In my recent years of psychotherapy clinics, I often see young women who love beauty, who have been dieting excessively for a long time in order to keep their bodies in shape, resulting in extreme weight loss, the most serious of which even have difficulty walking, but they still think they are overweight and must carry out the diet to the end. They are college women, white-collar workers, models, singers and ordinary workers. Most of them came to the clinic at the strong request of their family members and friends, or even forced to come to the clinic. After detailed consultation and examination, they were finally diagnosed as suffering from “anorexia nervosa”.
Anorexia nervosa, also known as anorexia nervosa, is an eating disorder characterized by the patient’s morbid fear of obesity, body image disorder, and excessive pursuit of slimness. The patient usually intentionally causes a significant weight loss to below the normal physiological standard weight and tries to maintain this state. It is most common in adolescents, with the onset of the disease occurring between the ages of 10 and 30, and mainly affects females, with a male to female ratio of approximately 1:9.5.
The cause of the disease is not yet clear. Most experts believe that the occurrence of the disease is the result of multiple factors.
1, physiological and psychological factors: after the age of 13, is the fastest developing stage of sexual physiology and sexual psychology. For girls whose psychosexual development is still immature, they lack sufficient psychological preparation for the development of their secondary sexual characteristics and increasingly fleshy body shape, and are prone to fear and anxiety, shyness, and a strong desire to keep or restore their body shape to the “slim” before development.
2, social and cultural factors: social pressure can seriously affect the concept and behavior of individuals. In modern society, a slim body as a sign of ability, elegance, and attractiveness, so that low weight is favored by people, for example, the British slim as a symbol of self-control, elegant behavior, attractive, and energetic.
3, other sociological factors: In most surveys on the prevalence of anorexia nervosa, it is found that patients are mostly from families with high social status or more affluent economy; the prevalence of urban population is higher than that of rural population.
4, the individual’s susceptibility to quality: often competitive, do things perfectly, like to pursue praise, self-centered, neurotic; and on the other hand, often show immaturity, instability, suspicious and sensitive, over-dependence on the family, introversion, shyness, low self-esteem, etc..
5, family factors: parents overindulge, overprotective and interfering children; families with dieters or families talk too much about weight loss and physical beauty.
6, the occurrence of the disease may also have some relationship with certain genetic qualities.
Patients with anorexia nervosa due to long-term control of eating, and even constantly use fingers to stimulate the pharynx, so that the food eaten and then spit out, which artificially disrupts the normal neurophysiological reflexes, and gradually the brain “see” food signal is not excited, digestive juices secretion is also reduced, gastrointestinal peristalsis also slowed down, the face of the fragrant food also No longer feel hungry, but really from the heart feel disgusted, want to vomit, psychological and biological responses tend to be consistent, which indicates that the pathological neurological reflexes have been formed. At this time, no matter how to force them to eat, or even if they change their minds to eat on their own initiative, I am afraid it is too late, because at this time to eat for them is really more difficult than taking medicine. In the advanced stage, patients are depressed, emotionally indifferent, mute, and even have hallucinations and delusions. Despite the severity of the disease, they still do not admit the disease and have a negative attitude toward treatment.
The main manifestations of patients with anorexia nervosa are.
1. Deliberate abstinence from eating as a necessary symptom. The amount of food eaten is far less than normal, or only low-calorie foods are chosen. Some patients are unable to tolerate hunger and experience bouts of bulimia, alternating between less food or fasting and bulimia.
2. Weight loss. More than 25% lower than before or normal people.
3, extreme fear of gaining weight, often using excessive exercise, vomiting, diarrhea, taking appetite suppressants or diuretics, hiding or abandoning food to reduce weight.
4.Self-perceived fatness with body image disorder, or part of the trunk is too fat. Even if it has been obviously wasted. Still think it is not thin.
5, there are sexual function and sexual development disorders. Amenorrhea in women, hypersensitivity or impotence in men. In prepubescent individuals, the psychosexual and physical development is delayed.
6.Severe cases are associated with malnutrition, hair loss, swelling, hypotension, hypothermia, bradycardia, and even disorders of water-electrolyte and acid-base balance.
7.It may be accompanied by obsessive-compulsive symptoms and anxiety and depression.
8.Refusal to admit the disease and unwillingness to cooperate with the diagnosis and treatment. In particular, they do not recognize that low weight and low food intake are pathological.
Since the incidence of anorexia nervosa is increasing, and anorexia nervosa can cause physical and psychological damage to patients and even endanger their lives, the prevention and treatment of this disease has become very important.
First of all, society should promote “healthy beauty”, not the so-called “bone beauty”; promote a reasonable healthy diet, avoid eating less junk food. Do not lead to obesity after an unreasonable diet, and in order to lose weight, but to the other extreme – excessive dieting. Usually pay attention to the combination of work and rest, reasonable arrangements for work, life and entertainment; exercise often; good friends, and actively participate in group activities; good at talking, learn how to regulate and relieve psychological stress; develop their own hobbies; reduce the chances of psychological disorders.
When the patient has reached the diagnostic criteria of “anorexia nervosa”, he/she should be treated in a psychological clinic in time. Patients who are dangerously underweight, have rapid weight loss, are severely depressed or when out-of-hospital treatment is ineffective should be admitted to a hospital ward.