Home page Psychology blog Bad Habits Non-Chemical Addictions Is Anorexia a Point of no Return or a Solvable Problem?

Is Anorexia a Point of no Return or a Solvable Problem?

18.06.2019 Author: Psychologist Pavel Khoroshutin

“Group rules:

1. Propaganda of “healthy fat” is not appropriate here – it will be banned. So it’s better even not to join.

2. The most important thing: we do not impose our point of view on anyone. It’s just for those who have their own views on the human body, its aesthetics. People with different views on thinness – find another place.


4. <…> We also delete messages like “weight and height is like this, I’m fat, how to lose weight and is it necessary at all?” It is necessary”.

From the rules of the group “40 kg” on “VKontakte”.

There are more than three hundred such groups on “VKontakte” social network. The number of participants in such communities ranges from several hundred to five million people. And despite the fact that the indicator of 40 kg on the scales in the vast majority of cases is incompatible with a healthy life, hundreds of thousands of young girls aspire to it.

According to a study by the Coalition on Eating Disorders, 1 person dies every 62 minutes from an eating disorder in the world. Anorexia is predominantly a problem of adolescence and early adulthood. In approximately 90% of diagnosed cases, girls aged 16 to 25 years suffer from it.

The seriousness of the problem is that it does not come down to weight loss alone, but provokes the appearance of many painful symptoms and concomitant diseases: dizziness, cramps, tooth decay, hair loss, stratification of the nails, increased cholesterol, suppression of the immune system, hypoglycemia, osteoporosis, infertility, arrhythmia and other heart diseases – up to a complete stop. According to various sources, from 5 to 10% of cases of diseases are fatal. [1]

What are the symptoms and causes of anorexia? How to recognize the presence of a problem in life and how to treat anorexia? We will talk about it in this article.


  1. Anorexia and its types
  2. Signs and symptoms of anorexia as a psychological disorder
  3. Stages of development of anorexia
  4. Causes of anorexia
  5. Methods of anorexia treatment
  6. Problem solving – the 7Spsy behavior modification technique

Anorexia and its types

refusal to eat

“I am 35. I have been sick of anorexia since 15 years. I was chubby in childhood, at 15 I weighed 62 kg, I was fat in the kindergarten, too. The reason of the disease was huge conflicts at home and, of course, the statements of the boys regarding my size. At the age of 15, any remark for a teenager is a great trauma, you can understand it”.

– Anastasia, losing weight up to 27 kg with a height of 160 cm

Anorexia is the absence or suppression of appetite in the presence of physiological demand in food due to damaged work of the feeding center.
Taking into consideration the peculiarities of the occurrence of anorexia, it is divided into the following types:

  1. Neurotic anorexia occurs against a background of prolonged depression and a continuous decrease in the psychoemotional background, which causes over-excitation of the brain and starts the processes of weight loss.
  2. Neurodynamic anorexia is associated with the occurrence of severe pain during eating or not related to eating, which provokes a refusal to eat and a decrease in appetite.
  3. Neurological (nervous) anorexia is a conscious restriction in food due to the belief in the presence of an imaginary or sharply overestimated obesity, an extremely persistent and purposeful desire to lose weight, which often reaches severe cachexia (complete exhaustion of the body) with a possible fatal outcome. [2]

In terms of causes, anorexia can be true and false:

  • In true anorexia, refusal to eat is caused by severe endocrine, mental or somatic disorders. True anorexia is caused by the disturbances in the digestive center of the cerebral cortex.
  • In case of false anorexia, refusal of food is caused by a critical attitude to one’s own appearance, a belief in one’s own imperfection and inferiority.

We will help you to combat your anorexia

Make for consultation WATCH VIDEO

Anorexia also occurs in children. Infantile anorexia is divided into primary and secondary. Primary childhood anorexia is a disease caused by a malfunction and malnutrition in a baby. Secondary anorexia is provoked by disturbances in the digestive system or other body systems.

From the point of view of psychology, anorexia is a learned model of behavior, and it can be changed. One of the effective methods of correcting negative attitudes that provoke a rejection of food is the 7Spsy behavior modification technique.

Signs and symptoms of anorexia as a psychological disorder

anorexia symptoms

“You must have forgotten that you are fat?

Remember the fullness, the feeling of heaviness that pulls you down, the hatred of yourself and your body.

Now remember the feeling of hunger. Lightness. Pride in yourself.

Remember that a moment in the mouth will stay all life – on the hips.

By the way, about them: look down and look at your huge hips.

Do you want them to become even bigger?

Do you want to be fat all your life?”

A fragment of the post in the group “40kg” on “VKontakte”

Diagnosis and treatment of anorexia begins with an assessment of the signs and symptoms of the disease.

Symptoms of the disease are:

  • registered body weight is at least 15% lower than the norm according to BMI (body mass index – a value that allows you to assess the degree of correspondence of a person’s weight and height);
  • decrease in blood pressure;
  • chills due to impaired blood flow;
  • a constant feeling of weakness in the muscles;
  • frequent dizziness, headaches and fainting;
  • brittle nails, cracking of teeth, bone fractures;
  • hair loss on the head, growing thin fluffy hair throughout the body;
  • amenorrhea (lack of menstruation) for more than three cycles.

The behavioral signs of anorexia include:

  • refusal to maintain body weight corresponding to body composition and height;
  • fear of weight gain (fatphobia);
  • continuous quantitative control of body weight and volume;
  • denial of own sheer thinness and critically low body weight;
  • disturbances in the perception of own body (the effect of a “crooked mirror”);
  • low self-esteem, self-flagellation. [3]

Anorexia signs test

Attention! The anorexia test below does not confirm the diagnosis, but only indicates some of the first signs of anorexia. Assessment of anorexia symptoms and confirmation of the diagnosis should be performed by a competent specialist.

For the statements below, note the grade, which is close to you.

Try not to spend a lot of time thinking, make a decision immediately after reading each statement.

The optimal testing time is from 1.5 to 2.5 minutes.

 Estimated StatementGrade of assessment
1I like the feeling of lightness in my stomach   
2I critically assess the condition and continuously measure the parameters of my body   
3I think about how to lose weight   
4I count calories before eating another serving of food   
5I refuse to eat high-calorie foods   
6I monitor my weight and get up on the scales after each meal (when there is such an opportunity)   
7I am terrified of the thought that I can get fat   
8I follow a diet and monitor the emergence of new means and methods of losing weight   
9I consciously skip meals, even if I feel hungry   
10I can resort to cleansing my stomach if I feel full or overeat (induce vomiting, use laxatives or diuretics)   
11I feel guilty after eating   
12People often talk about my thinness   
13Relatives make comments that I should eat more   
14It annoys me when people persuade me to eat more   
15I have delays of more than 2 months in the menstrual cycle   

If you have marked more than eight statements with degrees of “often” and “sometimes”, you may have a probable eating disorder and you should consult a specialist for more detailed diagnostics.

Stages of development of anorexia

signs of anorexia

“I started to lose weight when my boyfriend, a photographer, said that I had cellulite on the hips. Although at that time I weighed 52 kilograms. When I looked in the mirror, I really saw cellulite”.

From an interview with Anna, who has lost weight up to 32 kg with a height of 170 cm.

The course of the disease from its first signs to death can develop quite quickly – from two to five years. Anya Zholobova, proclaimed to be an anorexia icon on the Runet and became the star of a live television show. She started to lose weight at the age of 19. After losing 20 kg, her weight began to grow again. When seeing on the scale 44 kg, Anna attempted a suicide – she jumped out of the window of the fourth floor and miraculously remained alive. But, unfortunately, her life ended soon: Anya died in her sleep at the age of 21 from exhaustion and lack of oxygen. [4]

A similar story happened with Margarita Aslanyan, who lost weight from 66 to 39 kilograms. Health problems forced the girl to gain ten kilograms, but this did not help. In 2011, when Rita was 20 years old, she fell into a hunger faint and suffocated due to the fact that her tongue sunk into her throat and blocked her breathing. [5]

There are three stages of anorexia depending on the manifestation of the patient’s symptoms and behavior during the illness: dysmorphophobic, dysmorphomanic and cachectic.

1. Dysmorphophobic stage

At this stage, a patient increasingly possesses the idea of obesity. It seems to him/her that everyone around is inclined to critically evaluate his/her appearance and note the flaws in his/her figure. He/she is in constant concern and despondency, afraid of condemnation and ridicule from others. Eating habits are changing: starting to count calories, rejection of high-calorie foods and regular weight checks. Appetite at this stage remains stable or even increases.

Unable to cope with hunger, a patient can break down and eat at night.

2. Dysmorphomanic stage

At this stage, a patient is deeply convinced of the fatness and imperfection of his/her body. He/she constantly examines himself/herself in the mirror and complains about being overweight to others.

During this period, an anorexia patient is inclined to diligently engage in physical exercises. While awake, he/she prefers to spend more time standing, even in those activities that involve a sitting position: reading, writing, working at a computer, eating.

He/she drinks a lot of water and tries not to eat in front of others, eats in small portions, and after eating causes vomiting. The facts of refusal of food are carefully hidden from relatives, coming up with various tricks: to discreetly hide, spit out food or give it to pets. Before eating, he/she tightens the waist with a belt or corset so that food does not enter the intestines. He/she seeks to empty the stomach as early as possible, stimulating it with enemas. A patient experiences guilt and remorse after eating food in a larger quantity than the “norm” determined by him/her, or eating a “forbidden” product.

Against the background of an obsession with the idea of losing weight, a patient becomes addicted to pharmacological drugs that accelerate metabolism and reduce appetite, as well as laxatives and diuretics. A crave for caffeine and smoking is increasing.

3. Cachectic stage

This stage is characterized by general depletion of the body. If no measures are not taken to cure anorexia disease in the first two stages, the third stage occurs in a year and a half from the start.

Due to regular vomiting, the acidity of the stomach decreases and dystrophic disorders appear, appetite completely disappears. The appearance, taste and smell of food are disgusting, and toothpaste accidentally caught in the mouth during brushing is regarded as a sufficient amount of food. The skin dries up, the muscles become thinner and weaker, the teeth crumble and fall out, the subcutaneous fat disappears completely. Hair falls out, nails break, pressure decreases and pulse slows down. Anacid gastritis develops, which in essence is an atrophy of the mucous membrane, intestinal motility is absent. There is a prolapse of the internal organs, involution of the uterus and genitals, menstruation stops. A patient at the cachectic stage already weighs half the norm, but continues to be convinced that he/she is overweight. [6]

Causes of anorexia

anorexia symptoms

“At 10 years old, I became very sick, did not go out for four months, which led to the initial stage of childhood obesity. At 13, I became obsessed with the idea of losing weight. All methods of losing weight were dangerous: fasting, dozens of diets, vomiting, I even injured my gums so that it would be painful to eat. Probably I took all the drugs that supposedly helped to lose weight”.

– Maria, 16, weighs about 40 kg

As mentioned earlier, the symptoms of nervous anorexia are more likely to affect young teenage girls. This is due to the fact that social networks, commercials and glossy magazines show images of extremely thin models. Trying to meet the model standards, young girls become obsessed with the idea of losing weight and fear of extra pounds. At the subconscious level, anorexia is becoming a key factor in self-esteem. Girls think that refusing from food will help preserve their beauty, support their self-esteem and increase social significance. The teenage mind focuses on this idea particularly sharply due to immaturity and inadequacy. Girls completely lose their sense of reality, developing an extremely critical assessment of their own appearance. Thus, the main factor in the formation of anorexia is a mental disorder.

Today, many representatives of social media and commercial companies pay attention to the problem of imposing standards of beauty and their impact on the mind of young girls. For example, singer, composer and art philanthropist Manizha Sangin developed her own project “Beauty Injury”. Through musical compositions, videos, and public appearances, she conveys to girls the idea of accepting herself and her body, even if it is far from established concepts of the ideal and has obvious imperfections. “Yes, I am not your ideal, but who showed it to you?” – the question that sounds in one of Manizha’s songs makes us reconsider the attitude to understanding beauty as thinness. According to her hashtag #traumaticbeauty on Instagram, more than 500 inspiring stories about reappraising and accepting own body have already been published.

And in 2019, the singer, together with the well-known cosmetic brand, which for several years has been inviting non-standard models to participate in advertising campaigns, launched a large-scale international action #showus. As part of this action, more than five thousand photos of ordinary women without digital processing and retouching are available in the project’s online gallery and are broadcast on billboards in central cities of 39 countries. More than eight thousand signatures were collected by the Internet petition for the introduction of the mandatory marking “photo was retouched” in advertising materials.

The psychological factors affecting a probable disease from childhood include:

  • unfavorable situation in the family – when severe educational methods, corporal punishment and other forms of violence are applied to a child, he/she refuses food because of feelings of protest and hidden aggression;
  • divorce of parents, loss of a loved one or separation – in this case, the refusal to eat is due to attempts to gain control over the situation with a pronounced fear of loss;
  • difficult relationships with mother, prone to accentual neurosis – when mother makes high demands on a child, trying to cultivate leadership qualities in him/her everywhere and in everything, draws attention to the shortcomings and imposes the ideal figure;
  • mother’s attempts to build ideal well-being in the family – serious moral requirements are imposed on a child, mother denies the idea of a possible nervous breakdown in a child, seeks to solve health problems on her own, without turning to specialists for help, which in most cases makes the situation worse.
  • domination of parents regarding nutrition – nutrition control, punishment for malnourished food provoke a decrease in appetite and vomiting in a child;
  • hyper-care – parents prohibit much for a child and limit his/her contact with the outside world, showing excessive care, imposing the idea of the hostility of the outside world. The child feels a threat in everything, including food.

Complicated relationships with parents often become worse during the disease, which makes it difficult to treat anorexia. In such cases, psychological assistance is required both for a child and parents.

Anorexia can also occur under the influence of nonpsychotic factors:

  • pathology of the endocrine system – most frequently, inadequate functioning of the pituitary and hypothalamus, which leads to a low content of hormones or their absence;
  • digestive tract disorders – inflammation of the mucous membrane of the stomach and intestines, pancreatic failure, destruction of the liver, chronic appendicitis and hepatitis;
  • chronic renal failure – a condition lasting from three months, in which the main kidney function is disrupted – excretory;
  • the presence of cancerous tumors in the body systems – due to the impact on the endocrine system and emotional vulnerability of the patient;
  • periodic pains of a different nature (epigastric, intestinal, headache, menstrual) – at the subconscious level, the relationship of pain with eating is provoked;
  • prolonged hyperthermia due to transferred or chronic infectious lesions – disturbances in the functioning of thermoregulatory mechanisms in the human body;
  • diseases of a dental nature – fluxes and stomatitis, bleeding gums, tooth sensitivity to cold and hot food;
  • taking certain medications – antidepressants, tranquilizers, sedatives and drugs.

Genetic conditioning of the development of anorexia is also being discussed among genetic scientists, however, unambiguous research results on this topic have not yet been presented.

Methods of anorexia treatment

“Hi! Please help me get ill with anorexia. I really want to lose weight!”

“I also really want, but it doesn’t work out …”

From anonymous posts in a topical forum

The global difficulty in the treatment of anorexia is that patients themselves often do not recognize the fact of the disease, but, on the contrary, make it a cult: communicate in numerous forums, share photos and praise each other for extreme weight loss, publicly repent of breaks and overeating, make motivational appeals to each other. And they even want to get sick, seeing in this a solution to the problem with self-esteem and self-acceptance. Fans of the deceased Anya Zholobova, about whom we spoke above, continue to communicate in the community created by her, create memorial communities and “perform feats” – losing weight in her honor. In those cases when patients are aware of the danger of anorexia and try to eat, meals are accompanied by emotional discomfort, up to panic attacks.

Since anorexia is a disease that has obvious psychological problems in essence and physiological changes as a result, treatment should be comprehensive and include several directions:

  • medication and restorative treatment – aimed at improving the somatic state and restoring the elements lost by the body that are necessary for normal life (vitamin therapy, cardiovascular agents, restoring the level of fluid in the body);
  • dietitian control over nutrition and regimen – patients are prescribed 6-7 meals a day in small portions, followed by bed rest for at least two hours;
  • probe nutrition – used in extremely difficult cases, when the patient is already physically unable to eat independently;
  • behavior modification with the help of psychology – work to identify the true causes of nervous anorexia and changing attitudes, changing the learned behavior model.

One of the main tasks of psychotherapy is to eliminate the fear of control over weight change. In the process of restoring the body, the brain itself fixes the loss and allows you to compensate for the lack of weight. Full recovery is a very long process, you should be patient and should not lose hope, even in cases of relapse.

Mistakes in the actions of others that can become fatal to a patient

Mistake № 1

Parents and relatives are in no case advised to put pressure on a patient’s mind and force him/her to eat – this can only make the situation worse.

A successful therapy result is possible only when a patient is aware of the problem and wants to solve it. The task is to convey to the patient the danger of the consequences of anorexia and the need to treat it, that should be undertaken by a competent specialist – a psychologist.

Mistake № 2

It is impossible to recover from anorexia without the help of specialists – you need to accept this as a fact. On the Internet, there are many tips on how to recover from anorexia on your own at home. The number of such requests is terrifying. A patient can be at home most of the time during treatment, but only at the initial level of exhaustion (dysmorphophobic and early dysmorphomania stages) subject to fulltime presence of a loved one, close cooperation with doctors and psychologists and compliance with all their recommendations.

Prevention of anorexia in children and adolescents

The education in children and in yourself of adequate self-esteem is the best prevention of the disease. Watching and discussing documentaries, reading scientific articles and books will help a teenager understand that excessive passion for losing weight is a life-threatening problem. Set priorities: convey to a child the idea that there is nothing more important than health and that you should not chase the ideals inspired from outside.

Problem Solving – the 7Spsy behavior modification technique

In the search for psychological support, it is worthwhile to evaluate carefully the competencies of specialists and choose the best option for interaction with a psychologist. A convenient way to work is the 7Spsy behavior modification technique. This is a patented method based on the theories of the founders and authoritative experts in behavior psychology: I.P. Pavlov, A.A. Ukhtomsky, D.N. Uznadze, A. Banudra and others. Using this method, you can change the learned behavior model that provokes the disease. The method is compatible with both inpatient and outpatient drug treatment, as classes are conducted remotely, at a convenient time and in a comfortable environment. The psychologist supports the patient during the course, answers questions and gives advice via a convenient communication channel: by phone, in online chat or by e-mail.

We will help you to combat your anorexia

Make for consultation WATCH VIDEO

The 7Spsy technique will make a healthy and happy life a reality at a normal weight.


  1. Facts About Eating Disorders: What The Research Shows (http://eatingdisorderscoalition.org.s208556.gridserver.com)
  2. Marilov V.V. Dinamika nervnoi anoreksii v ramkakh pogranichnykh sostoianii. — V kn.: Problemy teoretich. i klin. med. razvivaiushchikhsia stran. — M.: Akademiia, 2009. (https://studbooks.net/900899/psihologiya/vidy_narusheniy_pischevogo_povedeniya)
  3. Meditsinskii spravochnik(http://www.med.tehlit.ru)
  4. Anna Zholobova — devushka, pogibshaia ot anoreksii (http://fb.ru/article/320314/anna-jolobova—devushka-pogibshaya-ot-anoreksii)
  5. Ia vizhu v zerkale chuzhogo cheloveka (https://meduza.io/feature/2017/04/27/ya-vizhu-v-zerkale-chuzhogo-cheloveka)
  6. Korkina M. V., Tsivilko M. A., Marilov V. V. «Nervnaia anoreksiia» (https://psychologyjournal.ru/books/nervnaya-anoreksiya-korkina-m-v-tsivilko-m-a-marilov-v-v/)