Anorexia: what causes it and what can help?

Anorexia is an eating disorder. It often starts in puberty and impacts not just eating behaviours but also self-image and body perception. But what exactly is anorexia? Those affected are not capable of building and maintaining a healthy relationship with food. They are afraid of gaining weight and have a distorted image of their body: they consider themselves overweight, even though they are not. Anorexia can have long-term developmental effects in children and adolescents who are still growing.

Anorexia can be identified by a number of symptoms. Possible physical signs include:

• Severe weight loss or a very low body weight for the respective age and height
• A fear of gaining weight or being perceived as overweight
• A distorted perception of one’s own body, constant dissatisfaction with figure and weight
• Irregular or absent menstrual periods

In addition to the physical symptoms, there are typical behaviours associated with anorexia. These are often the result of fear of weight gain. Those affected

• check their body weight very frequently;
• eat secretly or lie about food intake;
• withdraw from social activities, especially if they are related to food;
• eat very slowly, crush the food or avoid meals;
• obsess over the topics of calories and nutrition;
• do an excessive amount of sports, even when sick;
• avoid certain food groups or follow extreme diets.

Do you suspect that your child has anorexia? Try to talk about it, be empathetic and offer your support. If necessary, seek professional advice and support from a doctor or therapist on anorexia nervosa in teenagers and children.

What BMI is classed as anorexic?

17.5 kg/m² is the maximum BMI (Body Mass Index) in anorexia nervosa. A level of 14.5 kg/m² or less is life-threatening. Since BMI is age-dependent, these specific values do not apply to anorexia in adolescents and children. Generally speaking, BMI is not the only criterion for diagnosing anorexia. This is due to the fact that it only takes into account weight, height and age. However, this does not allow any direct conclusions to be drawn about body composition, such as muscle or fat percentage. BMI does not take into account individual differences in physique either.

Anorexia is a complex condition that can be caused by various factors. Psychological aspects can play a role, for example a perfectionist attitude, a strong need for control, low self-esteem or difficulties in dealing with emotions. Those affected will then resort to controlling food intake and body weight to cope with stress or negative emotions.

The causes of anorexia may also include social factors: the pressure to conform to certain beauty ideals can promote the development of anorexia in some people. Children and young people in particular are exposed to such ideals, for example when they use social media. Family dynamics and interpersonal relationships can also have an impact. Conflicts, unreasonably high expectations or a lack of emotional support increase the risk.

In addition, genetic and environmental factors, psychological susceptibility and certain life events can have an impact on the risk of anorexia. Stressful life circumstances, such as a change of school, parental separation or bullying, can be a trigger. Such events often lead to a sense of helplessness and despair, especially among younger people. Sufferers then try to achieve emotional stability by controlling their diet and their weight.

When it comes to anorexia, the earlier the illness is detected and psychotherapeutic treatment is initiated, the better the chances of recovery. The speed of the recovery process depends on the severity of the condition, the duration of symptoms, and the support people receive.

Treatment for anorexia usually consists of a combination of psychotherapeutic support, nutritional counselling and medical care.

Psychotherapy often takes the form of cognitive behavioural therapy. In the process, those affected learn to recognise and change unhealthy thought patterns. In nutritional counselling, individuals impacted and their families receive support to promote balanced eating behaviour. Some cases require additional medical treatment – especially if the anorexia has led to physical symptoms.

Specific measures for dealing with anorexia may include:

• A recovery meal plan: a recovery meal plan can aid recovery from anorexia. It is adapted to the individual needs of those affected and can help them to plan regular and balanced meals.
• Self-help and support groups: engaging in conversation with other sufferers can be very valuable. The groups offer support, understanding and practical tips from those who have experienced anorexia. A psychotherapist accompanies the participants.
• A diary: recording thoughts and feelings in a diary creates structure. This can help those affected to gain awareness of their own patterns and triggers.
• Relaxation techniques and mindfulness: methods like yoga, meditation or mindfulness for stress reduction can help people affected to cope with stress and create a deeper connection to their own body.

Anorexia can have various consequences, including long-term effects. The most common include:

• Osteoporosis (bone loss)
• Cardiovascular disease
• Renal dysfunction
• Impaired concentration
• Frequent infections
• Water retention
• Infertility
• Growth and development disorders in children and adolescents
• Other mental health problems like depression or anxiety disorders
• Withdrawal, neglecting social contact and interests

Just like other illnesses, the sooner anorexia is treated, the better. Both sufferers and family members should be cautious and take any potential signs seriously.