Anorexia. What exactly is it? Are there any particular social groups it affects? What are the symptoms? What are the causes? What are the treatments? How many individuals does it affect? What is bulimia?

Over the last few decades anorexia has become more and more frequent. From the perspective of the psychotherapist, anorexia is primarily a gender condition particularly among young adolescent females where it begins after first menstruation. Because anorexia symptoms continue beyond 6 months, it is classed as one of the psychological disorders. Treatment therapy requires lengthy periods of time because it is long-term throughout the adolescent years.

Feminine adolescent psychology obsessions with being overweight and food can become severe to the extent that it can disrupt everyday living. Secret obsessions with food lead to the individual becoming undernourished and dangerously underweight. Many adolescent anorexics have dry skin with painfully thin and almost skeletal appearances. Fear of putting on any weight leads to many anorexics establishing elaborate rituals where they weigh themselves before and after eating.

What triggers anorexia is the hormonal changes and rapid increases in body weight young women experience during the start of their adolescent period. Fear of not being able to control their body weight leads onto the development of anorexia. About 3-4% of the female population experience anorexia during their teenage years with some occurrences of anorexia continuing into their twenties.

Specific physiological symptoms are manifested by anorexics. Such as dry dehydrated skin, callouses on the back of hands, puffy face, puffy fingers, discoloured teeth, cold hands and feet. Many anorexics have fatigued appearances displayed in their skin. Another symptom is involuntary hand clenching. Yet another symptom manifested is tingling in the hands and in the feet. At this stage of the condition, starvation diets have profound psychological and physiological effects.

Behavioural symptoms manifested by anorexics include excessive exercising for long hours of the day to keep weight under control, wearing oversized clothes to hide the emaciated frame they have, avoiding taking food by hiding or disposing of food or by periodic vomiting. Many avoidance strategies regarding food are practised by anorexics such as washing the dishes or cleaning up at the family meal. Instead of eating, anorexics always find new ways to divert family attention away from the fact that they are actively avoiding food.

Much more serious patterns of disordered behaviour include dangerously low or high levels of fluid intake such as either drinking too little in order to control weight or drinking too much in excess to make it easier to secretly vomit their food. By diluting the blood like this, low plasma and sodium levels can cause kidney disease. Any secret starvation diet leads to loss of blood glucose and therefore energy with minimal amounts of glycogen in the liver. Blood becomes alkaline due to loss of potassium, chloride and bicarbonate.

Some of the commonly identified causes of anorexia are the following: fear of being fat, feelings of being in control regarding food, social approval from social pressure to stay slim, body image distortion, social withdrawal, family strife, low self-esteem, bereavement from the loss of parents, seeking to achieve an autonomous teenage identity as an act of rebellion against overbearing and interfering and overdemanding parents and secret sexual abuse from parents. Having to meet high expectations while living in the shadow of high achieving parents is another reason.

In fact, distorted thought processes at the root of anorexia nervosa are so extreme with regard to body image that they are in fact classes as delusional disorder. Distortions of perceptions regarding body weight can be stopped by anti-psychotic medications. Anti-anxiety drugs stop anticipatory anxiety and are beneficial in any dietary intake therapy designed to encourage normal eating. Negative automatic thought processes can only be changed by cognitive behaviour therapy.

Upon starting dietary therapy, psychotherapists can focus on food intake issues, nutritional requirements, meal planning and how to change the eating patterns of those previously following starvation diets. Early in the therapy there has to be close observation of the anorexics eating habits. Until the anorexic individual loses the sense of control and empowerment that distorted thoughts provide them with the starvation diet mentality will become entrenched.

Not only are there physiological symptoms associated with anorexia, there are some other symptoms which we have to consider. Such as self-harming, suicidal thoughts, obsessional thoughts, diabetes. To affect any changes in behaviour and attitude will take at least 6 months. Unless social factors, personal factors, interpersonal factors which foster the disorder can be challenged by psychotherapy there will be no improvement.

Group psychoeducational therapy is particularly valuable when treating anorexia as distorted thought processes can be influenced by education based therapy. Parents have to be taught the basic facts about the physical and psychological symptoms of anorexia. Even the anorexic has to be educated about the condition. Each of these steps has often proved to be beneficial for the anorexic.

Whenever supportive psychotherapy is introduced there are positive progressive improvements in the condition of the anorexic. Despite this, there is still the danger of the anorexic relapsing back into dangerous purging habits. While cognitive behaviour psychotherapy and counselling lead to individuals being able to overcome anorexia , it requires comprehensive treatment to challenge entrenched body image obsessesive thoughts.