Anorexia: What To Look For
What are some of the physical symptoms of an anorexic?
Some of the most obvious symptoms we would see would be the thin body, and one of the physiological pieces that kind of occurs with the thin body is that person loses their period. And so they may not have a period. Hyperactivity - when they become anorexic, because the cortisone levels tend to rise in the body. When the body's under starvation, the cortisone levels really rise, and the increased cortisone levels gives them the energy to actually do more than what their body is capable of doing. So that's why we'll see anorexics that are just, you know, always on the go and can't sit still and they're just constantly moving. The other piece that we often see with anorexics is like a fine layer of Lanugo hair, we call it. Like you get a fuzz - peach fuzz, kind of - like a lot of hair over their body. And the reason why they grow the hair over their body is because it's the body's way of giving them that extra layer of insulation because then you have the hair, that the hair traps a layer of air in there to give you that layer of insulation because they've lost so much body fat and they're constantly cold all the time. So the body's compensating for that starvation mode that the body is in by growing that peach-fuzz hair over their face and their arms and necks.
What are some of the behaviors that an anorexic exhibits?
When you have somebody in their early stages of anorexia, they're going to be very happy, have a lot of energy, they're going to be getting better grades than they've ever got before, and the parents will tell me that we didn't realize that this was anorexia because she was doing better than she'd ever done. This is because of that hyper-arousal. So, in the beginning stages of anorexia, when the person's losing weight and feeling happy and excited before the depression comes on, you'll have a very happy, energetic, she'll be doing a lot of exercise, her grades will be really amazing, and she'll be feeling on top of the world. So, in the beginning phases of anorexia you'll see those kinds of things. Then as the anorexia progresses, then what you'll see is more of the depression, and you'll see a lot of isolation. The person will not want to be around people, they'll be hiding their food, they'll be not wanting to eat, and there is all this control stuff around food that will start to show.
What are the moods or emotions of an anorexic?
Lots and lots of denial. Anorexia is classically loaded with denial. Unless the person has been in illness for a long time, they can come around and they'll say, "I feel I'm really depressed, because I have this disease that just really doesn't go off my life, and I really cannot be able to do that much." Typically, denial is something that we'll see. Also, because of that denial they're able to maintain positive moods. The moods usually seen will be: "I'm on top of the world", "I have my game", "I feel good", "I'm in control", "don't mess with my food", "don't mess with my exercise", or "I'm okay." You'll see a very elated person that's happy about how things are going with them. They don't like it when professional providers, just like myself, come into the picture and trying to make a break into that denial. They're usually not too happy about that. Then it brings you down to some reality about the coping mechanism they use to deal with whatever going with their lives.
Are there any hidden' physical clues to anorexia?
Absolutely. "I ate my whole lunch, mom, today." You know, they'll take their lunch to school, but they won't eat any part of it. But when mom asks, "So, honey, did you finish your lunch?" "Of course I ate all my lunch." A lot of defensiveness. There will be a lot of exercise in the room. They'll be exercising in their room. They'll be hiding food. They'll often hide food and sneak it away and not eat the food. When you find the child starting to have a lot of preferences for what they want to eat or they don't want to eat. So, all of a sudden, you know, they may cut out a whole food group. They may just stop eating a certain food group. That's a huge clue. I will often tell family members, it could be spouses, where I'll say, "Gosh, you know, your wife kind of turned vegetarian, are you wondering about why she may have turned vegetarian?" So, when there's a huge, radical shift that occurs with their food preferences, you kind of want to be on the alert for an eating disorder, for anorexia. And also there are physical clues, and the physical clues that we would see would be the hair would be dull and lifeless, or nails would be brittle. They'll suddenly have bruises all over their body, and they'll be taking them to the doctor and the doctor's not able to explain where these bruises are coming from. And those bruises are bruises form malnourishment. And they won't have color to their skin. And so what you'll find is a sudden dull kind of lifelessness to their looks in some ways. But also then you'll notice after a while their energy levels start to drop and they want to not be doing as much, and they'll start to want to sleep a lot or different things like that.
