What is anorexia?
Anorexia is a type of eating disorder. These are mental health conditions that impact your relationship with food, eating and yourself. Anorexia can make people worry about gaining weight, their body changing and/or eating certain foods.
It can lead someone to restrict what they eat to help them cope with difficult feelings. This may include trying to maintain 'control' of their bodies or diets or trying to 'numb' negative emotions.
Signs of anorexia
If you suspect you have anorexia, you might notice the following symptoms:
- negative self-talk or hearing a 'voice' that's negative
- feeling anxious about eating
- physical problems such as feeling dizzy, feeling cold often or losing hair
- skipping meals, eating very little or lying about what you've eaten
- being preoccupied with weight, body image and food
- becoming secretive about food and feelings
These are just some of the ways anorexia can affect people, but it is a complex illness that can affect people differently. A common thread however is usually that someone is unhappy with themselves or their situation, and anorexia is offering them a way to cope.
It's also important to note that not everyone with anorexia will be underweight. Atypical anorexia is a common condition and may affect people who are normal weight or even overweight.
Someone with Atypical anorexia has the same thoughts, feelings and fears about food, body, weight and shape as an anorexic, often leading to a damaging cycle of yoyo dieting and food restriction. Atypical anorexia can be equally damaging for both mental and physical health so getting the right kind of psychological support for this condition is vital.
Treating anorexia
Like all eating disorders, anorexia is complex. It is considered multi-factorial, which means there can be many causes. When looking at anorexia treatment, both mental health and physical health must be addressed.
Mental health treatment
Mental health professionals can offer psychological support to help people better navigate difficult emotions and improve their relationship with food and themselves. Common talk therapies used in eating disorder treatment include:
- Cognitive behavioural therapy (CBT)
- Maudsley anorexia nervosa treatment for adults (MANTRA)
- Interpersonal therapy (IPT)
- Family therapy
Physical treatment
Alongside psychological support, physical monitoring and support may be needed to help restore weight and improve overall health. This will depend on the severity of any physical symptoms but may require a combination of medical intervention and nutritional therapy.
Physical treatment aims to bring the body back to a healthy weight, resolving any nutritional deficiencies and ensuring normal digestive function.
How does nutrition support recovery?
Nutritional therapy can be an essential part of the recovery process. In terms of physical health, it can be used to ensure you get the right nutrients to feel better. It can also help the weight restoration process which is a vital part of getting your overall health back on track.
Mentally and emotionally, exploring nutrition can help you understand what your body needs to function, helping to ease food-related fear. You may begin to enjoy the process of cooking for yourself and create recipes that support your recovery goals. This can help you remember who you are outside of your eating disorder and boost confidence.
While nutritional treatment will be unique to the patient, there are a few areas the NHS suggest are focused on during recovery:
- Ensuring you're getting enough vitamins and minerals (you may be advised to take supplements)
- Supporting bone health (this may involve a bone-density scan to check bone health, medication if needed and nutritional support)
How can a nutrition professional help with anorexia?
If you have been diagnosed with anorexia, you will likely have been referred to a specialist care team by your GP. This team will closely monitor your physical and psychological health during the gradual weight-gain process.
A dietitian may be a member of this team, or you may seek out support from a nutritional professional alongside/following your initial treatment. Nutrition professionals can help you continue your recovery and devise a plan for the future.
In this video, dietitian Sarah Morton (HCPC Specialist Dietitian (RD) - BSc. (Hons) MSc. PgDip) explains how a nutrition expert can provide guidance and support as part of your medical team to help you rebuild a healthy relationship with food.
A professional who has experience working with disordered eating can help in several ways including:
- Identifying any nutrient deficiencies and offering guidance on foods to restore balance.
- Helping to reintroduce restricted food into your diet in a way that feels safe and comfortable.
- Work with you on devising a tailored meal plan with your recovery goals in mind.
Working with someone in this way can feel scary at first. You may worry that they will take over or make you eat something you don't want to. It's important to know that nutrition professionals are there to support you and work collaboratively.
They will learn about your history, your preferences and your goals, and work with you to find an eating plan that's right for you. Consulting a nutrition professional can even be a way for you to stand up to your eating disorder and take back control. With their guidance, you can work towards a healthier relationship with food happy in the knowledge that the steps you are taking are perfectly safe, and based on your choices.
Take some time to look at a few different specialists so that you can see who you feel most aligned with. Remember that this is your recovery journey and it is important that you find the right practitioner for you.
- Nutritional Therapist Sasha Paul (London eating disorder specialist)
Weight restoration
Weight restoration is often challenging but is a vital and integral part of recovery if you are underweight or at a suboptimal weight for your body type. Food restriction and being underweight affects cognition, intensifying fears and thoughts about food, body, weight and shape. A nutritional professional trained in eating disorders can help you navigate this journey to enable full recovery.
Any course of treatment is considered within the wider psychological context. This means that emphasis will be placed on speaking with the patient and understanding their needs.
What is refeeding syndrome?
Refeeding syndrome happens when someone who has been restricting their food a lot for a long time suddenly eats larger quantities of food again, quickly. Our bodies change when we don't eat enough, leading to a slower metabolism as we adapt to survive on less food.
Eating normally again too quickly can put our body back into 'active mode', using the nutrients we've been missing too quickly. This can create an imbalance and lead to physical symptoms like muscle weakness, breathing problems, irregular heart rates and even seizures.
Refeeding syndrome can be dangerous or even fatal. If your anorexia has led to an extremely low weight, it is vital to work with your medical team and a qualified dietician who specialises in refeeding programs. If you are in doubt about your own situation, be sure to seek medical advice.
While weight restoration is a small part of eating disorder recovery, it’s often the part people fear most. It is extremely difficult to go against your eating disorder. People might be telling you to “just eat” or “just gain weight” - but it’s so much more difficult than that.
- Nutritionist Shannon Western (eating disorder and disordered eating nutrition counselling)
Recovery tips for anorexia
Experts emphasise that recovery from anorexia is rarely linear. There is no one ‘cure’, just a process with stages of improvement. It can change in severity from week to week and relapse or improve depending on the emotional health of those affected. It can take time, but recovery is possible.
Here are some tips to help you stay motivated during your recovery:
Surround yourself with support
Having a support system around you can make a real difference when it comes to motivation. This might include your family, friends, colleagues, teachers or care team. You may also find peer support helpful, speaking to others who understand what you're going through can be reassuring, but it's important to explore this through facilitated and moderated avenues such as Beat support groups.
Set recovery goals
Having recovery goals gives you something to aim towards. This could be to gain independence, travel with ease, have the energy to play a sport you love, go to restaurants with friends or eat a favourite food you've been restricting.
Make a list of recovery goals for yourself and consider sharing them with your support system so they can support you in achieving them.
See food through a different lens
Food can feel like the enemy when you have an eating disorder, so it can help to reframe how you view it. This may require support, but challenge yourself to see food as a tool to feel better and reach your recovery goals. Remind yourself of meals you loved as a child and recreate the dishes for fun. Explore the joy of food shared with friends and savour the positive it brings to your life.
Celebrate your wins
When you achieve a recovery goal, no matter how big or small, celebrate it! You've done something amazing and taking a moment to appreciate that can help to build confidence and keep you motivated.
Don't see relapse as a failure
Relapses in recovery can happen and are normal. It can be difficult when this happens as it feels like a step backwards. Try to recognise what you have achieved and the strength you have in you to have done that. You still have that strength to draw on as you embark on the next step forward in your recovery journey.
