Eating and food intake disorders are characterized by a persistent disturbance in eating that leads to impairment in the consumption or absorption of food and causes significant impairment in physical health and psychosocial functioning. . Eating disorders are similar in their basic symptomatology, especially in the intake and absorption of food, but they also present great differences not only in symptomatic behavior, but also in their consequences. For this reason it is so necessary to establish a differential diagnosis through the consequences and symptomatology; In this Psychology-Online article we share with you what those are. consequences of anorexia and what are its symptoms.
What is anorexia
Anorexia is one of those established by DSM 5 (2013), and is differentiated from the other disorders in this category by its three basic characteristics:
- Persistent energy intake restrictionthat is, not constantly consuming any type of nutrient.
- Fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain.
- Alteration in the way you perceive your weight and your own constitution.
In general, anorexia is recognized as a mental disorder characterized by its obsession with gaining body weight, a distorted perception that is almost delusional about one’s own body which makes one see oneself very fat even when the appropriate weight for the patient is is far below what is established. For this reason, behaviors aimed at fulfilling their obsession begin, such as a significant reduction in food intake (fasting, diets, exercises).
Two types of anorexia nervosa can be distinguished:
- Restrictive type: This subtype describes presentations in which weight loss is primarily due to diet, fasting, and/or excessive exercise.
- Binge/Purge Type: This subtype describes presentations in which the patient has had recurrent episodes of binge eating or purging (i.e., self-induced vomiting or inappropriate use of laxatives and diuretics).
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Symptoms of anorexia
The symptoms of this disorder manifest in several areas: cognitive, emotional, behavioral, perceptual and physical. Below we share the classification of each of them.
Altered perception
An alteration in the way one perceives one’s own weight or body constitution, a lack of recognition of the severity of one’s current low body weight.
emotional disturbance
The person expresses a lot of fear at the idea of suffering increases in body weight, which is often evidenced by symptoms very similar to a noradrenergic response or a state of alert (anxiety symptoms). They may also manifest depressive signs and symptoms, irritability, insomnia.
Cognitive symptoms
Cognitive errors occur about the intake and absorption of food (beliefs about food, figure or standards of beauty and weight, especially the information they have about carbohydrates, fats and proteins); and other ways of processing information (such as attention, illusory or delusional experiences that maintain correlations with dysfunctional behaviors).
Behavioral alteration
Persistent behavior that interferes with weight gain, even at a significantly low weight (for example, exercising excessively, purging in order to vomit, using laxatives, using diuretics or enemas, dieting that leads to considerable restriction of energy intake in relation to needs). Some patients with a presentation of binge eating and purging tend to accumulate prescriptions or food.
Due to the persistent fear of gaining body weight, subjects with anorexia nervosa constantly check their weight with some scale or do obsessive counting about your carbohydrate consumption and during their visits to the doctor they usually consume large amounts of water in order to avoid interventions that they believe are unnecessary.
In addition to behaviors related to the interest in avoiding body weight gain, patients may also manifest a Social isolation very marked and a decrease in interest in sex.
Physical/physiological or somatic symptoms
In addition to the obvious loss of body weight, the physical symptoms are very broad, below we share some of them:
- Amenorrhea, decreased menstruation.
- Abnormalities in vital signs (for example, irregular heartbeat, low blood pressure).
- Loss of bone mineral density, a reduction of the inner tissue of the bones occurs, which causes them to begin to weaken and become less dense, that is, the bones become more prone to fractures.
- Fatigue.
- Dizziness or fainting.
- Dental erosion, that is, wear of the tooth enamel caused by frequent and prolonged contact of the teeth with acidic agents (in this case they are exposed to them through vomiting).
- Swelling of the arms or legs.
- Formation of petechiae.
- Constipation.
- Complaints of abdominal pain.
- Carotenoderma which is the yellowing of the palms of the hand.
- Fragile and brittle nails.
- Calluses on the knuckles due to vomiting.
- Abnormal blood cell count.
- In pre-pubertal girls, menarche can be delayed.
In most cases of anorexia, the individual maintains a body weight that is well below the minimum normal level for his or her age, sex, and stage of development and physical health.
Psychological and emotional consequences of anorexia
Many times the diagnosis of anorexia nervosa is comorbid with other mental disorders, especially depressive disorders.
The psychological consequences of anorexia are mostly the concurrent diagnosis of a major depressive disorder, that is, the presence of the following symptoms:
1. Abulia and anhedonia
Loss of interest () and loss of pleasure () in activities that you previously liked to do.
2. Depressed mood
The patient is sad and depressed most of the day, almost every day. Feel deep sadness, emptiness, hopelessness…
3. Sleep disturbances
Which can be both insomnia and hypersomnia almost every day.
4. Agitation or slowing down
Psychomotor agitation or retardation almost every day.
5. Fatigue
Extreme tiredness or loss of energy most days (anergy).
6. Alteration of self-perception
Feeling of worthlessness or excessive or inappropriate guilt (which may be delusional) almost every day.
7. Cognitive difficulties
Decreased ability to think, pay attention, concentrate, or make decisions.
8. Thoughts of death
Recurrent thoughts about death can also be self-harming ideas or suicide plans.
Physical consequences of anorexia
In anorexia the following abnormalities can be observed in laboratory tests: Its presence can increase the reliability of the diagnosis:
9. Extreme thinness
The most notable findings on physical examination mentioned in DSM 5 (2013) are wasting (pathological thinning).
10. Low blood pressure
One of the biological alterations that is a common complication in anorexia is hypotension.
11. Low body temperature
Another consequence of anorexia from the group of biological alterations that lead to physiological instability is hypothermia.
12. Lanugo
Also the finding that some sufferers can develop lanugo, fine, soft body hair.
13. Alterations in hematology
- Leukopenia (low leukocytes), which is common with loss of all types of cells although there is normally an apparent lymphocytosis (increase in lymphocytes).
- There may be a anemia mild.
- Also thrombocytopenia (decrease in the number of platelets in the bloodstream)
- Sometimes, although not very often, there may be bleeding problems.
14. Endocrine disorders
- The levels of thyroxine (T4) in the serum they are normally at a low-normal level.
- The levels of triiodothyronine (T3) are diminished.
- While the levels of Reverse T3 They are elevated.
- Men have low serum levels of testosterone while women have low levels of estrogen in the serum.
15. Alterations in the electrocardiogram
The bradycardia sinus is common. Although in some patients a significant prolongation of the QTc interval is observed. That is, the heart rate is slower. The heart rate may be below 45 beats per minute when the normal rate is between 60 and 80. Arrhythmias can also be detected.
16. Alterations in bone mass
It is common to observe low bone mineral density, with specific areas of osteopenia or osteoporosis. The risks of fractures are significantly high.
17. Edema, ecchymosis or petechiae
Some patients develop peripheral edema (located in areas such as the legs, ankles, feet, arms and hands); Ecchymoses or petechiae are rarely observed and may indicate a hemorrhagic diathesis.
Social consequences of anorexia
Although some people remain active in professional and social spheres, others show significant social isolation or an inability to maintain academic or career potential.
Below we share some manifestations of social deterioration:
18. Not paying attention to responsibilities
Inability to attend to social, family and work/academic responsibilities. He invests most of the day in activities aimed at controlling his weight, which has the consequence of not being able to attend to his other interests or responsibilities.
19. Isolation
Little relationship with close people. Breakdown of emotional relationships (friends and romantic partners) that often occur due to altered body perception.
20. Interpersonal conflicts
The patient presents constant conflicts with members of his professional team. Conflicts are often related to bodily aspects. There are also constant family conflicts related to his body weight.
Family consequences of anorexia
This pathology causes serious deterioration in the families of those who suffer from it, for this reason the work that must be addressed with each member of the primary support network to solve this problem is highlighted.
Families often find themselves socially helpless precisely because of the lack of specific units, and because of the guilt that can generate.
Families bear the consequences of the disorder in a significant way, because they perceive themselves to be guilty for the patient’s symptoms; this often generates conflict and unstable or unstable relationships. constant confrontations among its members.
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist…