Anorexia Nervosa – Screaming in Silence

What is Anorexia Nervosa?

Anorexia Nervosa is one form of Eating Disorders according to DSM-IV-TR classifications. To diagnose a person as an Anorexic, following are the diagnostic criteria:

A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected). 

B. Intense fear of gaining weight or becoming fat, even though underweight. 

C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. 

D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

The fear of gaining weight or becoming fat is not like the usual fear of gaining weight and becoming not good looking, because this fear drive Anorexics to do self-starvation actions and produce excessive weight loss. For the Restricting Type of Anorexia Nervosa, the person do not regularly involved in binge eating behaviors, but being excessively restrictive on their food intake. They would consume a piece of bread, or a glass of juice, or a small plate of vegetables … for the whole day! and for them, that’s all they need. On the other hand, the Binge-Eating/Purging Type of Anorexia Nervosa has numbers of binge-eating and purging episodes during their Anorexia period.

When Anorexic Screams in Silence

People in general may see self-starvation actions and excessive weight loss as something stupid and ridiculous. But when we have a moment to look deeper, we can find the reasons of why Anorexics do what they do. I knew many stories of how they have to go through stormy days when their loved ones called them as fat, piggy girl, round shape and many more. The diet habit usually starts on young age, 14 to 18 years old (read this story), but many findings open a new fact that Anorexia starts earlier than that. I knew one girl who shows symptoms of Anorexia Nervosa when she’s at her year five (Yes, Primary School)!

Sometimes the cause was the yearning feeling of getting attention from their parents – early on their teenager years. Some parents are good at criticizing – because they think that is equal with giving attention to their children. Some other parents shows ‘mind your own business’ attitude and therefore, their children can’t get closer to them. These young children desperately need help!

They need to be acknowledge, to be accepted and not to be ignored. They need to hear from their parents that they have problems and their parents are willing to help. Parents or spouse usually realize this when the symptoms of Anorexia become too obvious. This is when their scream starts to caught attention.

What Can We Do to Help?

There are many things that we can do – as family members, friends, spouse, or church friends. The most important things are to be available for them, pay attention to what they need (not the Anorexia’s need), concern about the problems and at the same, understand how an Anorexic think and perceive ‘food, fat, calories’ in their mind. How we think about food is totally different with their stand point during Anorexia episodes (this handout is useful for family and friends).

And most of all … listen to them when they ask for your attention. Do not wait until you hear they scream in pain and you are late to offer some help.

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