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Anorexia Nervosa Can’t Be Left Untreated – Here’s How to Get Help

When left untreated, the eating disorder anorexia nervosa can wreak havoc on a person’s physical, mental, and social health.Long-term lack of nutrition, from calories to vitamins, overwhelms the body and brain. Even in the short term, physical consequences can be severe. Anything from heart failure to the hair falling out might result if disordered eating habits continue and steps aren’t taken to get help.

Anorexia nervosa, like other eating disorders, begins with distorted body image, known as body dysmorphia. This condition is common to all eating disorders. In cases of anorexia nervosa, the person suffering body dysmorphia believes their body weight is too high or that they are “fat,” even when they’re medically underweight or even emaciated.

As the personal costs of untreated eating disorder symptoms add up, quality of life starts to plummet, necessitating an immediate change. On a more positive note, anorexia nervosa treatment centers can provide effective treatment in most cases. Here, we’ll discuss how anorexia nervosa develops, what kinds of negative consequences it can have, and how treatment can help people gain a full recovery.

Disordered Thinking Leads to Disordered Behavior

People with anorexia nervosa start to develop disordered thought patterns and eating attitudes that trigger their change in behavior. This manifests as feelings of anxiety when confronted with the prospect of eating certain kinds of food, sharing a meal, and an obsession with counting calories. It’s quite common for anorexia nervosa patients to develop rituals around what and how they eat, like refusing to eat one food if it touches another on the plate.

Restricting food intake is central to anorexia nervosa; it’s a way to regain control over a life that feels like it has none.

In some cases of anorexia nervosa, excessive exercise is another method of control over the fear of gaining weight. They may feel a compulsion to exercise in order to eliminate the calories they took in, no matter how few they actually were.Unfortunately, exercise can provide dopamine releases similar to that found when a person is feeling happy or has taken a narcotic drug. The excessive exercise or food restriction can become almost like an addiction.

Because the disordered behaviors can become compulsive in this way, treatment for anorexia nervosa usually begins with addressing the root causes, such as negative body image, before moving on to eliminating the behaviors. In terms of body image, people with anorexia nervosa cannot always see a realistic depiction of themselves in the mirror or pictures. Therapists working with eating disorder patients will often use mindfulness techniques and cognitive retraining to help identify which self-perceptions are flawed, and then move on from there to eliminate them.

Unfortunately, there’s no simple way for family and friends to change these perceptions without professional psychiatric help. By acquiring professional care, they can challenge the disordered thoughts and replace them with positive and adaptive ways of thinking.

Anorexia Nervosa and Mental Health Decline

As people with anorexia nervosa continue to act compulsively, the lack of sufficient nutrition can also negatively affect other aspects of mental health. Their symptoms may include difficulties concentrating, irritability, and high stress levels. Dramatic swings in emotion might also occur since mood swings and an inability to regulate emotions are symptomatic of a brain operating without enough fuel.

Anorexia nervosa and other eating disorders can also trigger or exacerbate other mental health conditions. The disordered and negative thought patterns that commonly affect people with eating disorders can make them feel depressed and anxious. Clinical depression and a variety of anxiety disorders occur much more frequently in people with anorexia nervosa than in the general population. These disorders can work hand-in-hand with anorexia nervosa; the shame and guilt that come with disordered eating behaviors fuel the depression, which fuels further disordered behavior, and so on.

Most inpatient treatment centers have a system of treatment in place for these co-occurring disorders. Treatment of all co-occurring disorders helps uncover the mental health conditions, their symptoms, and providing coping tools to support those on the path to recovery. The coping techniques and mindfulness practices learned in treatment can be continued long after leaving the treatment center.

The Physical Effects of Anorexia Nervosa

Calories are the basic fuel of our metabolism. The body simply can’t operate without enough of them. When caloric and nutritional intake is curtailed, various physical symptoms can appear quickly. They may include:

  • Dizziness
  • Nausea
  • Stomach pain
  • Bloating
  • Constipation
  • Fatigue
  • Headaches
  • Weakness

In a longer-term sense, the body may decrease its metabolism in an attempt to conserve available calories, leading to lower body temperatures. They may also feel cold constantly and experience swelling of the joints in the hands and feet. Sometimes, people with anorexia nervosa may develop lanugo, or a spread of fine hairs across the entire body, even when the hair on the head is falling up.

Hormone production is normally interrupted in severe cases of anorexia nervosa. A decrease in the production of thyroid hormones can result in muscle aches, joint pain, and itchy skin. The lack of adequate thyroid hormones also exacerbates certain anorexia nervosa symptoms, such as drying skin, anemia, and general weakness.

Malnutrition can eventually lead to a seriously compromised immune system and a high risk of infections. It can also result in damage to the heart, kidneys, and other organs as the body struggles to keep going without fuel.

Disruption of Social Life

As a result of feelings of guilt and shame about their bodies and their disordered eating behaviors, many people with anorexia nervosa start to withdraw from their social circle. It’s common for people with anorexia nervosa to completely skip any events that involve eating, like restaurant visits or barbeques. This kind of withdrawal is also common in cases of depression and anxiety, which commonly co-occur with eating disorders, creating a “perfect storm” of social withdrawal.

Various studies have examined the role that social support plays in the treatment of mental health disorders, including eating disorders. In essence, these kinds of disorders tend to create negative feelings and poor self-esteem in the patient, which leads them to avoid social situations, break appointments, and withdraw from even their closest friends and family.

It is for this reason that most eating disorder treatment programs make family involvement a priority and work with the significant others and family of their clients to create a strong social support system. These programs include sessions during active treatment as well as setting the foundation for activities when the patient returns to the “real world.”

Family programs should be designed to make everyone feel directly involved in the care process. Family members can attend special programming events to learn and support their loved ones in treatment.

Group therapy is also a huge part of reconnecting socially during inpatient anorexia nervosa treatment. The group therapy sessions are often the client’s favorite part of the treatment and recovery experience. Many people from all walks of life feel like other people can’t understand their perspective or where they’re coming from, and this is equally true with people suffering from anorexia nervosa. Group therapy sessions with people who know what you’re going through create a space where everyone is on the same page.

Getting Started on Treatment and What to Expect

After all these frightening possibilities, thinking about finding help for anorexia nervosa might seem overwhelming. Luckily, there is an effective treatment program available for almost every case of anorexia nervosa and other forms of eating disorder. In fact, over the past 30 years or so, eating disorder treatment has benefited from greater understanding in the medical and psychiatric communities as well as the general public.

Perhaps the greatest advance in treatment philosophies in the past 30 years is the increased understanding of the client’s intersectional needs. For example, it was often assumed for decades that anorexia nervosa and body dysmorphia only affected straight cisgender white women. Leading ED treatment centers like Monte Nido have put programs tailored for previously-ignored demographics at the forefront.

This means that people entering residential eating disorder treatment programs can expect personalized treatment that’s sensitive and responsive to gender, race, sexuality, and socioeconomic status. In 2020, no one should expect to be forced into a “cookie-cutter” eating disorder treatment program that does not take their needs into consideration.

The first step for people who are suffering from anorexia nervosa, or for their loved ones who want to help, is to reach out to a professional.  This can be your doctor, your therapist, or a treatment center. Monte Nido and affiliates have admissions specialists available to help people assess their needs in treatment and organize their admission into the facility (or setting up their outpatient sessions). These specialists collect the information they need to find the right level of care for each client before passing it onto the treatment team.

During this initial assessment, the admissions specialists will go over the potential client’s medical information, psychological profile, and history with eating disorders to determine how to proceed. They’ll go over available programs and locations with the potential client and their families, as well as discussing insurance and other financial considerations. People with anorexia nervosa are given a chance to make their admissions appointment at that time to start the care process.

Before committing to admission, the clients will have a chance to tour the facility, either in person or virtually, and talk to the staff. Every effort is made to acclimate the client to the center’s layout and schedule as soon as possible. If medical treatment is necessary to stabilize the client’s health before engaging in therapy and psychiatric treatment, the center can facilitate said treatment with a hospital or their own in-house medical staff.

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.