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What is anorexia?

Anorexia Nervosa is a serious eating disorder characterised by restricting food intake, distorted body image and a strong fear of gaining weight. Sufferers may also struggle with binge-purging behaviours or compulsive exercise. Many people will try to hide their behaviour, and may not realise how ill they are.

Around 6.5% of adults show signs of an eating disorder according to NHS research, although this is likely to be an underestimate. Of these, around 10% have anorexia. Although the majority of those diagnosed with anorexia are female, around 11% are male.

Anorexia has the highest mortality rate of psychological illnesses. It can cause serious physical complications, and has a significant impact on relationships, work and education. Early intervention is key, and so we need to be aware of eating disorders in order to identify and treat them as early as possible.

When things got too much or seemed out of my control I guess I turned to exercise for some sort of escape. My exercise became more and more, and my eating became less and less. My eating disorder started controlling and ruining me and my life.

Why might someone develop anorexia?

It isn’t known exactly what causes anorexia, and there are probably a combination of factors. Some risk factors for developing anorexia and other eating disorders include:

• Genetic predisposition and neurochemical factors, which research is starting to look into more
• Certain personality traits, such as perfectionism, or an obsessive or rigid personality
• A family history of eating disorders
• History of other mental health disorders (e.g. depression, anxiety)
• A strong focus on weight and body shape, for example because of pressure from society or work (e.g. dancers, athletes or models)
• History of sexual abuse, bullying or trauma
• Low self-esteem – feeling worthless or not good enough. For some, anorexia can give a sense of achievement
• The overemphasis of modern Western culture on thinness being equated with worth
• Anorexia most commonly begins in teenage years (although can develop at any age). This may be due to body changes during puberty, increased peer pressure and increased pressure from society
• Stressful life changes (e.g. relationship break-ups, bereavement, a new job or school)
• Difficulty expressing feelings
• Isolation or lack of social support
• Weight loss and food restriction – effects of starvation on the brain can include rigid thinking, reduced appetite, depression and obsessive-compulsive behaviours. This can become a vicious cycle, where the effects of starvation influence anorexia thoughts, which in turn increases the distress of anorexia and likelihood of continuing to restrict intake.

Social stigma and attitudes

There can be many misunderstandings of anorexia – for example, that the disorder is ‘vain’ or ‘superficial’ that it is ‘self-inflicted’ or a choice, and that sufferers need to ‘Just eat!’ This can result in trivialising or invalidating the intense distress of anorexia, rather than viewing it as a serious medical condition requiring treatment.

Some research has found that stigma (whether from the perceptions of others or coming from the individual towards their illness) influences recovery. Lower perceptions of stigma have been found in some research to be associated with better attitudes towards recovery and motivation to recover.

It is therefore important to challenge stigmatising attitudes, to increase knowledge and information about eating disorders, and to encourage individuals to seek support.

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