Telltale signs of anorexia

The death of model and anti-anorexia campaigner Isabelle Caro has focused attention once again on this grave disease, which plagues many young women and girls.

Caro's death at age 28 last week follows other high-profile young models claimed by the disease in recent years, such as Ana Carolina Reston (21), Luisel Ramos (22) and Eliana Ramos (18).

What are the signs and symptoms to indicate that someone is suffering from anorexia? Questions from many users prompted Health24’s DietDoc, Dr Ingrid van Heerden, to write this article.

Signs to look out for if you suspect that a member of your family is suffering from anorexia include physical and psychological symptoms. Here follows a quick symptom guide.

Physical symptoms

  • Extreme loss of weight in the absence of illnesses such as cancer
  • Abnormal levels of activity, including excessive exercising
  • Sleeplessness, the person often does not feel fatigued despite exhausting restlessness
  • Slow pulse and low blood pressure, which can cause fainting
  • Low body temperature, person feels cold all the time, even in hot weather
  • A layer of fine downy hair grows all over the body
  • Cessation of normal menstruation
  • Low blood potassium levels, which usually indicate the use of laxatives to purge food

From 'Thirty-two kilos' by Ivonne Thein. Digitally distorted photo.

Psychological symptoms

  • An abnormal drive to lose weight even if the person is not overweight
  • History of psychological disturbance and conflict with one or both parents
  • A refusal to acknowledge that there is a problem
  • Distortion of body image - people see themselves as grossly obese even when their ribs are sticking out
  • Denial of femininity in female sufferers
  • "A-type" personality - an urge to over-achieve and a tendency to severe self-criticism
  • Constant preoccupation with food - while they themselves are starving to death, they often cook vast meals for other members of the family
  • Craftiness. Patients hide food that they are supposed to have eaten, refuse treatment, flush tablets prescribed as part of their treatment down the toilet and do everything to outwit those who are trying to help them overcome their illness

Associated features

  • Anorexia is generally much more common in girls, teenagers and young women, but it can also occur in older women and in men
  • Anxiety and depression often also occur in patients with anorexia and some experts suggest that anorexia is a "distorted biological solution to an existential problem"
  • Prior obesity of the patient - after an initial bout of obesity in childhood or adolescence, patients often react by developing anorexia
  • Obesity of other members of the family - in such cases the extreme emaciation of anorexia is a way of disassociating the patient from her/his family
  • Yo-Yo dieting - cycles of starvation to lose weight followed by overeating can predispose patients to developing anorexia.

If you are worried that your daughter, sister, wife, brother or friend is anorexic, then check his/her behaviour against these signs and symptoms. If you can identify a pattern of behaviour that fits in with the signs and symptoms, then the person you are worried about may have anorexia and needs help.

– Dr Ingrid van Heerden, DietDoc.
(Updated by Olivia Rose-Innes, January 2011, Health24)

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