Tammy is 31 years old and weighs 32 kilograms. She has anorexia nervosa. How does an attractive, intelligent young woman loose herself down this dark path?
Causes of Anorexia
The causes of anorexia are complex. This eating disorder can be caused by a combination of many different problems including genetics, perfectionist personalities, abuse, bullying, low self-esteem, cultural pressures, and control issues. Addictive personalities and stressful life events such as family break up, or going away to school can also be triggers. Social pressures that place additional stress on being thin including ballet, gymnastics and modelling often contribute to anorexia. Brain chemistry, with high levels of cortisol and low levels of serotonin, is also believed to be a possible factor. As many as 10-20% of women, aged 15 to 40 suffer from anorexia. 6-10% of anorexics die of complications from the disease. Anorexia is not just a female condition, many boys and men are also falling prey to eating disorders.
Tammy was the perfect child, always willing to please. She was popular with her peers and her teachers. She had many hobbies including piano, horse riding, ballet, and karate. She was also a perfectionist, and would often practice a piano piece or ballet steps until she had tears of frustration running down her face. She was tenacious and never gave up until she managed to conquer what she had set out to do.
As a teenager at an Arts Educational boarding school for dancers, Tammy lost a lot of her self-confidence, and also developed body image issues. Nobody can be sure when the seeds of anorexia started to germinate in Tammy’s life, although the catalyst that tipped her into the abyss was an oppressive and dominating relationship.
Loss of Control
Tammy was engaged to a bully, who showered her with mental and emotional abuse. She is a graduate with a Swiss degree in Hotel Management, and is a member of MENSA but he belittled her achievements and sabotaged any possibilities of furthering her career. He controlled everything, including Tammy and her actions, and strongly discouraged contact with her family and friends.
This eventually took its toll on Tammy who gradually ate less and less. Her fiancé didn’t seem to notice or care. She felt invisible. When she started to lose weight off her already slender frame, other people noticed and commented. For someone starved of genuine affection this seemed to justify her very existence, and subconsciously may have fuelled the flames of anorexia even further. She lost more weight and started to feel in control again. She broke off the engagement, but by then she was strongly addicted to this deadly diet.
Denial
Her life and all her thoughts revolved around what she ate, and how she could get rid of it. Laxatives and hours of exercise became her best friends, to the exclusion of all else. Anyone who tried to stop her was the enemy. She was obsessed with food and learnt which were the lowest in calories; all other foods were avoided at all cost. She learned to eat without eating; disguising the fact that she was taking in fewer and fewer calories. All attempts to convince her that she had an eating disorder ended in vehement denial. The weight continued to melt off.
Diet Addiction
Gradually Tammy has realised that she is in serious trouble, her addiction is out of control, and she is unable to stop. She feels trapped and possessed. A part of her wants to eat and live. Another part of her looks on food with loathing, as the cause of all her misery. She believes that if she eats, she will become fat, ugly, and unloved. She cries and begs for release from this constant torment. She wants to stop her persistent obsession with food. She wants to have friends and a normal life and not be consumed by this eternal misery, but as soon a she eats anything, stomach pains wrack and ravaged her emaciated body.
Symptoms of Anorexia
Tammy is physically and psychologically unable to eat. She wakes up each morning with the resolve that today she will eat, but she sits at the table and hides her food in her napkin when she thinks nobody is watching, and eventually only manages a few mouthfuls.As a result of malnutrition and chronic under eating, Tammy is unable to digest food properly, and suffers from painful bloating and constipation.
It is difficult for her family and friends to watch her waste away. Tammy is starving to death. Her bones protrude painfully, her muscles have withered away, and her skin is dry and yellow. It is impossible not to worry about her every breath. Normal ranges of Body Mass Index for women are between 20-25% fat, while the minimum BMI for organ function and survival is 12 percent. Tammy’s Body Mass Index is 11.6. Russian Roulette without gun.
Anorexia causes a substantial loss of heart muscle and can cause the heart to shrink. The perpetual fear that her heart will give up the struggle for survival, or her kidneys will fail from potentially fatal potassium deficiency as well as the long-term effects of osteoporosis, haunts her family.
She has poor circulations and is always cold. She barely has any blood pressure, and her very low weight is now life threatening. Her brain, organs, and every single cell in her body is starved of nutrients. Her judgement is clouded; she is often uncharacteristically, moody, short tempered and irritable, a mere shadow of her former self, which are all symptoms of the disease that has this deathly grip on her.
Anorexia Cure
Tammy has finally agreed to be admitted to hospital where a dedicated team of doctors, dieticians, therapists, and psychologists can take of her psychical and emotional needs. Getting professional help is a giant step towards her rehabilitation. Therapies take many forms, although Cognitive Behaviour Therapy is becoming widespread in treating anorexic patients.
Nobody is pretending it is going to be easy. Prognosis for a full recovery is only 25% and will entail months or years of therapy, while many anorexics require treatment for the rest of their lives. As with all other addictions, it will take a monumental effort to control the urge to relapse, and will have to be taken one day at a time. Most anorexics believe that the strong hold the disease has over them can never be broken. Change is undeniably hard, but it is possible.
Tammy is scared of failure and that the demons will never leave, but she is still the little girl in the leotard practising her ballet steps. She won’t give up until she conquers what she has set out to do. Tammy is not alone in her struggle. Her family and friends stand behind her, and know that she can let go of what she is. “When I let go of what I am, I become what I might be.” - Lao Tzu
Sources: -
07/08/2011 Anorexia Nervosa
07/08/2011 Signs, Symptoms, Treatment
07/08/2011 Eating Disorders
Terence J Sanbek. The Deadly Diet. Oakland CA: New Harbinger Publications Inc .1993
Erika Gösi - I was born in Hungary, but I have lived abroad all my life where I was fortunate to have experienced many wonders of Africa and Australia, ...
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