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This post was written by Gia Marson, Ed.D.
Eating less than your body needs can be harmful—it can interfere with your health, relationships, and development. Worst of all, it can be life-threatening.
Anorexia nervosa is a complex, serious illness emerging from a combination of genetic vulnerability, temperament, and personality traits, combined with environmental, physiological, and sociological components. What makes the impact of the significant nutrition deficit dangerous is that it sets off the potentially devastating physiological and psychological effects of starvation.
The harsh reality is that mortality rates are higher for those with anorexia nervosa than for those with other mental illnesses and six times higher for them compared to the general population.
“Our study shows a very clear and substantial biological component to anorexia nervosa, and my hope is that this will offer some support to patients and their families.” —Cynthia Bulik, Ph.D.
Choosing to diet is not the same as choosing to have anorexia
It’s not your fault. However, only you can choose recovery. While anorexia nervosa can start with rigid eating beliefs and behaviors—such as restricting food or setting strict food rules in order to achieve a certain physical appearance—it’s not a fad or a choice. It impacts people across many categories: genders, body shapes and sizes, races, ages, ethnicities, and socioeconomic backgrounds.
“The United States national comorbidity study shows that 25% of anorexia nervosa... presentations are male. So this is not an insignificant minority anymore … It’s substantial.” —Stuart Murray, Ph.D.
People with anorexia nervosa have an intense fear of weight gain and a distorted image of their body. They also often don’t recognize the potential for serious health consequences related to imposed nutritional deficits, overexercising, muscularity-oriented eating, muscle building, or refusing to maintain an adequate weight for their sex, age, developmental status, and health condition.
You may think that you are not sick enough
Even if you have been diagnosed with anorexia nervosa or suspect you have it, you may find it hard to believe. Or you may think you’re not sick enough. Chances are, if you’ve considered whether you’re “sick enough,” you probably are.
These common beliefs can prevent you from engaging in treatment or getting started in the first place, despite the eating disorder causing unwanted havoc in your life.
Effective treatments have common goals
The specific paths to nutritional restoration differ from person to person. But a non-negotiable agenda is to meet your body’s energy needs through food to restore healthy physiological functioning of your organs, hormones, metabolism, and more. Medical management is necessary. Depending on your symptoms, you may also engage in therapy, nutritional counseling, and/or psychiatry. Evidence-based treatment for anorexia nervosa include family-based therapy (FBT), cognitive behavioral therapy-extended version (CBT), adolescent-focused therapy (AFT), and more. The three tips below can help with anorexia recovery and relapse prevention.
Tip #1: Make food your medicine
The key to getting your health back is to view food as your medicine. The most important message I share with clients and their families is this: Don’t get distracted by how you got to this point. Instead, focus on what you’ll do to get the food you need to restore your brain and body to health.
Your brain needs ample nutrition over a period of time before it will get out of starvation mode. Once it does, your body and mind will get the message that you no longer have to conserve energy, and your cardiorespiratory, gastrointestinal, endocrine, metabolic, dermatologic, and psychiatric systems can return to normal functioning.
Tip #2: Build your team
When you begin reintroducing enough food, careful medical monitoring is required because of the potential for dangerous electrolyte shifts. For parents leading a child or adolescent’s recovery using family-based therapy, it is essential to partner with a medical provider. You may also consider getting assistance from other professionals. A registered dietitian can guide your nutritional restoration, and a skilled therapist can help you tolerate the process of nutritional rehabilitation and reckon with personality traits or cognitive habits that may hinder full recovery.
Identifying a trusted parent, partner, or friend who can help you stay accountable to your health is another way to have support as you develop a realistic recovery plan.
Tip #3: Make your life bigger
While eating more is a first step, there is plenty of evidence to suggest that it may not be enough. Beyond food, it may be necessary to target traits or symptoms that may keep you from full recovery or may make you vulnerable to relapse, such as perfectionism, anxiety, cognitive rigidity, fear of specific foods, harsh self-talk, body dissatisfaction, obsessiveness, or intolerance of uncertainty.
Equally as important, introduce positive people and activities into your life. Make time to do more of what you enjoy, and spend time with people you care about. Full healing comes about when you experience the freedom to thrive based on your authentic self and live according to your values. You may want to consider how to curate your social media environment.
“We’re seeing so much on social media that makes us feel like we are less than, or we’re not what we should be, that you kind of need a mantra to repeat in your head when you start to have harmful or unhealthy thoughts.” –Taylor Swift
Recovery is a leap of faith worth taking
Even if you are ambivalent about recovery, start early for the best chance to fully recover and live without lasting medical consequences.
It may seem daunting to recover if your brain and body are dealing with the effects of starvation. But life on the other side is worth it. In full recovery, you’ll be able to laugh more easily, know what you want with greater clarity, and use your natural strengths such as persistence when things are difficult. Moreover, you’ll foster a drive for achievement in the direction of leading an intentional, full, happy, healthy, thriving life.
References
Gaudiani, Jennifer. (2019). Sick Enough: A Guide to the Medical Complications of Eating Disorders. New York: Routledge.
Hudson, J. I., Hiripi, E., Pope, H. G., Jr, & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61(3): 348–358. https://doi.org/10.1016/j.biopsych.2006.03.040
Murray, S. B., Loeb, K. L., & Le Grange, D. (2018). Treatment outcome reporting in anorexia nervosa: Time for a paradigm shift? Journal of Eating Disorders 6: 10. https://doi.org/10.1186/s40337-018-0195-1
Watson, H. J., Yilmaz, Z., Thornton, L.M., et al. (2019). Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nature Genetics 51: 1,207–1,214. https://doi.org/10.1038/s41588-019-0439-2
Fast Facts on Eating Disorders. Academy for Eating Disorders. https://www.aedweb.org/resources/about-eating-disorders.
