- What is anorexia?
- The long-term effects of anorexia
- Who is most at risk of anorexia?
- Factors that increase the risk of anorexia
- Reducing the risk of developing anorexia
What is anorexia nervosa?
The term anorexia is originally from the Greek:
an = - ‘without’ + orexis = ‘appetite’.
Anorexia nervosa is a complex eating disorder and serious mental health condition in which people severely reduce their food consumption, or refuse to eat, in order to achieve extreme weight loss.
Research suggests that this kind of eating disorder is a way of trying to cope with mental distress associated with a negative, distorted self-image of the body and a fear of weight gain.
Individuals suffering from anorexia, rather than seeing food as a temptation to be avoided, are more likely to be disgusted by food and often continue to see themselves as overweight however much weight they lose.
The long-term effects of anorexia
Anorexia can have profound effects on long-term health. In its most extreme form, anorexia weakens the heart, which then loses muscle mass along with the rest of the patient’s underweight body. This is one reason anorexia is known to have the highest death rate of any mental illness.
The National Center for Biotechnology Information
There is also a concern that death rates are underreported, which has resulted in MPs in the UK calling for better research and improved data collection on eating disorders such as anorexia.
Who is most at risk of anorexia?
There are five main groups of people who seem to be at greater risk of being affected by anorexia:
- Fashion models (as role models)
- ‘Body checkers’
- Obese men
- Sexual minority groups.
Anorexia tends to emerge during teenage years and is four-times more likely to affect women than men. One possible reason for this gender difference is the societal value where women attach greater importance to outward appearance and physical attractiveness than men. This is especially true when there are also differences in the criteria associated with feminine and masculine attractiveness, for example a greater association with slenderness in women and muscularity in men.
Fashion models (as role models)
More disturbingly, there has been a trend over several decades of using ever-thinner models in women’s magazines, especially in fashion, where the ideal of beauty is increasingly associated with slimness. From size zero models to airbrushed images in magazines, the messages about the value of thinness are largely directed at girls.
One report suggests some other consequences of this: ‘women have been shown to be more likely than men to report body-checking behaviours, such as ritualistic weighing or trying on special clothing to check for fit, or to engage in body avoidance behaviours, such as not wearing form-fitting clothes that would make the wearer more aware of her body shape’.
While research shows that women are typically more likely to experience anorexia than men, analysis of NHS data shows a huge rise in the number of men experiencing problems. There is evidence to suggest that men are also facing increasing body image pressure and are affected by anti-obesity messages.
Although anorexia is heavily gendered and often associated with ‘femininity’, it is estimated that up to 25% of men experience an eating disorder of some kind.
Sexual minority groups
An area where further evidence is required is the increased risk of eating disorders within sexual minority groups. Of the limited research available, there is a growing field of evidence suggesting that LGBTQ+ groups are at a greater risk of emotional and behavioural eating disorders and body image disorders compared to heterosexual individuals.
At a lower risk?
It has been suggested that anorexia is less common in cultures where a fuller, curvier female figure is considered to be attractive, such as in parts of Africa and Latin America, and among African Americans and Latinos.
However, this finding may simply reflect a lack of research into anorexia among non-White populations, although it is an area probably worth researching further.
Factors that increase the risk of anorexia
Anorexia, with its associated mental health conditions, is such a complex eating disorder that a wide range of factors can influence it. These are some of the better known factors:
- Traumatic early life experiences
- Parental relationships
- The ‘glorification’ of thinness in society and culture
- Social media and social networking
- Exposure to online images of weight loss and anorexia
- Personality traits
- Impact of the Covid-19 pandemic
Traumatic early life experiences
Studies have shown that eating disorders in general – not just anorexia – tend to occur more frequently among those who have experienced maltreatment as children.
Women with eating disorders, including anorexia, have reported higher rates of sexual abuse. This incidence of sexual abuse in eating disorder patients appears significant. Fifty percent of both anorexic and bulimic patients reported a history of sexual abuse. This compares with only 28% of the non-anorexic, non-bulimic control population.
One review has suggested that ‘difficulties in parent–child relationships predispose women to eating disorders’.
The ‘glorification’ of thinness in society and culture
Studies have shown that a person’s attitude towards their own body and weight can be shaped by the media, peer groups and by family. When this influence results in a negative self-perception, it can increase the risk of anorexia.
There can be significant consequences to the ‘glorification of slenderness and thin people, leading to, and supported by, the internalization of a slender… beauty ideal’. For example, if someone defines themselves in terms of their weight or their appearance, or they grow up in an environment in which there is a preoccupation with weight, or learn to associate ‘irrational anxiety about body fat with gaining weight’, or have ‘prejudicial, stigmatizing beliefs about fat people’, they can be at a greater risk of developing anorexia.
Social media and social networking
This glorification of thinness in our social media age is probably greater than ever before. It has been shown to heighten feelings of bodily dissatisfaction among teenagers through the representations and images conveyed. Most concerning is the existence of pro-anorexia websites, which promote unhealthy, underweight ideals and images.
A number of studies over the years have also pointed to a significant association of the condition with social class, particularly linked with girls from middle-class and upper-middle-class backgrounds. However, this association has been questioned, and a Swedish study of 2 million males and females found a stronger association with levels of parental education than with social class.
Recently, there has been a growing concern that the use of social networking sites by those suffering from, or at risk of, eating disorders may lead to an increase in symptoms and adverse effects on their mental health.