Anorexia Nervosa / Anorexia
If a person suspects that he / she or a loved one is suffering from Anorexia, it is important to remember that the condition is treatable and seek the help of a professional as soon as possible.


What is anorexia?

Anorexia is a behavioral pattern where the person limits his / her energy (kilojoule / calorie) and food intake so that it is lower than the minimum expected for people in a similar situation (eg in relation to gender, age, health and level of development). The person also has a great fear of being “fat” and makes sure that he / she prevents them from gaining weight. The person's experience of his / her physique is usually overly negative, and this has a major impact on his / her evaluation of himself / herself. The person's fear of being “fat”, and the accompanying anxiety about weight gain, is not relieved by his / her weight loss, but there is a sense of pleasure due to the addictive elements of the behavior, as mentioned above.

In some cases, the fear of being “fat” is not present, or not conspicuous.


What can make ME vulnerable?

  1. Temperaments that are more prone to anxiety and perfectionism are more susceptible to anorexia.
  2. Environmental factors and genes also play a role.
  3. Cultures that attach great importance to being lean are more vulnerable to eating disorders, as well as occupations where people are preferred to be lean, e.g. an athletics career and modeling work.
  4. People who have close relatives with symptoms of anorexia nervosa and / or other addictions are also more vulnerable to developing the symptoms themselves.
Did you know?
  1. Anorexia is most common in teenage girls and young women, usually between the ages of 16 and 20.
  2. About one percent (1%) of teenage girls suffer from anorexia before the age of 18 years.
  3. Girls are 90% more likely to develop anorexia than boys.
  4. Anorexia usually begins between early adolescence and young adulthood.


Risks / consequences

Anorexia is a very serious condition that needs professional help. The symptoms usually lead to:

  1. isolation and loneliness;
  2. problems in meeting the requirements set at school or work;
  3. health problems (at an advanced stage it can lead to organ problems, brain injury and heart failure);
  4. the risk of dying from anorexia is greater than with other eating disorders; and
  5. The risk of suicide can also be high for people with anorexia.


What are the symptoms of anorexia?

The following symptoms are indicative, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5), which is widely accepted as the most authoritative source worldwide. Please note Please note that an official diagnosis may only be made by a qualified person.

To be diagnosable, the following symptoms must occur:

  1. inability to maintain body weight above the minimum expected weight for height and age; less than 85% of expected body weight;
  2. intense fear of gaining weight and being "fat" even if the person is underweight;
  3. perception of body image disorder; excessive emphasis on the influence of physique and size on self-esteem; denies the severity of malnutrition; and
  4. associated physical illness (s) secondary to starvation (eg amenorrhea for longer than three months, or menstruation only after estrogen administration).

Anorexia can be further distinguished by:

  1. Restrictive type
    The person does not control his / her intake of emptying procedures, e.g. self-induced vomiting or use of laxatives, enemas and diuretics.
  2. Overeating / emptying type
    In the current anorexia cycle, the person has frequent episodes of overeating and emptying sessions (binge / purge).
Did you know?
Anorexia does not only occur among teenage girls; anyone from the age of 12 can experience eating disorders. So should parents of children and teens; even the children of the elderly, also be aware of the symptoms (since anorexia also occurs among the elderly).


Treatment of anorexia

Why is treatment needed for anorexia?
It is important for someone with a severe eating disorder, such as anorexia, to get help. Freeing yourself from the condition - without help - is extremely difficult. Medical, as well as psychological and psychiatric help is essential in the treatment of an eating disorder.

Who can diagnose me or a loved one?
Because anorexia is so complex, we would recommend that you be tested and diagnosed only by a clinical psychologist or psychiatrist. They are trained to distinguish between the different conditions.

What role does a psychologist play in my treatment?
A psychologist can diagnose anorexia and treat it psychotherapeutically. This means that he / she can help you understand what your diagnosis is, how to live with it and how to apply a strategy that can lead to behavior change. A psychologist in South Africa may not prescribe medication and usually works with a psychiatrist in a team.


What can I do to manage my illness?

  1. builds knowledge about anorexia (ask your doctor, read about the disease, ask questions until you understand);
  2. sleep enough;
  3. reduce stress factors as far as you are in control; and
  4. get psychotherapy from a trained psychologist who can help you learn important skills to control anorexia.


Advice for loved ones and family members who live with or work with someone who has been diagnosed with anorexia

If a loved one is diagnosed with anorexia, your support and motivation can play an important role in accepting and managing their diagnosis. Here are guidelines on how to assist such a person:

  1. Be patient. People who suffer from an eating disorder do not always have the ability to say how they feel or what they are experiencing. Give them a chance to get used to the diagnosis first and gradually work out a concrete plan for how they will manage their lives going forward.
  2. Be informed. Build knowledge about anorexia. The more you and your loved one, family member or colleague know about the disease, the better you can work together on how you can support him / her and how you can manage the disease.
  3. Ask what your loved one needs from you. One can easily think you know what is best for another person, but the easiest is to ask how he / she wants you to act.
  4. Listen, rather than constantly giving advice or trying to reason logically. It is important for the person to take responsibility for the illness and the effect it will have on his / her life. When someone makes choices on behalf of someone else, it may cause the person to become dependent on the helper and then not want to fight the disease himself. It is not your illness, but your loved one's. Listening is a wonderful way to support your loved one.
  5. Get to know the symptoms so that you can act early. Not everyone's symptoms of anorexia manifest in the same way, so it's very important to understand how the person's symptoms manifest in your life. For example, when your loved one starts eating significantly less than at other times, you can start applying certain measures in the meantime.
  6. Do physical activities with the individual. This may be a cliché, but regular exercise is of great benefit to the mental health of people with psychological diagnoses. It relieves tension and anxiety and helps in the production of transmission substances that fight a low mood. So regular balanced exercise is actually a successful antidepressant. Balance, however, is the watchword. Remember that exercise should be restricted or discontinued in advanced stages of anorexia to prevent further weight loss.
  7. Encourage a balanced eating and sleeping pattern. An established routine not only helps the person to manage their illness, but also to see the signs / symptoms early.
  8. Take a good look at yourself! Remember, a person in your life with diagnosed anorexia can also negatively affect you by involving you in their disorder. Living with a person who has been diagnosed with anorexia can feel frustrating, exhausting and sometimes chaotic. Make time for yourself too.
We all sometimes focus on our weight and health, but that does not mean that we all experience the state of anorexia. However, it is important to keep an eye on yourself or your loved ones as less noticeable signs occur more frequently.
Certain people are naturally more likely to be slim. This does not mean they are diagnosable with anorexia. Always be on the lookout for pattern changes; that is, when you or a loved one does not feel, think or act as normal for more than three months.


If you or a loved one is struggling with mental health issues, we suggest the following options:
  1. call your GP (if available);
  2. go to your nearest hospital emergency room;
  3. call one of the following emergency numbers: SADAG (the South African Depression and Anxiety Group) 24-hour helpline: 0800 456 789 or suicide crisis line: 0800 567 567; or
  4. contact Wie is ek?