Imagine people who look at their reflection in horror and disgust every time they passed by a mirror. Those people perceive themselves as overweight and ugly and cannot stop thinking about ways to lose weight. The thought of gaining an ounce of weight terrifies them into a pool of anxiety, leading them not to eat for days. Every gram and calorie eaten needs to be calculated to make sure they have not passed their personal weight limit. However, in reality they are severely underweight and malnourished. Their reflection shows ribs sticking out, flesh and bones, as thin as they could be. Anorexia Nervosa is a psychological illness; it is not a lifestyle. An action, such as holding food from oneself, is determined a psychological disorder when it interferes with an individuals daily tasks. The Diagnostic and Statistical Manual of Mental Disorders (DSM) characterizes Anorexia Nervosa “by distorted body image and excessive dieting that leads to severe weight loss with a pathological fear of becoming fat”(Jade). Some people do not realize that Anorexia Nervosa is an actual psychological illness. Often when people see a skinny girl walking by they nonchalantly say, “oh that girl looks anorexic, she should eat a burger”. Using mental illness terms casually in daily vocabulary causes people to think mental illnesses are not severe. Some people confuse mental illnesses such as Anorexia Nervosa for normal emotions, such as feeling sad. It is perceived that some individuals lose a great amount of weight to get attention, but for the most part, that is not the case. Even though attention seeking may be a motive for an anorexic in the beginning, Anorexia Nervosa is a real psychological disorder people suffer with diverse causes and effects.

The pressure of being thin, beautiful, and ultimately perfect is surrounding people at all times. It is plastered all over social media with the image of having a small waist and flat stomach or inspirational quotes such as “skinny never tasted so good”; it is in the headlines on newspaper with a new workout routine, and even in daily conversation. Anorexia Nervosa is not just caused by one factor; it is a combination of psychological, sociocultural, and biological factors. An individual does not have Anorexia Nervosa with all these factors; it is different for everyone (Anorexia and Effect).

It is assumed that Anorexia is just a diet gone wrong, but according to Headspace a National Youth Mental Health Foundation, “when a person has an eating disorder they can experience a range of distressing and disabling feelings and behaviors, not just restrictive eating, but bingeing, purging, and/or excessive exercising. These behaviors are often experienced as being out of the person’s control”(Headspace). This depicts one of the psychological factors, stating that the individual has no self-control over their actions even though it is hurting them. It is not Anorexia if the individual has the control over themselves to stop dieting and realizing that they are at a low unhealthy weight. Low self-esteem is another cause for this disorder and individuals with low self-esteem think negative thoughts about themselves such as not being good enough, ugly, and fat. Katie Metcalfe, who battled against Anorexia, stated, “I had no self-confidence, and my body became a focus of paranoia” (NHS). This describes how low self-esteem can lead an individual to become Anorexic. Their physical appearance becomes the only aspect they can change and they lose control of their own control because of the disorder. Some individuals measure their self worth by their thinness (UMM). As stated before in the definition of Anorexia Nervosa, individuals with this disorder have a distorted perception of their body image. According to a study from US National Library of Medicine National Institutes of Health, “several neuroimaging studies have documented structural and functional alterations of occipito-temporal cortices involved in visual body processing” (NCBI). The occipito-temporal cortices which is located in the occipital lobe is where the visual processing center is. Even when other people tell the person who is Anorexic that they are too thin, in the mirror they will see a fat person (University of Michigan Department of Psychiatry). Also, chemical changes occur in the brain when the body is deprived of nutrients causing the body to rely on adrenaline, which is a hormone that causes stress and fear, instead of the food for energy, which is not there since the person does not let himself or herself eat. This causes the perception to be distorted since the chemicals are not the way they should be (Health). One of the most prominent psychological causes is the constant fear and anxiety. The fear and anxiety can develop into the intense fear of gaining weight; in result they become obsessed with controlling their weight. It also causes them to weigh themselves repeatedly, portion food carefully, and only eats small quantities of certain foods (ANAD).

These psychological causes can also be influenced by sociocultural causes. One of the biggest culprits of causing people to feel worthless and potentially influence an eating disorder is the media, but it is not only the media, it can be friends, family, and peers. The cultural norms are promoted by the media through magazines and popular culture (Eating Disorders). Take a glance at the magazines in the grocery store, it would not be surprising if all that is seen is thin women or perfectly sculpted men on the covers. Better yet, the magazines will tell their viewers how to get the body that is presented on that magazine. Of course, the one fact that they do not tell their consumers is that it is all digitally altered; meaning the people and celebrities in the magazines do not look perfect in real life. These images are seen constantly throughout everyone’s lives and influence young girls and even boys to go on diets and take extreme measures to achieve a look that is not realistic. These diets and excessive exercising can lead individuals to become obsessed and therefore develop Anorexia when the individual loses self-control. Not only does Anorexia affect the average person, but is also affects the people in the industries in Hollywood. Many models and celebrities often develop Anorexia through the pressure of getting into the industry and staying in the industry as well. Former model Georgina Wilkin who has recovered from Anorexia states, "My agent told me I looked great when I hadn’t eaten for 48 hours…At one point I was hospitalized because I was so ill -- a few weeks later I was booked for a Prada campaign" (Krupnick). This depicts the intense pressure put on models to get the job they want and to keep their jobs. Also it shows the general public that it is okay to be unhealthy by losing a great amount of weight since they look great.

Similarly, not only do agents tell models they look great after starving themselves for 48 hours, friends, family, and peers do as well with out realizing it. From friends and family one can feel pressure to be thin. It comes from simple comments such as “oh you should probably not eat that” and “you look a bit heavier”. Sometimes these simple comments stick to the person constantly reminding them that they are not good enough and that they need to lose weight. For instance, Laurie, who overcame Anorexia stated, “I even had a counselor at my after-school YMCA program make an example of me. She told some other kids that she used to be as big as me. It really hurt me too” (Ucdavis). This depicts how simple it is to trigger someone to go down a path to lose extreme weight. Also, it shows how a counselor who is supposed to protect children is making a child feel more insecure than ever in front of peers. That one comment led Laurie to go from the size 14 to a size 9 in one summer (Ucdavis). It is not healthy to lose a ton of weight over the course of two or three months, but Laurie could not stop exercising since she developed the disorder. In many instances with individuals that are anorexic, their first motive is that they wanted attention and wanted to be skinny. For example, Amie who suffered with Anorexia, just wanted to be skinny in the beginning. In the beginning she states, “everyone else that I saw that was happy was thin too, so I figured if I lost weight, I would be happier and people would like me more-pay attention to me more” but later on she lost her friends because she would fight with everyone since she was moody and the anorexia took her over. In the end she ended up being hospitalized a few times and received treatment. She did recover from it but she sometimes gets jealous of people that cannot overcome their eating disorder but she knows that the anorexia I just talking in her head (Ucdavis). This depicts that even though in the beginning it may start off with “I like the attention”, in the end it turns into an illness that takes over the person’s life and makes it hard for them to live normally. Wanting attention is only a part of the disorder that eventually disappears because the disorder takes over their mindset and tells them they need to lose more weight because they are fat (EPublications). From constantly viewing digitally altered images daily to a comment a friend said, Anorexia Nervosa might possibly develop from these simple actions from society.

Anorexia Nervosa is often related just with psychological causes however; it has biological causes as well. Just like how Diabetes run in families so does Anorexia. Recently a group of researchers from University of Iowa and the University of Texas Southwestern Medical Center discovered the two genes that cause Anorexia. The study was done on two large families that had members who are anorexics; in each family more than half of them had the disorder. The results of this studied found that the first gene which is ESRRA, when mutated, that gene did not turn on the activity of other genes that are associated with eating habits, and this suppressed function is linked to a higher risk of eating disorders. The other gene that was discovered in this same study was HDAC4, which also inhibited the same genes that is linked to a higher risk of eating disorders, but when this gene mutated it increase expression of certain genes including ESSRA (Two Genes Linked to Increased Risk for Eating Disorders). The discovery of these two genes associating with this disorder shows that Anorexia can be predisposed. Psychologist Bulik of Virginia Commonwealth University, who was a researcher in the study, agrees that focusing solely on sociocultural factors provides a limited view of the disorder (Two Genes Linked to Increased Risk for Eating Disorders). It is no coincidence that these two genes cause a person to become Anorexic, because before this discovery the two genes have already been known to exist in the metabolic pathways in muscle, fat tissue, and are regulated by exercise (Uiowa).

Similarly in another study done in the UK, and Norway on 200 girls who were treated for anorexia the results showed that, “70 percent of the patients had suffered damage to their neurotransmitters, had undergone subtle changes in the structures of their brains, or both” (Rachel Shukert). Rachel Shukert, the author of Have You No Shame? And Other Regrettable Stories, who is an Anorexic states, “I am perfectly prepared to believe that my vulnerability to anorexia was a direct physiological legacy from him [her father], as I believe are many of our shared characteristics: tenacity, discipline, determination, drive (all of which are directly related to the anorectic personality) (Rachel Shukert). This depicts that knowing Anorexia is caused by genetics in some cases shows that it is not likely because of an attention getting ploy. People would not accuse a person having a cold that they are lying about it because there is scientific evidence that colds exists and is a sickness. These studies presents evidence that anorexia nervosa can be possibly predisposed in some individuals weakening the argument against the attention getting ploy.

There are psychological and physical effects to anorexia nervosa. Accusing an individual of getting the flu to seek attention is an uneducated claim. Just because Anorexia Nervosa is a psychological illness it should not eliminate it from being treated like any other disease. People who have the flu sometimes become delusional which is a psychological effect, but does that disregard the fact that the person is ill? No, just like how being delusional and having a high body temperature is an effect of the flu, being below the normal body max index and having a distorted body image is an effect for Anorexia Nervosa.

It is a given that there are psychological effects to Anorexia Nervosa, but it is important for people to realize what actually happens to a persons mind after suffering from this disorder. As mentioned before in the causes, individuals with this disorder have a distorted perception of their bodies. Throughout a period of time, no matter how thin they are, they continue to believe that they are still fat and need to keep losing weight or maintain their personal perfect weight. Also, they have an inner voice telling them constantly that they are fat and they even think that thinking about certain fatty foods can make them fat (ANAD). Also, most anorexics suffer from depression too. With depression comes along more negative thoughts, which might be suicidal thoughts. According to the Women’s Health Government website, “rates of death are higher than in any other psychological illness with 1 in 5 long term sufferers succumbing either as a result of starving or as a result of depression and suicide”(EPublications). This depicts the toll individuals take when they suffer form Anorexia Nervosa especially when the risk of suicide is 57 times greater among them than the general population. The prolonged starvation impairs the simple act of thinking, concentrating, and to think rationally. This causes individuals who suffer from this to not be able to understand their condition and that they need help (Jade). When people normally don’t have a proper meal the whole day imagine how moody and unfocused they get because they have not eaten in hours. Now apply that to someone who has been starving themselves for years or months. Their train of thoughts is jumbled and nothing makes sense to them because they cannot make sense of it since they are in starvation. People who suffer form Anorexia nervosa may tend to withdraw themselves away from their personal relationships such as their friends and family. They may even become very secretive about their eating habits so they do not communicate as much with their loved ones or just lose interest in things they previously enjoyed doing (Anorexia and Effects). This may cause strain in their personal relationships especially with their families. Sometimes some family members will notice that something may be wrong but don’t want to cause any type of drama or make things worse by confronting the person. They might give into whatever the person wants because they feel guilty if they don’t (Eating Disorders). On the other hand in some cases some families confront the person, asking them to stop exercising to trying to get them to eat, which may cause them to lash out even more and go deeper into their illness (Causes of Eating Disorders). The toll of suffering from Anorexia Nervosa psychologically is torture with not being able to perceive things normally to not being able to focus on anything but weight. It is not likely that people would put themselves through this just to get attention because if the person who was doing this to get attention it would mean that they are in the normal mindset and can process their thoughts. Individuals who are anorexic cannot help the thoughts that are in their head telling them they need to lose weight and they cannot decipher their thoughts or the thoughts the disorder makes them think (Health). This illness takes over their mind and body.

From exercising an unhealthy excessive amount to starving oneself, Anorexia Nervosa definitely has physical effects. Starting from the top of the body, the hair thins and gets brittle. In the heart there can be low blood pressure, slow heart rate, heart palpitations, and heart failure. In the blood there can be anemia and other blood problems. The muscles could become weak and the joints can become swollen. In the bones Osteoporosis, which is when the bones become brittle, can develop, one can be prone to fractures, and bone loss. In the kidney there can be kidney stones and kidney failure. In the body fluids there can be low potassium, magnesium, and sodium. In the intestines there can be constipation and bloating which they might be caused by eating a small amount. With the hormones in the females their menstrual cycle can stop completely which can cause trouble getting pregnant. And if they do become pregnant there is a likely higher chance of a miscarriage to happen. Not only does it affect the mother it affects the baby, which can be born with low birth weight, which is very dangerous for the baby. The skin becomes very weak, bruising easily, there can be a growth of fine hair all over body, get cold easily; yellow skin, and nails may get brittle. (EPublications). With an accumulation of that, the worst physical symptom of anorexia nervosa is death. “The mortality rate among people with anorexia is 12 times higher than the death rate among females ages 15 to 24 from all other causes”(Mental Health America). This illness can shut down each organ day by day ultimately causing death. In the end the person definitely will not look they want to look. Anorexia Nervosa may start from enjoying the attention from others because of their weight loss, but in the end it is not about attention, it is about the illness it self that takes over the persons mind and body.

Since Anorexia Nervosa is a real psychological illness that interferes with a person’s life daily, there are numerous solutions to fight this illness. 95% deny that they need help and usually refuse treatment when they are first brought to medical attention (Jade). This leads to the person to be forced into getting help. The earlier the person is treated the better the outcome will be. There are different types of treatments for this disorder. One of the treatments is behavioral technique, which is fixing the persons behavior that is causing the problem. For example, there is the reward system; if they eat they will be able to go to the bathroom alone (Eating Disorders). There are also therapy sessions, which strengthen the individual getting them to overcome their fears and get back into the control of their actions and thoughts. In the late stages of anorexia people have to get medicated and be hospitalized since the behavioral and therapy sessions won’t work at this late stage. Getting medical help and having a support system is crucial to a person who is suffering from anorexia (Mental Health America). Without it they will continue to go down a dark path that may lead to an unwanted end.

The misconception of Anorexia Nervosa being an attention getting ploy may never be erased from society’s mind, even though this illness is real which has causes and effects. Getting attention maybe a part of an anorexic’s thoughts in the beginning, but it develops into the disorder where the illness controls their actions and thoughts. It does not reject anorexia nervosa from being a psychological illness. However, the misconceptions of this illness can be changed through an effective education about psychological illnesses. This can lead society to realize that Anorexia is an illness and that individuals who suffer from it need help and support.