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Anorexia: When to Start Worrying?

She is 10-14 years old, she has a low opinion of her figure, at the table sluggishly picking at a plate and counting calories according to the schemes found on “weight-loss” sites. After all, summer is coming soon, and you need to be stunning in a swimsuit and mini. What is this – the beginning of the disease or ordinary teenage experiments?

My daughter is 14 years old and she has always been thin,” says 42-year-old Larisa. – I was seriously worried when she said that she was not on a diet, she just never felt like eating. I tried to convince her that it is dangerous to harass myself like this, because you can reach anorexia, but she brushes it off and calls my fears delirium. The pediatrician says she is thin, but in his opinion, this is not a disaster. And I worry and follow her, afraid to miss the signs of a serious disorder … “

Larisa, like other parents of adolescents, runs the risk of becoming a victim of a new media psychosis, an obsessive fear of the threat of anorexia in their children. This fear is fueled by magazine photos of disembodied fashion models, shocking photo shoots on sites about anorexia, disturbing articles and confession books on the topic …

There is reason to be wary, but is it worth it to immediately panic? We will try to assess the situation soberly: not all adolescents are at risk of illness. It manifests itself only in 1–2.5% of them.

Anorexia is not a consequence of the old fashion and not an easily passing teenage problem. It is a mental illness with which medical professionals have been confronted for centuries.

At the beginning of the twentieth century, anorexia was recognized as a mental illness, although as early as the twelfth century Avicenna described a case of curing a patient whose condition today would be classified as anorexic.

“Orexis in Greek means appetite, desire,” explains psychotherapist Nadezhda Zuikova. – The name of the disorder – literally “lack of desire” – does not accurately reflect its essence. After all, anorexic people are desperately fighting the desire to eat in order to look in accordance with their, more often distorted ideas about harmony and beauty. “

This disease became widespread after the discovery of food preservation methods and … the invention of the refrigerator! From the point of view of psychoanalysts, in our unconscious he has become the symbolic equivalent of the mother, once the main supplier of food for us.

Anorexic says “no” to the ability to satisfy hunger. According to the French psychoanalyst Jacques Lacan, he eats “nothing” – the only “object” that in his eyes looks quite pure and noble. At this moment, he feels his absolute autonomy and omnipotence.

“Nothing” is the only “object” that in the eyes of anorexic looks quite pure and noble

Adults can also suffer from anorexia, but it mainly manifests itself in girls 10-14 years old. Boys get sick less often about four times.

“The search for their own identity causes a deep contradiction among adolescents: they feel the need to be at least in something the master of their lives, the desire to demonstrate the results of this“ power ”and at the same time they are afraid of growing up, afraid of responsibility for their lives, their choices,” explains Nadezhda Zuykova.

In addition, in adolescence, the body and appearance change dramatically. It may seem to a girl that it is impossible to love her “such” – and even more so, it is inconceivable to love herself. She often has a vague self-loathing, a feeling that she tries to fight by hiding in an imaginary world and thus denying her real body.

When worried, a teenage girl can go headlong into studies or playing sports – and there is nothing to worry about here, unless this feeling of rejection of herself, of disgust will sweep her entire emotional life.


It is difficult to say exactly what triggers the disease mechanism. Anorexia sometimes starts with a diet, but more often, as child psychologist Alena Romanova says, “it manifests itself after any painful events: the death of a loved one, divorce of parents, change of residence, school conflicts … As a rule, girls with anorexia are very impressionable, suspicious nature, and in adolescence these traits are aggravated. “

“In general, this disease can be considered a consequence of many reasons against the background of difficult parent-child relationships,” says Nadezhda Zuikova. “Besides, anorexia can be not only acquired, there is also a genetic predisposition to it.”

So no one will say for sure why the disease hits some and bypasses other adolescents.

Our attitudes towards food are shaped at an early age by the influence of the mother-child relationship – and some psychoanalysts have been quick to link the mother’s role to the source of the disease.

Some psychoanalysts were quick to link the maternal role to the source of the disease.


Anorexia and thinness cannot be considered synonymous. “Thinness can be a sign of physique or a symptom of some kind of somatic illness,” explains nutritionist Valentina Zimina, head of the clinical nutrition department of the Central Clinical Hospital. “Anorexia is primarily a mental illness.”

The disease strikes its victims with an internal split: on the one hand, their intelligence is above average, and on the other, they develop an anorexic mentality. “I had a voice inside me as if giving orders,” admits 12-year-old Anya, “he demanded that I stop overeating if I didn’t want to look like a fat jellyfish. And I had to eat as little as possible – I just couldn’t do otherwise. “

You cannot decide to become anorexic, you can only experience the presence of the disease as a reality that you cannot resist. Anorexics seems to draw into a kind of mental funnel, where the perception of her own body is distorted – the girl stops seeing, realizing the consequences of her behavior and lives only by denying her illness.

Anorexics seems to draw you into a kind of mental funnel, where the perception of your own body is distorted

But how do you know if a teenager is in danger? And how should parents behave? Do not create an atmosphere of constant anxiety around the child. Not following too closely, asking leading questions and unceremoniously controlling his life.

Being thin by itself doesn’t mean anything: sudden weight loss can be linked to growth spurt, but it’s important to determine if your child has an appetite.

With the help of specialists, we have compiled a list of those signs that should cause concern. Those parents who discover one or more of them, above all, should not lose their composure.

To begin with, they, without a child, need to consult a specialist and discuss the necessary steps with him. And this is very important, emphasizes Nadezhda Zuikova: “If you think that you can cope on your own, you will fail.”


How to distinguish a teenage girl who is fond of fashionable diets from anorexia? Experts name several behavioral deviations that parents need to be aware of.

1. Diet without a goal

A teenage girl’s body changes under the influence of hormones. She goes on a diet to lose weight. In this case, she usually sets a clear goal for herself: to lose three kilograms in a month or fit into tight jeans.

If she stops eating without any intelligible purpose, this may be the first sign of anorexic behavior.

A teen on a diet usually suffers from restrictions, talks about it and complains. An anorexic girl never complains. On the contrary, fasting makes her euphoric.

2. Sorting products

For anorexic, sitting down at the table is a real test. The girl counts calories, refuses fat and sugar, chews each bite for an infinitely long time.

Products should not mix and touch each other, so as not to defile her “pure” idea of ​​the ideal of her own body. Unlike simply following a diet, an anorexic girl does not avoid food.

“Some of them keep food in their room, as this enhances their sense of self-control and control over the situation,” notes Nadezhda Zuikova.

3. Disguise

As soon as the disease begins, the anorexic girl begins to choose loose clothes to hide her body.

She comes up with all sorts of excuses in order not to sit down at the table – she got sick, overslept dinner time, was already having dinner with a friend, and will eat later.

The girl does this not for pleasure, not by calculation, but rather in order not to injure her loved ones. She realizes that she can hurt them – although she does not really understand why – and tries to protect them.

However, it is very difficult to maintain a balance between what is happening in her inner world and in the real world. These efforts internally drain her.

4. Bulimia

At some point, in nine out of ten girls who get sick, anorexia is replaced by bulimia. In this case, the disease is much more difficult to recognize, as the girl begins to eat and usually gains weight again. However, the problem itself does not change from this.

“Bulimia is the opposite of anorexia,” explains Valentina Zimina. “The girls eat everything incessantly, and then, tormented by guilt, try to induce vomiting.”

Bulimia is given by blush, yellowed, watery eyes. Sometimes a girl can use “cleansing” medicines – laxatives, diuretics. But by no means are appetite suppressants – she needs to control her desire to eat herself.

And finally, wanting to cleanse herself, she drinks an incredible amount of water – up to 5-6 liters a day.


It makes no sense to look for those responsible for the occurrence of anorexia: this disease has only victims. Psychotherapist Nadezhda Zuykova emphasizes that parents can become invaluable allies of doctors and play an important role in the recovery of their child.

Why parental persuasion, threats, and entreaties don’t work?

Because the relationship between parents and children during puberty is too complicated. Anorexic mentality pushes the adolescent to manipulations that can destroy family ties. Those who hope to defeat a child’s illness with promises and agreements are mistaken: they only delay the moment of providing medical care.

What happens to the body of an anorexia patient?

It disrupts metabolism, slows down puberty up to amenorrhea (absence of menstruation), that is, systemic endocrine disorders occur. With significant weight loss, a decrease in pressure, temperature is characteristic, and changes in the heart rate occur. Edema appears, problems with skin, nails, teeth are inevitable …

What should parents do if they find signs of illness in their child?

To begin with, consult with a psychotherapist who will determine in which direction to move. Only a comprehensive treatment program can be successful with the cooperation of nutritionists, psychologists and psychiatrists who will guide both parents and adolescents, individually select the appropriate therapy for their case, and choose a treatment strategy. Parents need to be patient, strong, and support their children for several months of treatment.

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