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What is anorexia nervosa?

Anorexia nervosa is a serious psychiatric disorder. Patients with anorexia are typically convinced that they are too fat. This fuels their so called drive for thinness, a strong desire to lose weight. Anorexia patients derive their self esteem from being able to lose weight. Successful weight loss gives them a sense of having extraordinary willpower. Conversely, any weight gain is considered as a form of personal failure and the mere thought of gaining weight elicits strong feelings of anxiety.
There are two types of anorexia nervosa patients: (1) the binge eating /purging type; (2) the restrictive type. The first type of patient experiences regular eating binges in which she will eat objectively large amounts of food within a specific time period. Out of fear of weight gain, the patient will afterwards purge herself through self-induced vomiting and/or the misuse of laxatives and diuretics. The second type of patient does not have any eating binges and appears able to continuously restrict food intake.

What are the causes and how can it be treated?

Important questions are how (and why) anorexia nervosa can develop and what factors underlie the maintenance of the disorder. Research into these questions focuses on the role of the thin ideal, disturbed body image, the fear of weight gain, concerns about appearance, weight and shape, low self-esteem, and the potentially reduced sensitivity to the reward value of food. All these factors appear associated with the etiology of anorexia nervosa, but there is still discussion on how each of these factors taken separately contribute to the disorder. This may be one of the reasons that generally, the treatment of anorexia nervosa is eclectic. Apart from efforts to promote weight gain and to normalize eating behaviour, treatment usually also aims to achieve acceptance of one’s body, to be able to discuss one’s emotions, to increase self-esteem and to improve general social skills. Whether this eclectic and extensive approach is effective (and indeed necessary) still awaits empirical validation.