental factors. Biological factors include abnormalities in serotonin metabolism in the brain, which may influence appetite regulation. Genetic studies have also identified specific gene polymorphisms associated with susceptibility, but genetic risks usually interact with environmental factors.
Psychological factors include perfectionism, low self-esteem, and difficulties in emotional regulation. Patients often equate body weight with self-worth, forming a distorted cognitive pattern of "weight = self-value." Socio-cultural influences, such as media promotion of thinness and peer pressure, can exacerbate anxiety about body image.
Physiological symptoms include significantly low body weight below standard, metabolic abnormalities, and endocrine disturbances. Typical signs include amenorrhea, dry skin, hypothermia, and abnormal hair growth (lanugo). Long-term malnutrition can lead to irreversible damage such as cardiac failure or osteoporosis.
Psychological symptoms involve pathological fear of weight gain and cognitive distortions. Patients may severely underestimate their body weight, believing themselves to be overweight despite being underweight. Common behaviors include secretive food hiding, excessive calorie counting, exaggerated exercise routines, or behaviors like vomiting or laxative abuse to induce appetite suppression.
Diagnosis requires adherence to the clear criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5): 1. Significantly low body weight due to excessive weight management; 2. Intense fear of weight gain; 3. Distorted perception of body image. Medical evaluation should exclude other diseases causing nutritional deficiencies.
The diagnostic process involves three stages: first, a structured questionnaire assessment by a psychiatrist; second, dietary diary analysis by a dietitian; and third, physical examinations including electrocardiogram, blood biochemistry, and endocrine function tests by an internist. Exclusion criteria include thyroid dysfunction or gastrointestinal diseases and other organic causes.
Treatment typically involves a multidisciplinary approach. Psychotherapy, such as cognitive-behavioral therapy (CBT), has been proven effective in improving disordered eating cognition. Family-based treatment (FBT) is particularly effective in adolescents, helping to improve the support system through family dynamic adjustments.
Nutritional rehabilitation is a key component, involving gradual re-establishment of normal eating patterns and nutritional assessment. In severe cases of malnutrition, hospitalization may be necessary to prevent organ failure. Pharmacotherapy, such as selective serotonin reuptake inhibitors (SSRIs), may be used for patients with comorbid depression, but medication alone has limited efficacy.
Preventive strategies should focus on social education and early identification. Schools and workplaces should avoid linking body weight directly with value judgments and promote health-oriented rather than appearance-based body image education. Medical institutions can include dietary behavior screening in regular health check-ups.
Family prevention involves fostering open communication environments, avoiding negative comments about children’s body image. Media education is also crucial, encouraging diverse aesthetic standards to reduce narrow definitions of "ideal body shape." Community resources such as anonymous hotlines or online self-assessment tools can assist high-risk groups in early help-seeking.
Seek immediate medical attention if any of the following indicators are present: 1. Unexplained weight loss exceeding normal range within six months; 2. Abnormal appetite accompanied by physiological disturbances (e.g., amenorrhea, dizziness); 3. Severe eating-related compulsive behaviors affecting daily activities. Delaying treatment may lead to irreversible organ damage.
Early intervention for mild symptoms can significantly improve prognosis. Consider consulting a healthcare professional if you notice behaviors such as weighing oneself more than three times daily, refusing social meals, spending over an hour examining body parts in front of a mirror daily, or engaging in purging behaviors. Medical professionals can provide objective assessments and treatment plans.
When an individual's weight is significantly below normal and accompanied by pathological fear of weight or appearance, and physiological abnormalities (such as amenorrhea or low blood pressure) occur, immediate medical attention is necessary. If the patient’s refusal to eat leads to malnutrition or psychological assessments indicate compulsive weight loss behaviors, medical intervention is essential.
What is the role of family members in the recovery process?Family support is crucial. Family members should avoid criticizing dietary choices, instead providing non-judgmental communication and helping establish regular eating routines. In certain treatment models, such as family-based therapy, relatives are more directly involved in treatment decisions to promote emotional and behavioral adjustments in the patient.
Do all patients with anorexia nervosa require hospitalization?Hospitalization depends on the severity of the condition. If the patient exhibits cardiac abnormalities, electrolyte imbalances, or refuses outpatient treatment, hospitalization for 24-hour monitoring and nutritional support is necessary. Mild cases or those in recovery can be managed through outpatient follow-up, with regular risk assessments.
How does societal obsession with thinness affect treatment outcomes?The societal glorification of thinness can worsen pathological weight loss behaviors. Treatment should help patients develop healthy body awareness and promote diverse aesthetic values to mitigate recurrent symptoms or treatment refusal caused by social pressure.
Is ongoing follow-up necessary after recovery? What signs should be monitored during follow-up?It is recommended to follow up for at least 1-2 years after recovery, as the relapse rate can be as high as 30-50%. Close monitoring of weight fluctuations, recurrence of restrictive eating behaviors or compulsive exercise, and mood disturbances is essential. Long-term psychotherapy and nutritional counseling can effectively reduce the risk of recurrence.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
