Anorexia Nervosa
My fingertips could easily touch as I wrapped my tiny hands around her upper arm. Her face
looked the color of chalk and her eyes and cheeks looked sunken in like there was some
imaginary force pulling on them from the inside. She was once a member of the high school
dance company and the soccer team but now she seemed to be struggling for her life. Tears
flowed down my face as I looked into her eyes and pleaded
for her to get some help. This was my best friend. She had
been struggling with Anorexia for just under a year and every
time I saw her she seemed to be getting worse and worse.
In the beginning she had a little extra weight that she
wanted to lose so she could better compete and perform in the
activities she participated in. She then started losing
weight...quickly. She would spend hours and hours at the gym
working out every single part of her body she could think of
and she would never eat more than a couple granola bars and
fruit snacks a day. She had reached her goal weight within a
month but she just kept losing more and more weight. It wasn't until about 7 months had gone by
that I really started to notice something was very wrong. I would ask her about it but she would
quickly turn away and say "oh it's nothing, just a little diet to get ready for the summer."
Concerned I began asking around and researching what could possibly be going on with my
friend and I came to the conclusion that she was suffering from anorexia.
"Anorexia nervosa is a serious and sometimes deadly disease in which a person restricts their
intake of food causing an extremely low body weight and a distorted image." (Greenblatt pg.19)
Although anorexia occurs in both men and women, ninety percent of the cases occur in women
and in that ninety percent most of them are adolescents between the ages of fifteen and nineteen.
In the United States about 1 in every 100 girls suffer from anorexia. Overall 8 to 11 million
people struggle with eating disorders (Greenblatt pg.18). Most people don't even know that
someone has anorexia at all because they are masters at hiding it. Sometimes they are even
complimented in their early stages because of their thinness and the amount of exercise they get.
Only when they become sickly thin do people start noticing that something is wrong.
When someone becomes anorexic they suffer both physical and psychological symptoms.
Because they are quite literally starving themselves, they suffer from many physical symptoms
such as a very low body weight, anemia, bone loss, brittle dry nails, fatigue, weakness, growth of
baby fine hair all over the body, missed menstrual periods and irregular heart rate among many
other symptoms. The psychological symptoms include fear or refusal of eating even when
hungry, intense fear of weight gain, altered body image, anxiety, depression, withdrawal,
irritability and secretive behavior. All of these symptoms of anorexia have some effect or another
on the body. It effects the cardiovascular system, digestive system, endocrine system just to
name a few (Levenkron 33-34).
I often wondered to myself how would I know if someone I know is anorexic? For this, the
Diagnostic and Statistical Manual of Mental Disorders IV has given us four criteria for the
diagnosis of anorexia nervosa. First, they have a refusal to maintain body weight at or above a
normal weight for age and height. Next, they have an intense fear of gaining weight or becoming
fat, even when underweight. Thirdly, their self-perception is grossly distorted and they have
weight loss that is not acknowledged. Last, for women who have already begun their menstrual
cycle, they may miss their menstrual periods (Greenblatt 25).
Many times as I sat talking to my friend about her disorder I asked her "what made you
become anorexic?" She told me that there wasn't one particular thing that turned her to anorexia
but it was a bunch of little things. She then however, did proceed to tell me one big reason that
influenced her. "Societal pressure" she said. "No matter what you want in life it pays to be thin."
I was somewhat bugged by that answer and then proceeded to find out some more information
on my own. As I was researching I came across many factors that could influence anorexia but I
narrowed it down to the five most popular causes mentioned which are societal pressure, genetic
influences, personality traits, family dynamics, and dieting. With societal pressure women in this
society, just like my best friend, often measure themselves against what they see in the media.
They see super skinny models on the cover of magazines and on
TV and they think that they have to look like that or they won't
be attractive. This idea then sinks into their head and that causes
them to diet. Women judge themselves harshly on their outward
appearance and they think that they must conform to this ideal
of a thin body in order to obtain true feminine beauty. Some
studies have even been done of schoolchildren and the data is
shocking. One example said "45 percent of those in grades three
through six say they want to be thinner and 37 percent have already dieted" (Greenblatt 31). That
is a scary thought knowing that at that young age they already have pressure to be thin.
Another cause of anorexia is genetic influence. Although a person with certain traits are more
likely to become anorexic it doesn't mean that a person with these traits has or will have
anorexia. Anorexia does seem to run in the family and if someone in your family has had
anorexia you are 10 times more likely to become anorexic yourself. According to a study in the
Archives of General Psychiatry they found that more than half of the risk for anorexia can be
attributed to genetic make-up.
Personality traits also have quite an impact on anorexia. Studies have shown that certain
personality traits have been linked to anorexia such as perfectionism, neuroticism, harm
avoidance, anxiety, insecurity, rigidity, need to control, low self-esteem and a lack of selfdirection. Many of these personality traits make the person very vulnerable to eating disorders.
Family dynamics is another cause of anorexia. Some people think that family dysfunction lies
at the core of this disorder. Some families become too close and too meshed together that they
start making decisions for each other and those individual boundaries are then crossed. In these
types of families they speak for each other and intrude on each other's feelings. This then causes
the individual to feel helpless without any control to govern themselves which leads to the only
thing they feel like they do have control over and that is their bodies. Women, especially young
women, want to feel like they have control and make their own decisions but when that is taken
away they feel vulnerable and insecure which may in some cases lead them down the path of
anorexia.
The last cause is dieting, and we all know how much
pressure society puts on the women in general to look
young, thin and beautiful all their life. Many women
however, are not that way and that further brings them to
the conclusion that they must diet. There are many healthy
ways to lose weight but some women choose to severely restrict their diet which can become
detrimental to both mind and body and may, in turn, promote anorexia. Many women who
restrict their intake of food to extremely small amounts can begin to have obsessive thoughts and
behaviors about eating and they can even foster an "all or nothing" attitude which can be very
dangerous to the health of your body. It can also promote isolation in your life, anxiety, poor
self-esteem, poor nutritional choices and it also interferes with the body's signals of hunger and
satiety.
I sat as I watched her laying on a hospital bed with tubes in her arm and down her throat. I
was terrified and relieved at the same time. Terrified of what might happen next but relieved that
regardless of the treatment, she was getting the help that she needed. She came to the point
where she got so sick that she could no longer control what happened and she almost lost her
life. Thankfully, due to the many outreach programs for anorexia, she is alive and well today.
Anorexia is real. My friend was one of the lucky ones who survived but many do not. It is very
important to know and understand the many causes of anorexia so that if needed you may
provide the help that someone needs that could ultimately save their life.
Works Cited
Greenblatt, James M. Answers to Anorexia. Minnesota : Sunrise River Press, 2010. Print.
Levenkron, Steven. Anatomy of Anorexia. New York: W. W. Norton & Company, Inc., 2000.
Print.
Wardlaw, Gordon, Anne Smith, et al, comp. Contemporary Nutrition:A Functional Approach.
Custom. United States: McGraw-Hill Companies, 2012. 484-89. Print.