Anorexia Mentalis: Causes, Symptoms and Treatment


Anorexia mentalis, or anorexia nervosa, is an eating disorder more common in girls and women than in the male population. People with anorexia have a distorted perception of their body. They often think they are fat or fear of becoming fat. The main goal in their life is to lose weight. They eat very small amounts of food.

People with anorexia do not want to keep their body weight and they are never satisfied with how much they weigh. People with anorexia also have a low self-esteem because of the shape of their body. Also, they do not see that they have weight problem. When women are anorexic, they usually have not had three periods in a row.

The beginning of anorexia

As stated above, mental anorexia is more frequent with the female than the male population. It is also more common in adolescence. The beginning of anorexia is associated with a determination to lose weight, because girls see themselves as fat. Also, there are many girls and women that are dieting to become fit and are not anorexic. Emotional stress and trauma, as well as some inner conflict can induce anorexia. Actually, studies have found that an anorexic person had suffered a family loss, neglect, separation, sexual disorders, or he or she has a special personality type.

The beginning is gradual. A person is usually picky on food at first, eats less food, complains about digestion and constipation problems, feels bloated and thinks that he or she cannot walk as before because of the weight. An important thing is to know that these people are extremely thin so the main problem is with the perception of their body. When food intake decreases, many emotional problems may occur – indifference, depression and sensitivity. They usually withdraw a person from the social environment. The relationship with parents is also changed. Aggression and hostility toward the mother figure is very common, and also, anorexic boys show a tendency to be more dependent on their mother and for a longer time. Anorexic adolescents and young people have excessive workouts and eat low fat and carbonates food.

Some physical symptoms also occur. Extreme weight loss and sometimes complete kaheksia can be very visible. The skin is dry, loose and pale and looks old. Lanugo–soft and fine hair–starts growing all over the body. Blood circulation is slow, finger tips and nose tip look bruised, and white feathery hair may occur all over the body. Constipation is frequent. The period (with women) stops until the body weight is back to normal. Also, the production of the follicle hormone is stopped in most girls.

An anorexic person is obsessed with calories and fat content of foods. Sometimes, preoccupations with food, recipes and cooking may occur. During meals (usually in front of family or friends) rituals are present. An anorexic person cuts food into tiny pieces and eats it slowly.

Because the person feels bloated, usually, after a while, he or she starts using purgatives – laxative, diet pills or water pills. Sometimes the person engages in self-induced vomiting.

Symptoms of anorexia

Rapid and unexplained weight loss, denial when perceiving body weight, low self-esteem and a distorted body image, negative comments on appearance, an irregular menstrual period (amenorrhea), low body temperature, low pulse, body sugar and blood pressure, depression and resignation. Sometimes, anorexia leads to distorted social relations and withdrawal from the social environment.

An anorexic person fears when there is a sign of weight gain. Then, the person takes all measures to prevent further weight gain.

All these symptoms can lead to dangerous and sometimes fatal consequences. Starvation and an unhealthy diet can lead to heart attacks or heart failure, kidney failure and electrolyte imbalance. The diet of anorexic people is high on protein (when consuming food) and low in fat and carbohydrates. This can lead to muscle and organ damage. When the body has no fat to live off of, it begins to digest muscles and tissue.

Causes and psychodynamics

Causes of anorexia are found in neurological, psychological, psychosomatic and cultural factors. Neurological factors should be considered in some cases, but a diagnosis should be determined very carefully. There is a significant correlation between neurological and psychological factors. Psychological distress can cause hormonal misbalance and hormonal misbalance can cause psychological problems.

Psychodynamic and psychoanalytic researchers usually consider certain factors, when it comes to anorexia, and they give explanations, while analyzing the behavior, structure and functioning of an anorexic person, his or her defense mechanisms, inner conflicts and early relations with mother and parents in general.

Psychodynamics depend on whether the anorexic syndrome is a symptom of another disorder (adolescent crisis, behavioral disorder, neurosis, etc.), or is it a mono-symptomatic disorder.

One of the main causes of anorexia is a distorted image of body. The body, or body parts are seen as fat, large, bloated, heavy and the physical stimulus is uncomfortable and disturbing. The body is seen as bad and ugly, so the person wants a thin body which is a symbol of bravery, beauty, intelligence and power. This leads to the tendency to starve the body, to dispose all the toxins and intimidating aspects of one’s personality. This is also a sign of auto-aggression. The ability to deny the need for food gives a person self-esteem and respect. An anorexic person does not feel hunger or the need to eat. Anorexic people, even though they feel physically weak, are very mobile and feel fatigue less than people usually do. Forced feeding in early childhood can change the body image of an anorexic person. The person can feel depressive, anxious and as though he or she is losing a part of his or her identity. This is why the food intake is ambivalent. Anorexic people usually show anorexic behavior and then, there is a period when they overeat. In both emotional and cognitive functions, we can see ambivalence. The early conflicts are revived, primarily the conflict with the person’s mother, who satisfied and frustrated the need for feeding and emotional and physical contact.

The Ego of an anorexic person is weak and is always defending itself from conflict by regression, splitting and a projection into its own body. The Ideal Ego is filled with the feeling of power and greatness. That is why a person has the need to control the body-needs, as well as the other ones. Usually, the anorexic person takes all the attention in the family and that is how he or she controls other people and this boosts his or her confidence and narcissism.

Difficulty with relationships and accepting sexuality is one of the explanations for anorexia, among both male and female. In women, the feminine body traits are considered bad and a sign of animalistic features; also the possibility of pregnancy and difficulty to identify with a role of a women because of the lack of identification with aggressiveness is there, and, finally, there is the rejecting mother.

The beginning of anorexia is in early childhood. In an early mother-child relationship the child was frustrated during feeding time – the mother refused to feed the baby, or she did not feed the baby enough or when the baby needed food.

The prognosis of anorexia mentalis

The development and prognosis of this eating disorder depend on the depth of the conflict and the willingness to treat it. This kind of eating disorder can last for a long time and is usually prolonged by the family relations, behaviors and atmosphere in the family group. Prognosis is better among females. Even though this eating disorder is less common among males, anorexia lasts longer and the prognosis is worse because of the psychodynamics and the depth of regression of this disorder.

The best therapy for this kind of mental eating disorder is family therapy, psychotherapy (psychodynamic, cognitive-behavioral and group therapy) and behavioral therapy (positive reinforcement for weight gain). Sometimes, medication is imperative when the weight loss may be fatal. The medication includes antidepressants (because anorexia is followed by depression and indifference). Hospitalization is necessary when the weight loss is life threatening and followed by some physical symptoms. Physical activity is a must as well, and there are various exercises and workouts an anorexic person should undergo, starting from low intensity exercises and slowly working his or her way up the exercise tree as he or she puts on more weight.


When people decide to lose weight, the first thing a person should do is to decide what the real reasons for weight loss are. Weight loss should be a way to become healthier and happy. Weight loss is not an instrument to control people or to deny sexuality. A variety of eating disorders is caused by psychological factors, mostly inner conflicts. The goal of weight loss or becoming fit is to be healthier and to be satisfied. Every person should ask herself what is the main reason for weight loss and try to work on the issues, if there are any. It is much easier to lose weight when in state of content, rather than for some reasons that make us unhappy and conflicted.


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