Understanding Anorexia Nervosa: A Guide to Signs, Health Risks, and Recovery in Melbourne

Anorexia Nervosa is a severe and life-threatening psychiatric illness, not a diet or a lifestyle choice. It is characterised by relentless self-starvation, an obsessive fear of gaining weight, and a distorted perception of one's own body. For the individual struggling and the family who loves them, the experience can be one of fear, isolation, and confusion.

At Shaw Psychology, our general and clinical psychologists in Melbourne are dedicated to providing evidence-based, compassionate care to individuals on their journey to recovery. This guide aims to shed light on the signs of Anorexia Nervosa, underscore the importance of seeking help, and outline the effective treatment pathways available.

Recovery, like nurturing a delicate plant, requires patience, gentle care, and the right conditions to foster resilience and new growth.

Recognising the Signs of Anorexia Nervosa

Anorexia Nervosa affects every aspect of a person's life. The signs can be broken down into behavioural, psychological, and physical categories.

Behavioural Signs:

• Severe food restriction: Dramatically limiting the amount and types of food eaten.

• Obsessive rituals: Rigid rules around eating (e.g., cutting food into tiny pieces, eating in a specific order), obsessive calorie counting, and weighing food.

• Social withdrawal: Refusing to eat meals with family and friends or avoiding situations where food is present.

• Excessive or compulsive exercise: Exercising punitively, far beyond what is healthy, even when tired, ill, or injured.

• Secretive behaviour: Hiding food, lying about how much has been eaten, or wearing baggy clothes to hide weight loss.

  
  

Psychological & Emotional Signs:

• Intense fear of weight gain: This fear persists even with significant weight loss.

• Distorted body image: Seeing oneself as overweight despite being dangerously underweight.

• Perfectionism and rigid thinking: An all-or-nothing mindset, particularly around food, success, and self-worth.

• Low self-esteem: Tying self-worth almost exclusively to body weight, shape, and control over eating.

• Anxiety, depression, and irritability, especially around mealtimes.

  
  

Physical Signs:

• Significant and rapid weight loss, or in younger people, a failure to meet expected growth milestones.

• Feeling constantly cold.

• Fatigue, dizziness, or fainting spells.

• Hair loss or thinning.

• For females, the loss of menstrual periods (amenorrhea) or irregular periods.

• Development of fine, downy hair on the body (lanugo).

  
  

The Serious Health Risks of Anorexia Nervosa

The physical consequences of starvation are severe and can be irreversible. Anorexia Nervosa has the highest mortality rate of any psychiatric illness. The risks include life-threatening cardiac problems, osteoporosis (brittle bones), kidney and liver damage, severe dehydration, and gastrointestinal issues. Early and effective treatment is crucial in mitigating these dangers.

The Path to Recovery in Melbourne

Recovery from Anorexia Nervosa requires a multidisciplinary, evidence-based approach, as outlined in numerous clinical handbooks. In Melbourne, this journey typically involves:

1. Seeing a GP: Your doctor is the first point of contact for medical assessment and to create an Eating Disorder Plan (EDPT), which allows access to Medicare-rebated sessions.

2. Building a Treatment Team: This usually includes a psychologist to lead the psychological therapy, a dietitian to guide nutritional rehabilitation, and the GP to monitor physical health. A psychiatrist may also be involved.

3. Evidence-Based Psychological Therapy: At Shaw Psychology, we utilise several gold-standard treatments for Anorexia Nervosa:

4. Family-Based Treatment (FBT): Often the first-line treatment for children and adolescents, FBT empowers parents to take a central role in their child's nutritional and behavioural recovery.

5. Cognitive Behavioural Therapy - Enhanced (CBT-E): A leading treatment for adults, CBT-E is a highly individualised therapy focusing on the specific thoughts, feelings, and behaviours that are maintaining the eating disorder.

6. Specialist Supportive Clinical Management (SSCM): This therapy combines clinical management (like advice and encouragement) with supportive psychotherapy, focusing on issues the client identifies as important.

7. Schema Therapy & ACT: Can be integrated to address deeper underlying issues like core beliefs about worthlessness, perfectionism, and body image disturbance.

   
   

A First Step You Can Take Today: Practising Self-Compassion

The internal voice of Anorexia Nervosa is often relentlessly critical. A foundational skill in recovery, drawn from resources like "The Anorexia Recovery Skills Workbook," is to begin cultivating self-compassion. You can try a simple Self-Compassion Break:

1. Acknowledge the Suffering: In a difficult moment, pause and say to yourself, "This is a moment of suffering," or "This is really hard right now." This validates your emotional pain.

2. Recognise Common Humanity: Remind yourself, "Suffering is a part of life," or "Many people feel this way sometimes." This helps you feel less isolated in your struggle.

3. Offer Kindness to Yourself: Place a hand over your heart or another soothing place and say, "May I be kind to myself in this moment," or "May I give myself the compassion that I need."

This isn't about fixing anything, but about changing your relationship with yourself from one of criticism to one of kindness.

An Example:

Ethan, a 19-year-old university student in Melbourne, saw his focus on "healthy eating" and gym performance spiral out of control. He became obsessed with food rules, his weight dropped significantly, and he started avoiding seeing his friends. His worried parents helped him see their family GP, who created an Eating Disorder Plan. Ethan began therapy, working with a psychologist and a dietitian. Initially resistant, the non-judgmental, collaborative approach of CBT-E slowly helped him see the eating disorder as a separate entity, not his true identity. A significant turning point was challenging one small food rule—adding avocado to his toast—a terrifying but empowering step he took with the support of his team.

(Please note: This is a fictional vignette created for illustrative purposes only.)

Recovery is a Journey of Hope

Recovering from Anorexia Nervosa is challenging, but it is absolutely possible. With specialised, compassionate, and evidence-based care, individuals can restore their physical health, develop a peaceful relationship with food and their body, and rediscover a life full of meaning, connection, and self-worth.

If you or someone you care about is struggling with the signs of Anorexia Nervosa in Melbourne, please reach out.

Contact us today on (03) 9969 2190, visit our website at www.shawpsychology.com to learn more, or book an initial consultation directly online here: https://bit.ly/bookshawpsychology.