“Your best friend, your worst enemy, a nagging parent, your only admirer, your whole world.” This demon by your side is a choice, but once you start you get sucked in and it’s nearly impossible to get out. When you let this take over your life, everything you swallow turns into numbers in your head. People who suffer from anorexia are known to control and lose body weight; most commonly through the means of voluntary starvation, excessive exercise, or other weight control measures such as diet pills or diuretic drugs. It is a physical and psychological disease, and if it isn’t stopped the sufferer can waste away completely.

To be diagnosed with Anorexia Nervosa according to the DSM-IV-TR, a person must show some of these main symptoms: refusal to keep body weight at or above the minimal weight for age and height, intense fear of gaining weight or getting fat even if they are currently underweight, denial of the seriousness of the current low body weight, and the absence of at least three consecutive menstrual cycles (amenorrhea) in women who have not yet gone through menopause. People who suffer from this disease will often starve themselves to the point of looking skeletal and still worry about gaining weight. Some of them join pro-anorexia sites on the internet where they can talk to other people who are going through the same experience. They will often refer to what is nicknamed “thinspo”, or “thinspiration”; pictures of extremely skinny people to remind them of how “good” they will look after a few more pounds lost. Some sites will have daily blogs reminding you of how fat you are to give you an extra boost. Other sites take a more friendly approach by giving you lists of healthy, no-calorie foods as well as things to do to distract yourself from eating.

This problem goes deeper than just getting skinny; there are many other health factors that come into play when you starve yourself. The physical problems include extreme weight loss, stunted growth, endocrine disorder, decreased libido, reduced metabolism, hypothermia, thinning of hair, constantly feeling cold, zinc deficiency, reduction in white blood cell count, reduced immune system function, pallid complexion and sunken eyes, tooth decay, poor circulation, nerve deterioration, fragile appearance, dizziness. You think that’s bad? Let’s count the psychological problems; distorted body image, poor insight, pre-occupation or obsessive thoughts about food and weight, obsessive compulsive disorder, belief that control over food/body is synonymous with being in control of one’s life, refusal to accept that one’s weight is dangerously low, hallucinations, loss of memory, depression, easily irritable. Behavioral problems will be noticeable as well; like excessive exercise, food restrictions, checking mirror constantly, and it can even lead to self-harm or substance abuse. Many people don’t understand just how bad this disease can get. Some parents just think “Oh I will just make her eat more dinner this time and she will remember how good food tastes”, but they don’t understand that there is so much more to it than that.

Anorexia is thought to have the highest mortality rate of any psychiatric disorder, with about 6% of people diagnosed with the disorder eventually dying from related causes. 1 in 100 people suffer from anorexia, and in about 17 out of 20 cases they are teenagers. Not scary enough statistics? The suicide rate of people with anorexia is also much higher than the suicide rate of the general population. This is thought to be the major cause of death for those with the condition. Here are some percentages: 0.5-3.7% of females suffer from anorexia nervosa, 1.1-4.2% of females suffer from bulimia nervosa, 4.5% females, 0.4% males report bulimia in first year of college, and 0.5-1% of adolescents have anorexia. Eating disorders in general have doubled since the 1960’s and it’s increasing in younger age groups; some being as young as age seven.

The exact causes of anorexia nervosa have not yet been determined. Genetic and environmental factors most likely play a role. Biological tests can help with determining the diagnosis of anorexia, but it is based on a combination of behavior, the persons beliefs and experiences, and physical characteristics of the person. In my opinion, some people have a distorted body image to begin with and think they always look fat. While in some cases, a person is fat (or thinks they are) and decides to take on an anorexic lifestyle to physically and mentally improve themselves. Other times people become anorexic because food is the only thing they can control in their lives, and these people often get caught up in self-mutilation or sometimes drug use.

There is no “cure” for anorexia; you cannot simply inject someone with a formula that will make them eat. It’s extremely hard for people to break this disorder once it grabs them, and some people never let go. But the first thing you have to do and the biggest challenge is to make the person recognize that their eating behavior is a problem, not a solution to their problems. This is an extremely hard task because they don’t see “Ana” as an eating disorder. You can’t pump food into them for the cure either. When someone with this disorder is put in treatment, the hospital will make them eat first to regain normal body weight, then they have to work out the psychological issues. You can make an anorexic eat, but you can’t make them want to. Even after they are “treated”, food will always be numbers to them, no matter what.

Anorexia is a vicious disease. Once it takes a hold of you, you can’t break free. You can try and try as hard as you can, but your life will never be the same. Some people choose to lose body weight rapidly by means of starvation, but for others it’s not a choice; it’s a way of life. If you know anyone who might be anorexic, don’t call it out to them like Dr. Phil at an intervention. Be there for them when they need you, because that is the most you can give them.