Anorexia Nervosa is a psychological disease, often called "slimmer's disease" - although "starver's disease" might be more descriptive. Typically, anorexics have a low self-esteem, feeling that they have little impact on others; they believe that by controlling their bodies they are controlling their lives.

It is common for anorexics to be perfectionists. They may be abnormally neat, and tend to see things in extremes - beautiful or ugly, fat or thin. They tend to be good children, who want to please their parents. They are often passive and agreeable, not asserting themselves, and often not eating becomes a power struggle.

Hurtful comments about their bodies can often be a trigger. As can an environment which values high achievement and excellence,which can lead to the belief that the only way to be valued as a human being is to become perfect.

Obsessive exercising, laxative use, and avoiding eating by saying "I've already eaten", "I'm not hungry", wearing baggy clothes and an obsession with body shape and size are all indicators that something may be amiss.

Paradoxically, an obsession with food is also common. Preparing elaborate and delicious meals, and then not eating with everyone else; working with food; knowing in detail how many calories/kilojoules foods contain.

Early recognition and early intervention are the best way to deal with anorexia. Support from family and friends is also crucial.

Counselling, therapy at eating disorder clinics and support groups are all ways of dealing with the problem.

Treatment for eating disorders may encompass:

• Behaviour Modification: a system of rewards and incentives to change behaviour, often requiring the sufferer to record food intake and associated feelings.
• Psychotherapy: individually or in groups. Through psychotherapy, people are helped to correct their concepts of body-image and to develop positive self-seteem which enables the lessening of feelings of inadequacy and guilt.
• Education: dietitians or nutritionalists may assist in the retraining of healthy eating patterns.
• Family Therapy: the family as a unit, is encouraged to develop ways to cope with the disorder.

Bibliography

Anorexia Nervosa and Related Eating Disorders, Inc. (http://www.anred.com/, June 1998)

Cooke, K. Real Gorgeous - The truth about body and beauty (Sydney: Allen & Unwin, 1994)

Britannica Online. Nutrition: Diet and diseases: Obesity and Other Disorders of the Diet (http://www.eb.com:180/cgi-bin/g?DocF=macro/5004/70/50.html, June 1998)