Anorexia: initial physical and psychological symptoms

(DA), among which we include anorexia nervosa, bulimia, binge-eating disorder, is the side effect of a modern society, in which external beauty resonates more than the uniqueness of the person and one's identity.

also serious. In anorexia it is not the food that changes its value, the desire, the interest and the importance towards food itself remain, but it is the act of eating that changes its connotation, becoming dangerous and distressing. The terror of gaining weight dominates and generates the need to control nutrition with the consequent uncontrolled weight loss in search of thinness.

There are two forms:

Restrictive anorexia, characterized by a strict diet, fasting and / or excessive and compulsive exercise.
Anorexia with bulimia in which recurrent episodes of binges or elimination behaviors (self-induced vomiting, excessive use of laxatives or diuretics) can be added to the reduced food intake, to get rid of what has been ingested and the sense of guilt.

or adolescence, in the last year there has been a lowering of the age of onset and the 10-13 age group is affected, due to the repercussions that the Covid-19 pandemic has had on young people. appearing at such a young age, the physical and psychological consequences of malnutrition are much more serious, because tissues such as bones and the central nervous system have not yet reached full maturity.

, no longer a criterion for diagnosing anorexia nervosa but in any case a sign of excessive and rapid weight loss, and an increase in physical activity, sometimes more evident than dietary restriction. There may also be the appearance of the yellow-orange color of the palms and of the soles of the feet, due to the excess of plant foods rich in carotenoids that accumulate in the skin.

All these signs are associated with an "evident impairment of health status. One of the diagnostic criteria for children and adolescents is the weight which must not be" less than the normal minimum "for their age. In children, whose symptoms are more faded due to their age there is nausea and feelings of not hunger.

higher calorie content (rich in fats and carbohydrates). Added to this is the continuous search for thinness, facilitated by the obsessive-compulsive trait of the anorexic subject that allows scrupulous adherence to routines and a controlled diet.

Finally, environmental influences could also favor the development of anorexia, especially for some work areas, such as the world of fashion and dance where thinness of the body is emphasized.

Among the genetic factors, however, we find a "positive anamnesis for this type of disorder, that is, having a family member who suffers or has suffered from eating disorders and clinical perfectionism, a genetic trait of the personality that consists of low self-esteem, the need never to be satisfied and to ask more and more of themselves, not having tolerance towards their mistakes.

The family environment can also be decisive: growing up in a family where interpersonal communication is difficult and difficult is also expressing one's feelings and emotions, makes anorexia an attempt to communicate with family members and a tool to attract attention. .

To learn more: Anorexia Nervosa: How to Recognize It and What to Do and pressure, there may be bradycardia, nails and hair become brittle, the skin appears dry and overall the anorexic subject appears debilitated and cachectic. There are also electrolyte abnormalities, endocrine alterations, anemia, metabolic alkalosis and hypoglycemia, deficiencies of various micronutrients, vitamins and minerals.

The typical psychopathological mechanisms that are observed in anorexia nervosa are: the fear of gaining weight and the disturbance of the body image (Dysmorphophobia).

The fear of gaining weight is kept at bay through some well-researched strategies. The anorexic patient chooses low-calorie and unappetizing foods, distributing the food all over the plate, cutting it into small pieces and chewing very slowly. Furthermore, the anorexic subject tries to control the feeling of hunger with the use of spices and to induce a sense of gastric fullness, he prefers foods rich in fiber and increases the intake of liquids. He often takes coffee, tea, energizing drinks to increase vigilance over food intake and looks for a way to eat alone, to avoid criticism or control.

Another attitude that can lead to suspicion of anorexia is "vicarious nutrition, or" eating through others ", observing them, passing them their food, cooking energy foods for them, such as cakes and sweets.

The already complicated picture of anorexia becomes even more complex due to dysmorphophobia or the non-objective perception of one's own body weight. because you will never reach the ideal weight that satisfies you.

ideal for his age. To achieve this goal, the support of a "multidisciplinary team through nutritional psycho-education is important.

The aim is to make the patient aware that some of the symptoms he experiences (feeling cold, irritability, obsessiveness) are the consequence of being underweight and do not represent his personality, but are reversible with the normalization of weight.

Specifically, the role of the nutritionist consists in "associating the food plan with the use of supplements of vitamins and mineral salts (for example calcium and vitamin D to prevent bone loss), in quantities appropriate to the patient's age, until the therapy food is not complete and balanced.

The intervention of the nutritionist must be supported by a psychological approach. The latter is of fundamental importance because those suffering from this eating disorder do not realize the seriousness of the situation and for this reason their collaboration in the treatment program is lacking. In some cases, the family must also be involved in planning the meals of children and adolescents receiving individual treatment. The full cooperation of professionals, the patient and the family becomes a resource for achieving the goal of healing.