While the symptoms of anorexia nervosa manifest themselves most obviously in food, for sufferers, it is never just about eating. Sufferers often talk about control and discipline. One woman who suffered from anorexia for over 30 years said to BBC reporters, "Just as some people are successful at sport, I was that dedicated to being ill."
Anorexia nervosa is a mental illness in which sufferers obsess about what they eat, often choosing not to eat at all or to exercise compulsively. In most cases, it starts during adolescence. Eating disorders are the most deadly of all mental illnesses, killing more people than alcohol abuse, depression and drug addiction. Though many people associate anorexia as a problem that affects only upper middle-class white girls, disordered eating is much more common in adolescents of color, and is becoming increasingly prevalent in boys.
The number of people with the disorder have remained steady, more doctors are reporting seeing more increasingly younger patients, some younger than 10. Researchers theorize that we are attempting to solve the problem of anorexia incorrectly. They theorize that some people are genetically predisposed to develop anorexia.
Currently, the outcome of anorexia is very poor. Only half of people who are diagnosed with the disorder are expected to recover. Many patients described cycling in and out of hospitals; one woman interviewed by BBC had been in an in-patient facility for 18 years in the last 20 years alone. One professor, Bryan Lask, founded the eating disorder unit in London's Great Ormond Street Hospital, a children's facility, and says that the problem lies in the way that doctors treat anorexia.
Lask and his team have been studying the insula, a portion of the brain that is abnormal in patients with anorexia. He says that, until we understand the underlying causes of anorexia, the treatment outcome will remain poor. In most facilities, the emphasis is placed on re-feeding and weight regain. Once patients regain their weight, he says, facilities act as if they have been cured – when that is certainly not the case.
That approach hurts many sufferers of anorexia, even those who outwardly seem to have moved past it. Another woman interviewed by BBC, who says she developed anorexia at the age of 11, says that she was diagnosed with osteoporosis at age 18, two of her vertebrae are crumbling, and she does not yet know if she will be able to have children one day.
Experts estimate that every 1 in 200 women in the United States suffers from anorexia. Only 1 in 10 receives treatment.