People who intentionally starve themselves suffer from an eating disorder called anorexia nervosa. The disorder which usually begins in young people around the time of puberty, involves extreme weight loss – at least 15% below an individual’s normal body weight. Those experiencing anorexia nervosa also have an intense fear of becoming fat, even when underweight. Many people with the disorder look emaciated but are convinced that they are overweight.
Sometimes hospitalization to prevent starvation is needed while the individual continues to deny the condition. The illness may stop the menstrual cycle, a condition called amenorrhea. Men with anorexia often become impotent.
For reasons not fully understood, individuals suffering from anorexia nervosa become terrified of gaining any weight. Food and weight become obsessions. For some, compulsive behavior shows up in strange eating rituals or the refusal to eat in front of others. It is not uncommon for people with anorexia to collect recipes and prepare lavish gourmet feasts for family and friends, but not partake in the meals themselves. They may adhere to strict exercise routines to keep off weight.
Medical consequences of anorexia nervosa
In people with anorexia, starvation can damage vital organs such as the brain and heart. To protect itself, the body shifts into "slow gear": monthly menstrual periods stop; breathing, pulse and blood pressure rates drop; thyroid function slows; nails and hair become brittle, skin dries, yellows, and becomes covered with soft hair called lanugo. Excessive thirst and frequent urination may occur.
Dehydration contributes to constipation, and reduced body fat leads to lowered body temperature and the inability to withstand cold. Mild anemia, swollen joints, reduced muscle mass, and light-headedness also commonly occur in anorexia. If the disorder becomes severe, loss of calcium from bones, making them brittle and prone to breakage can occur. Patients also may experience irregular heart rhythms and heart failure. In some patients, the brain shrinks, causing personality changes. Fortunately, this condition can be reversed when normal weight is reestablished.
Scientists have found that many patients with anorexia also suffer from other psychiatric illnesses. While the majority suffers from clinical depression, others experience anxiety, personality or substance abuse disorders, and many are at risk for suicide. Obsessive-compulsive disorder (OCD), an illness characterized by repetitive thoughts and behaviors, can also accompany anorexia. Individuals with anorexia are typically compliant in personality, but may have sudden outbursts of hostility and anger or become socially withdrawn.