Anorexia Nervosa and Anorexia Athletica

Anorexia nervosa and anorexia athletica are two different conditions that belong to a class of mental health problems known as eating disorders. People with anorexia nervosa reduce their body weight and maintain an abnormally low weight by significantly restricting their intake of food and calories. People with anorexia athletica also reduce their body weight and maintain an abnormally low weight, but rely on compulsive participation in excessive exercise to achieve their goals. Anorexia nervosa is officially recognized as an eating disorder by the American Psychiatric Association, while anorexia athletica is an unofficial term frequently used by mental health professionals.

Anorexia Nervosa Basics

Anorexia nervosa is commonly referred to simply as anorexia. People with the disorder develop an obsession with appearing thin and have an intense, irrational fear of gaining weight. As a result, they heavily restrict their intake of any food that can potentially lead to weight gain. In some cases, this food-restricting behavior is the only method used to control body weight. In other cases, anorexics exhibit some of the behaviors found in another common eating disorder – called bulimia nervosa – and combine severe food restriction with bouts of binge eating that are followed by purging behaviors such as vomiting or abuse of diuretic medications, enemas or laxatives. In addition, some people with anorexia nervosa combine food restrictions with participation in excessive exercise.

In America, roughly 85 to 95 percent of people with anorexia nervosa are female, according to the U.S. Department of Health and Human Services’ Office on Women’s Health. The disorder typically appears in teenagers and young adults, although it can appear much earlier or later in life. Like other eating disorders, the behaviors found in anorexia nervosa generally have very little to do with food. Instead, they occur when an individual has problems dealing with ongoing sources of anxiety, depression, stress or other types of emotional difficulties. Underlying causes for these difficulties commonly include a combination of genetic predisposition and factors such as the cultural and social environment, specific personality traits of the affected person, and chemical imbalances within the brain and body.

Anorexia Athletica Basics

Anorexia athletica is also known by names that include compulsive exercise, hypergymnasia and sports anorexia. While it can occur in almost any teenager or adult, it most commonly appears in skilled athletes, especially those participating in sports that place an emphasis lean, small body types. Instead of focusing directly on their personal appearance, people with the disorder focus on their athletic performance, and measure their bodies-and, therefore, their self-worth- through comparisons with successful competitors in their field. Because exercise is normally a beneficial activity, doctors sometimes have difficulty separating healthy exercise patterns from unhealthy patterns. However, people with anorexia athletica typically continue exercising even when their activities clearly harm them. As with anorexia nervosa, the disorder commonly occurs in people with ongoing emotional difficulties, including depression, anxiety or low self-esteem.

Signs and Symptoms

Common outward signs of anorexia nervosa include avoiding eating, eating only small amounts of a variety of foods, eating only small amounts of specific "acceptable" foods, strict counting of calories, weighing foods before eating them, exercising even when ill or injured, frequent use of diuretics or laxatives, self-induced vomiting and frequent use of diet pills. People with the disorder also frequently weigh themselves repeatedly throughout the day, hide their bodies in baggy clothes, talk constantly about food or weight, and think of themselves as fat regardless of their actual weight.

Potential signs and symptoms of anorexia athletica include an ongoing daily preoccupation with exercise, feelings of guilt or anxiety when you can’t follow your normal exercise schedule, exercising when you should be working or attending school, feelings of isolation while exercising, loss of more than 5 percent of your healthy body weight, lying about the extent of your exercise routine, exercising even when significantly injured or ill, thinking about food only as it relates to exercise, and basing your self-worth on the amount of exercise you complete each day. Potential Effects

Anorexia nervosa can lead to a variety of significant or serious conditions throughout your body, including anemia and other blood diseases, muscle weakness, osteoporosis-related bone fracture, kidney stones, memory problems, poor body development, loss of menstruation, female infertility, electrolyte imbalances and skin that bruises easily. Potentially fatal consequences of the disorder can include heart failure, low blood pressure and kidney failure.

Anorexia athletica can lead to problems that include loss of muscle mass, bone and cartilage damage, joint damage, and tendon and ligament damage. Even minor injuries can have long-term health consequences in someone who exercises obsessively. Women and girls with the disorder can also stop menstruating or develop osteoporosis. In addition, people who have combined symptoms of anorexia nervosa and anorexia athletica can develop potentially fatal heart irregularities. Treatments

Doctors typically treat anorexia nervosa with a combination of psychotherapy and medications that combat underlying problems such as depression or anxiety. Types of therapy used include group therapy, family therapy and a behavior retraining technique called cognitive behavioral therapy. Roughly 50 percent of people with the disorder eventually recover. Treatments for anorexia athletica also typically involve some form of psychotherapy, as well as appropriate use of medications.

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