The Deadliest Mental Disorder — Anorexia Nervosa (2024)

The Deadliest Mental Disorder — Anorexia Nervosa

Anorexia nervosa is an eating disorder characterized by a relentless pursuit of thinness, difficulty maintaining an appropriate body weight, and a distorted body image. People with Anorexia Nervosa generally restrict the number of calories and the types of food that they consume on a daily basis. As with Bulimia Nervosa, some people with the disorder exercise compulsively, purge via vomiting and laxatives, and/or binge-eat as compensatory behaviors.Anorexia can affect people of allages, genders, sexual orientations, races,sizesand ethnicities and can be deadly if left untreated.If you or a loved one are struggling with anorexia, you can learn more aboutanorexia eating disorder treatment here.

Out of all the mental disorders including depression, anxiety, schizophrenia, and bipolar disorder, which do you think is the deadliest? A review of nearly fifty years of research confirms that Anorexia Nervosa has the highest mortality rate of all mental illnesses (Arcelus, Mitchel, Wales, & Nelson, 2011). But why is that so? Today, we are going to discuss the evidence behind this statistic and address the common medical complications associated with Anorexia Nervosa. We are also going to talk about how & where to get properly evaluated for medical concerns and the different treatment options for Anorexia Nervosa.

Anorexia Nervosais the second most fatal mental illness, only behindopioid overdose.

What Is Anorexia Nervosa?

Anorexia Nervosa is an eating disorder defined by a relentless pursuit of thinness. According to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the diagnostic criteria for Anorexia Nervosa are:

Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.Significantly low weight is defined as a weight that is less than minimally normal, or for children and adolescents, less than that minimally expected.
Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
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 persistent lack of recognition of the seriousness of the current low body weight.

There are two types of Anorexia Nervosa:

Restricting type: during the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.

Binge-eating/purging type: during the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior.

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Common Medical Complications Of Anorexia Nervosa & Why It Is Fatal

Simply put, Anorexia Nervosa affects your whole body.

Physical symptoms include:

Heart problems: abnormal heart rhythms, mitral valve prolapse, and heart failure

Bone loss, leading to fractures
Anemia
Females may suffer from amenorrhea—the loss of the period; males may have decreased testosterone.

*Amenorrhea is very serious. It can lead to infertility, osteoporosis, and hair loss.

Comorbid mental disorders include:

Depression
Anxiety Disorders
Personality Disorders
Obsessive-ccompulsive Disorder (OCD)
Substance Use Disorder

But How And Why Is It So Deadly?

Research has found that the rate of mortality due to all causes of death for subjects with Anorexia Nervosa is 5.9% (Sullivan, 1995). At least one-third of all deaths are estimated to be due to cardiac causes, mainly sudden death (Neumärker, 1997). Moreover, due to the psychological effect of Anorexia Nervosa, 1 in 5 deaths is caused by suicide (Arcelus et al., 2011).

Evaluations For Medical Concerns

With all the health risks listed above, a medical evaluation is necessary to assess clients for these complications in order to determine whether hospitalization is necessary. Since patients often do not present with a chief complaint of an eating disorder, the primary care physician plays a major role in detecting and evaluating signs of Anorexia Nervosa. Annual health supervision examinations and preparticipation sports physicals both are ideal screening opportunities. A medical evaluation usually includes—

Medical history
Physical examination: weight and height; vital signs including heart rate, blood pressure both supine and standing, and temperature; cardiovascular assessment; and skin examination.
Laboratory assessment: serum electrolytes, blood urea nitrogen, serum creatinine, serum glucose, liver function tests, etc.
Excluding medical disorders: neoplasm, chronic infections, uncontrolled diabetes mellitus, hyperthyroidism, etc.

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Treatment Options

Early diagnosis and treatmentcan make a huge difference in the prognosis (the expected development of an illness) of Anorexia Nervosa. According to the National Eating Disorders Association (NEDA), the following three types of psychotherapy are some of the evidence-based treatment options for Anorexia Nervosa.

Cognitive Behavioral Therapy (CBT): A relatively short-term, symptom-oriented therapy focusing on the beliefs, values, and cognitive processes that maintain the eating disorder behavior. It aims to modify distorted beliefs and attitudes about the meaning of weight, shape, and appearance, which are correlated to the development and maintenance of the eating disorder.

Dialectical Behavior Therapy (DBT): A behavioral treatment supported by empirical evidence for treatment of binge eating disorder, bulimia nervosa, and anorexia nervosa. DBT assumes that the most effective place to begin treatment is with changing behaviors. Treatment focuses on developing skills to replace maladaptive eating disorder behaviors. Skills focus on building mindfulness skills, becoming more effective in interpersonal relationships, emotion regulation, and distress tolerance. Although DBT was initially developed to treat borderline personality disorder, it is currently being used to treat eating disorders as well as substance abuse.

Acceptance and Commitment Therapy (ACT): The goal of ACT is focusing on changing your actions rather than your thoughts and feelings. Patients are taught to identify core values and commit to creating goals that fulfill these values. ACT also encourages patients to detach themselves from emotions and learn that pain and anxiety are a normal part of life. The goal isn’t to feel good, but to live an authentic life. Through living a good life, people often find they do start to feel bette

AtBALANCE eating disorder treatment center, we treat the spectrum ofeating disorders, includinganorexia,bulimia,binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. We offer a variety of virtual programs and services to help our clients not only reduce eating disorder symptoms but also move toward a more harmonious relationship with food and their bodies.Learn more about our anorexia eating disorder treatment optionhere.

This blog was written by BALANCE Intern, Enchi Dai.

Enchi is a Bachelor’s-Master’s student at New York University, majoring in Psychology. After her recovery from disordered eating, Enchi became passionate about spreading ED awareness, advocating for intuitive eating, and promoting Health at Every Size. Enchi is also an ACE Certified Personal Trainer and Registered Yoga Teacher (RYT 200). Her goal is to help people become healthier both physically and mentally, instead of encouraging them to pursue a certain body image. Along with her internship at BALANCE, Enchi works as a Research Assistant and Crisis Counselor to prepare herself for the future career as a Clinical/Counseling Psychologist.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mentaldisorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients withAnorexia Nervosa and other eating disorders. Archives of General Psychiatry, 68(7), 724-731.

Neumärker K. J. (1997). Mortality and sudden death in anorexia nervosa.The International journalof eating disorders,21(3), 205–212.https://doi.org/10.1002/(sici)1098-108x(199704)21:3<205::aid-eat1>3.0.co;2-o

Sullivan P. F. (1995). Mortality in anorexia nervosa.The American journal of psychiatry,152(7),1073–1074. https://doi.org/10.1176/ajp.152.7.1073

Types of Treatment. (2017, October 5). National Eating Disorders Association. https://www.nationaleatingdisorders.org/types-treatment

The Deadliest Mental Disorder — Anorexia Nervosa (2024)