If you took a blog break during the holiday, here’s my late December post about creating realistic characters who have survived trauma.
Today I’ll focus on the most lethal eating disorder: Anorexia Nervosa. There’s actually a link between one kind of trauma — sexual abuse — and eating disorders. One study found that 1 out of 4 women with Anorexia Nervosa has been sexually abused. The rates of sexual abuse were even higher for other eating disorders: 1 out of 3 women with Bulimia Nervosa, and 1 out of 2 women with Binge Eating Disorder. I’ll cover Bulimia Nervosa in my next post.
“Anorexia” means a lack of a desire to eat, but it doesn’t necessarily mean a lack of appetite. Individuals who develop this disorder at first have to stave off severe hunger to achieve weight loss. The diagnosis must also include “Nervosa”, referring to psychotic thinking including intense fear of weight gain, distortion of body image, and obsessional preoccupation on food, weight, and shape.
There are four symptoms of Anorexia Nervosa:
1. Severe underweight (less than 85% of expected body weight or less than 17.5 Body Mass Index). For example, a 5’7″ woman would meet criteria if she weighed less than 111 pounds (50.35 kg).
2. Intense fear of gaining weight. Many individuals fear that if they gain one pound, they’ll suddenly gain one-hundred pounds. The eating disorder provides a false sense of control, and individuals fear losing that control.
3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body shape on self-evaluation, or denial of the seriousness of the current low body weight. Individuals determine their self-worth solely based on their weight/shape.
4 Amenorrhea in women (absence of at least three consecutive menstrual cycles). Individuals meet criteria if they only have menses when on the birth control pill.
When people joke they wish they could get Anorexia Nervosa, I fume inside. This disorder is a personal hell, locking individuals into an addiction that brings so much misery to them and their families. Their self-worth is so impaired they don’t feel deserving of caring for themselves — of living, really. It’s selflessness gone awry.
Walter Kaye, M.D. is doing some fascinating research on the brains of individuals with AN, finding logic in the illogical refusal to eat when underweight. He’s shown that individuals with AN have high levels of serotonin activity in their brains. Serotonin is a chemical messenger implicated in sleep and appetite, and the high levels of serotonin activity produce agitation for those with AN. When these individuals stop eating, the serotonin activity decreases, providing a sense of calm and happiness. However, eating a combination of carbohydrate and protein elevates serotonin levels, jacking up their anxiety and the “noise” in their brain. If eating made you feel this horrible, would you eat? Probably not.
Individuals with this disorder have difficulty making decisions, tend to be emotionally stoic (not only are they restricting their food intake but they’re also restricting their emotions), perfectionistic (often achieving 4.0 GPA’s), and highly anxious.
Men can and do suffer from Anorexia Nervosa though it’s more common in women. I’m not familiar with fictional heroines suffering from this illness — are you? A famous singer who died from AN is Karen Carpenter:
Her music is is beautiful, and it’s a tragedy the world lost her smooth voice to this illness. In effect, Anorexia Nervosa steals a woman’s voice.
Here are two of my favorite books about eating disorders:
There’s a lot more I could say but I’ll stop here. Please let me know any of your questions or comments.
Now onto the Meet an Author Monday Blog Hop, hosted by Lisa Sanchez.