Adjusting weight and nutrition for anorexia nervosa. Anorexia from how many kilograms Video anorexia - documentary film

According to surveys among teenagers, more than 40% of girls aged 13-16 years say they are overweight. More than 70% of girls 16 years old have already tried some kind of diet without consulting with specialists. Fashion today dictates the standard of beauty - a slender, tall woman. Teenage girls strive to look like models, ignoring both the individual characteristics of their figure and their height (a taller girl visually looks slimmer).

In some cases, the desire for beauty turns into a disease - anorexia. But how to identify signs in an adult woman?

How does anorexia begin?

Anorexia develops over a long period of time; it appears unnoticed either by the patient or by those around her. Usually it all starts with a healthy and reasonable desire to lose weight. There are periods of dietary restriction, addiction to diets and exercise. The girl brings her figure back to normal, but continues to lose weight: the thoughts of losing weight and the pleasure of a new figure are so exciting that the anorexic can no longer stop.

Where is the line between the natural desire to be slim and the painful desire to lose weight - at any cost?

Anorexia Symptoms: Dietary Changes

At the beginning of the disease, the patient reads a lot about proper nutrition and sports. Often girls, especially in adolescence, are addicted to various diets, many of which are harmful to the body, but few people are stopped by this. Initially, the patient refuses certain unhealthy foods - cakes, sweets, pastries. Gradually, dietary restrictions become more and more stringent: the girl stops eating all sweets, then foods high in fat: butter, hard cheese.

The list of “allowed” products is decreasing every month. As a result, the diet may be reduced to buckwheat and oatmeal, vegetables and water. At the same time, the amount of food consumed decreases. There are also frequent restrictions on the time of eating: girls take the popular advice “not to eat after six” very seriously, and do not allow violations of this rule, even if they did not have time to have dinner earlier. In the most severe cases, girls with anorexia begin to fast for several days

It is important to note that all symptoms of anorexia nervosa do not occur instantly, but stretch over time over months and years. Dietary restrictions are steadily increasing, the girl does not allow herself any indulgences, even if her weight has long returned to normal.

Signs of anorexia: unhealthy exercise and food purging

Girls with anorexia are often involved in various sports, but for them sports are not a way to maintain health, but a method of losing weight. The attitude towards sport as a method of weight loss manifests itself in many situations. If a girl with anorexia feels unwell, she will not miss a run - after all, this is necessary for losing weight. The choice of exercises and sports is also very specific: for quick weight loss - jogging, for “burning fat” in the waist area - abdominal exercises. At the same time, other muscle groups, for example, arm muscles, are of little interest to a girl suffering from anorexia.

Another popular weight loss option for anorexia is a “food cleanse” by inducing vomiting and taking laxatives. If after eating, especially sweets, a girl regularly rushes to the toilet, there is a high probability of inducing vomiting. This is far from a harmless thing - due to gastric juice, tooth enamel is destroyed, and an inflammatory process develops in the throat.

Regular use of laxatives or diet pills is another common symptom of anorexia. The harm of long-term use of pharmacological drugs without indications and without medical supervision is obvious.

At what weight does anorexia begin?

The limits of normal weight can be measured using the body mass index.
Body mass index is calculated using the formula:
I =m/h2,
Where:
m - mass in kilograms
h - height in meters
For example, a girl’s weight = 50 kg, height = 170 cm. Accordingly, the body mass index in this case is equal to: BMI = 50: (1.70 × 1.70) = 17.3

Lack of body weight is a reason to consult a doctor to determine the causes and ways of weight correction.

Body Mass Index (BMI) Calculator

Using this online calculator you can calculate your body mass index, BMI (from the English Body mass index - BMI). Using your body mass index, you can check the relationship between your body weight and your height and find out whether you are overweight or underweight. To calculate your body mass index (BMI), fill in the fields corresponding to your height and weight in the calculator. Enter your height and weight with an accuracy of tenths, then the calculation result will be most accurate.

Signs of anorexia: psychological changes

Despite the conspicuous low weight, the main symptoms of anorexia are still psychological. It is in the consciousness of a girl with anorexia that the most significant changes occur, which lead to.

Anorexia begins as usual. The psychological impetus for starting to lose weight comes from ridicule or harsh statements from classmates/fellow students. Sometimes statements about fatness can be especially traumatic if they are said by a guy to whom the girl is not indifferent. The girl's self-esteem is reduced, and after such ridicule it decreases even more: she begins to think of herself as unattractive and inferior.
At some point, the girl decides to lose weight.

She believes that if you change your appearance, you can immediately become attractive and popular among your peers and among the opposite sex.
With such motivation, the girl quickly brings her weight back to normal. It’s good if she managed to lose weight wisely and avoid harmful diets, taking laxatives, weight loss drugs and inducing vomiting.

What prevents her from stopping losing weight?

Self-esteem in anorexia is very strongly related to body image. The first successes in losing weight cause real euphoria: the girl feels more beautiful and more successful than before. She sees the envious glances of her friends, the interested glances of guys, and this is a powerful incentive for her to continue working on her body. Work on the body usually continues with losing weight - the girl is used to this, and her consciousness has already firmly connected losing weight with popularity, success and happiness.

A patient with anorexia has a distorted perception of her body image: with extremely low weight, she continues to believe that in some places, for example, on the hips, there is fat that needs to be gotten rid of. It is virtually useless to convince her - neither for the parents nor for the psychologist.

Find out more:

In addition to the obsessive desire to lose weight, a person with anorexia usually communicates less with friends, and her circle of contacts narrows. Thoughts and hobbies are related to food: cooking, diets, calories.
The mood of a patient with anorexia may be depressed or change frequently. Depression and sleep disturbances are common.

Physiological symptoms of anorexia

The physiological symptoms of anorexia vary depending on the stage of anorexia. When weight loss is significantly below normal, all systems and organs of the body suffer, but disorders are not always noticeable in the first stages of anorexia: a healthy young body has a margin of safety. The first visible signs of anorexia are:

problems with the menstrual cycle
constant weakness
hair loss, brittle nails

The functioning of the endocrine system is disrupted, the concentrations of hormones, primarily sex hormones, change.
With a lack of protein in food, the body begins to destroy muscle protein, including the heart muscle. This leads to various negative consequences...

When to see a doctor for anorexia?

As with most diseases, with anorexia the rule is true: the earlier it is started, the easier and faster the patient can be cured.
If in the first stage of anorexia it is possible to do without medications, only with outpatient treatment, then in the last stages the patient ends up in intensive care, with a body weight below 35-40 kg and the risk of death. According to statistics, the mortality rate for anorexia without therapy is 5-10%.

Anorexia? We are ready to help you!

The desire to lose weight can be so unbearable that thoughts of how to become anorexic do not leave the girl for a long time. Taking into account the trends in the fashion world and the preferences of modern men, it is not difficult to explain the desire to become slim, even to the point of excessive thinness. We will help you figure out what information about this disease is true, in what time frame you can become anorexic at home, what you need to do and how to motivate yourself.

Despite the motivation to achieve results as quickly as possible, losing weight will take time, during which you need to go through several main stages. Let's consider how to drive yourself to anorexia for any girl?

The progression of the disease has 3 stages:

Discorfomanic form. At this stage, the girl suspects that her weight is somewhat abnormal and she looks overweight. Long-term examination of the reflection in the mirror indicates the presence of a dysmorphomaniac type of illness. This is followed by a quick selection of diets; the girl can only view or use them. Every day a woman talks about being overweight - now a psychological problem has already arisen;
Anorectic form. Constant fasting leads to weight loss. Anorexia often gets worse over months. After losing some weight, usually 30%, a euphoric desire appears to continue losing weight. The diet practically turns into a hunger strike, while the brain does not even show the desire to eat. It is likely that in addition a person exhausts himself with physical activity;
Cachectic. The ability to sensibly assess your weight disappears. The body begins to malfunction, hypotension appears, the menstrual cycle is delayed or stops completely, and libido decreases. All organs are affected, so the presence of other diseases is revealed during diagnosis.

Before becoming anorexic, a girl must go through all 3 stages.

In 2-3 days

It doesn’t take 2 days for people to become typical anorexics, but it’s quite possible to start with a diet in a few days. In such a short period of time, the body is able to get rid of annoying kilograms.

Let's look at what anorexics eat using the example of a 3-day “liquid” diet:

Fermented milk drinks – , milk, ;
Cocoa;
Broths, but only low-fat ones;
Tea without sugar;
Kvass.

For more than 3 days, such a diet is contraindicated, since the number of calories is scanty. Between diets, you need to stick to a different diet; doing it more than once a week is not recommended.

In a week

Anorexic girls often adhere to the so-called. It is designed for weekly use. The idea is that each day is assigned a specific color and you can only eat foods of that color. The diet of anorexics is quite strict, but for beginners a soft form is suitable, which is the “colored” diet.

Colors for days of the week:

Monday – white, (mostly dairy products) with the exception of chocolate;
Tuesday – red (tomatoes, watermelon, bell peppers, etc.);
Wednesday – green (cabbage, cucumbers, greens, etc.);
Thursday – orange (melon, tangerines, oranges);
Friday – purple (eggplant, grapes, plums);
Saturday – yellow (bananas, apricots, corn);
Sunday is a fasting day, drink exclusively mineral water.

A heavier diet for a week involves preparing the diet in such a way that the daily caloric intake is around 500 kcal. Before becoming anorexic, you need to study the characteristics of your body and find out the foods to which you are allergic.

For example, let's look at how women become anorexic in a week using the following diet:

Breakfast – coffee without sugar and an apple;
Lunch – 1 orange;
Lunch – vegetable soup with beans, salad for the second;
Dinner - 100 grams of carrots, but be sure to grate them so that they are absorbed faster.

In 2 weeks

Often diets are designed for a longer period of time with alternating foods. There is an excellent option for how anorexics lose weight - this is. There are also foods with carbohydrates here, but they are in small quantities. The diet is designed for 12 days:

Day 1 – 1 liter of kefir per day;
Day 2 – 6 oranges, it is better to eat them 5 times, and 2 pieces for lunch;
Day 3 – 0.5 kg of cottage cheese, always low-fat;
Day 4 – 0.5 kg of zucchini game (cook without vegetable oil);
Day 5 – 1 kg of apples after peeling, usually the trimmings are 200-300 g, so you can take 1.2-1.4 kg of regular apples;
Day 6 – 1 bar (100 g) of dark chocolate;
Day 7 – 300 g half-skimmed cheese;
Day 8 – 1 liter of tomato juice and 150 g of vegetable salad;
Day 9 – 400 g of lean boiled meat (chicken, veal, rabbit);
Day 10 – vegetable salad;
Day 11 – 0.5 kg of cottage cheese;
Day 12 – 1 kg of plums.

Stories of anorexics often indicate the effectiveness of another diet; girls claim that they lose about 7 kg in 2 weeks.

Typical diet broken down by day:

Water. It should be a little carbonated. It is optimal to drink 1.5 liters throughout the day;
Milk and a large but unsweetened fruit. The fat content of milk is 0.1%, and any fruit - apple, grapefruit;
Repeat the diet of the first day;
Unsweetened tea, vegetable salad. Drink 500 ml of tea without adding sugar, to remove appetite, eat carrots, greens and fresh cabbage in the form of a salad, you can add 1 tbsp. vegetable oil;
Milk. 1 l 0% fat milk;
Egg, tea, broth. During the day you can eat 1 boiled egg, unsweetened and light tea, broth with vegetables (cabbage, peas, potatoes, chicken breast) and 1 large fruit. Consume all these products in 4 doses;
Yogurt, tea and cottage cheese. Everything should be low-fat, and the tea should not be strong;
First day diet;
Milk and fruit. 1 liter of low-fat milk and 1 large fruit;
First day diet;
Vegetable and herb salad. Leafy greens and vegetables (celery, dill, parsley, etc.) are added to the salad; you can add 25 g of vegetable oil. You should get a 1 liter bowl per day;
Milk. 1 l with 0% fat content;
Egg, cottage cheese and mineral water. It is advisable that the egg be hard-boiled, low-fat cottage cheese 100 g, you can drink as much water as you like;
First day diet.

Anorexics definitely weigh much less after such a diet: the number of kilograms lost depends on the girl’s body and her previous weight. The rule is that the greater the amount of fat, the faster the weight is lost. For a skinny girl weighing 45 kg, losing 3 kg will be more difficult than for a fat 90 kg woman losing 7 kg.

We recommend reading:

For a month

Famous and beautiful anorexic models have been on diets all their lives and use 2 or 7 day courses quite aggressively, so monthly programs have been developed. In the intervals between them, shorter and lighter/strict diets are performed.

The main feature of the monthly diet is caloric restriction, that is, you can eat anything you want, but only within the specified calorie limits. To do this, you will have to carefully study the calorie content of all products and approach the choice qualitatively. Mainly eat vegetables and unsweetened fruits.

So, the home formula for becoming anorexic is:

days 1, 2, 8, 9 – 500 kcal;
days 3, 30 – 300 kcal;
days 4, 7, 13 – 400 kcal;
days 5, 19, 25, 26 – 100 kcal;
days 6, 12, 18, 23, 27, 28, 29 – 200 kcal;
11, 24 days – 150 kcal;
Day 14 – 350 kcal;
Days 15, 22 – 250 kcal.

After a short time, the girl becomes anorexic, as the manic desire to lose weight gradually intensifies, the first results lead to euphoria.

What not to do

Anorexia is a popular disease and girls strive to become one, but there are a number of ways to achieve the goal that are strictly prohibited, as they greatly harm the body:

Tablets with worms. Pills are often advertised that lead to weight loss, and they actually work because worms appear in the body. It is usually huge in size. A girl can eat as much as she wants and still lose weight. Such drugs are extremely dangerous, as over time they develop intoxication and other disorders;
Antidepressants. Often anorexics take medications that suppress vigor and reduce appetite, and they themselves expect that in this way they will achieve their goal. In fact, the drugs have a number of side effects.

Consequences

Losing weight at such a rapid pace invariably leads to serious consequences. As the disease worsens, health deteriorates further and can ultimately lead to death.

Among the most common consequences of anorexia are:

The girl often loses her hair and teeth, this is due to a lack of calcium in the body and changes in hormonal levels;
Bone fragility increases many times over, also due to the lack of calcium;
Pathological abnormalities in the functioning of the heart. Arrhythmia, extrasystole, weak pulse, ischemia and the rest are common factors of anorexia;
Depression. The psychological state of a person is very complex; due to a lack of vitamins, the brain is simply not able to maintain focus on important thoughts and digest information normally. The risk of suicide increases manifold;
Deviations in the digestive tract. The perception of complete food practically does not occur; when eating anything, a gag reflex begins;
Nervous abnormalities (breakdowns, lack of logic in behavior). Sometimes this is accompanied by the development of bad habits such as drug addiction.

Following beauty standards often leads girls to various extremes, in particular anorexia. Instead of the expected beauty, a woman gets a serious physical and mental disorder. A person cannot get out of this problem on his own, because the disease psychologically affects him from the inside.

Outwardly, a person looks extremely unnatural, and protruding bones scare people away and cause ridicule from others, which leads to even greater psychological deviation. The life of an anorexic woman can hardly be called happy, since constant illnesses and a morbid obsession with her own weight lead to depression. Quite often, anorexic women commit suicide due to prolonged depression.

When you look at photos of young girls who died from anorexia, you are filled with horror. A tribute to fashion for the ideal figure finds its fans. Only the views of those who want to lose weight and lose weight to death and those who understand that this is a mental illness differ from each other. The Medical Encyclopedia characterizes the eating disorder as a type of anorexia: anorexia nervosa.

Who is affected by anorexia nervosa?

Anorexia nervosa affects people who are overly concerned about their diet and appearance. This disorder is persistent voluntary fasting to maintain excessively low weight that is inappropriate for age and height. The reason is the unfounded fear of getting fat. It occurs in both sexes, but adolescents, maturing girls and women are most often affected.

Symptoms include continuing to diet even after reaching a weight below that appropriate for height and age and despite excessive weight loss and an emaciated appearance and weight loss - counting calories, which becomes an obsession. As a rule, the diagnosis is made in the late stages of the disease. Anorexia nervosa should be diagnosed with Simmonds' disease, adrenal insufficiency, neuroses with anorectic syndrome, depression, and schizophrenia.

Sad consequences

Anorexia nervosa ultimately leads to abnormal changes in the body: cessation of menstruation, changes in body hair, muscle weakness, dehydration, anemia, low blood pressure, weak heart rate, constipation, mouth ulcers, tooth decay, metabolic disorders, decrease in body temperature. Prolonged anorexia often impairs the functions of the heart, liver, bone marrow and causes a decrease in calcium in the bones (osteoporosis) and changes in internal organs, as a result of eating a small amount of food and insufficient intake of microelements and vitamins useful for life, etc.

Treatment includes gradual changes in diet under medical supervision to ensure adequate calorie intake and gradual weight gain; individual, group or family therapy. Life-threatening weight loss requires hospitalization. Unfortunately, sometimes it is too late, the organs undergo changes, and even if doctors rescue such patients from the “clutches” of death, they remain disabled forever.

After discharge from the hospital, patients need long-term contact with a psychotherapist. One third of girls, even after treatment to restore body weight, do not experience menstruation, as a result of which they urgently need treatment from a gynecologist-endocrinologist.

A little math

Calculation of body mass index (BMI) (the relationship between weight and height). The BMI indicator gives a rough guide, since people may have different bone density and the proportion of muscle in their total body weight.

BMI = Weight (kg) / Height (m) squared.

16 kg/m2 or less Marked weight deficiency
from 16 kg/m2 to 18 kg/m2 Insufficient (deficit) body weight
from 18 kg/2 to 25 kg/2 Norm
from 25 kg/2 to 30 kg/2 Overweight
from 30 kg/2 to 35 kg/2 Obesity 1st degree
from 35 kg/2 to 40 kg/2 Obesity 2 degrees
from 40 kg/2 or more Obesity 3 degrees

His calculation: divide your weight in kilograms by your height in meters squared. Example: BMI = 68 kg: (1.72 m x 1.72 m) = 23. (from 18 to 25 is normal).

Symptoms of anorexia

The symptoms of anorexia are a set of primary and subsequent signs by which one can recognize the onset of this terrible disease and try to prevent its development.

The standard of female beauty in the modern world is considered to be thin, graceful and slender girls, shining with their beauty on fashion catwalks and on the screens of Hollywood films. It is no wonder that most teenagers, especially the fair sex, with all the fervor of youthful maximalism, strive in everything to be like their famous idols. Therefore, they consciously and purposefully refuse food, go on strict diets and simply starve themselves in order to achieve aristocratic pallor and a physique like that of well-known stars. But such abuse of one’s own body does not pass without a trace; most often it leads to the development of a disease such as anorexia.

What is such a disease? Why does it occur and how does it begin? What are the first signs of the disease and what should you focus on?

Anorexia and its varieties

The name “anorexia” itself is borrowed from the Greek language and literally translates as “no appetite.” It manifests itself in a complete refusal to eat, which leads to rapid weight loss and entails mental disorders and nervous disorders, the main manifestations of which are phobia of obesity, manic desire to lose weight, unreasonable anxiety about weight gain, as well as a false painful perception of one’s physical health. forms.

Approximately eighty percent of anorexia sufferers are teenage girls between twelve and twenty-four years of age. The remaining twenty percent are women and older men.

The worst thing is that this disease leads to very sad consequences and in twenty percent of cases ends in death, the vast majority of which are suicide. Anorexia is considered an occupational disease in models, where it accounts for approximately seventy-two percent of cases. Timely qualified medical care leads to a complete recovery of patients in only forty to fifty percent.

Unfortunately, this disease has become so deeply ingrained in everyday life and has become so widespread among the population that in some countries it is legally prohibited to give jobs to overly thin models or anorexic models with unhealthy thinness.

There are several varieties of this disease.

According to the mechanism of development, anorexia occurs:

neurotic – when refusal to eat is caused by a strong negative emotional background, pathologically affecting the cerebral cortex;
neurodynamic – when the decrease and loss of appetite is caused by the impact on the brain of strong non-emotional stimuli, such as severe and intense pain;
neuropsychiatric - in other words, neurological, nervous, psychogenic anorexia or cachexia, which occurs against the background of a purposeful and conscious refusal to eat and is considered as a severe mental disorder - one of the types of self-destruction, classified in several degrees of severity.

In the countries of the European Community, the use of sibutramine was suspended in 2010, when the European Medicines Agency published the results of studies on the risks of side effects of the drug: the drug should not be taken by patients who have ever had diseases of the cardiovascular system - it can cause tachycardia, atrial fibrillation, and increased blood pressure , as well as convulsions, dizziness, dysmenorrhea and more than 20 side effects.

Motivator from the “40 kg” community

Fluoxetine

He's Prozac. This is not a weight loss drug, but a strong antidepressant, one of the side effects of which is loss of appetite. A person suffering from depression, when taking fluoxetine, will notice an improvement in mood, a decrease in anxiety and fear, and normalization of sleep. A pronounced effect will appear within a week of taking the drug. If fluoxetine is suitable for the patient. If not, then the impressive list of side effects of taking fluoxetine is not the worst thing. At one time, the pharmaceutical company that produced Prozac hid the fact that more than 2,000 people committed suicide while taking fluoxetine drugs. Despite the fact that before this, suicidal thoughts did not bother them, despite depression.

Aspirin or turmeric? 8 methods of contraception that are better not to try!

Hell's cocktail: ephedrine, caffeine, aspirin. Ephedrine is a psychoactive poisonous alkaloid, a raw material for the production of drugs containing methamphetamine and ephedrone. The storage, use and sale of ephedrine is prohibited in Russia, but this fact does not stop anorexics. It is impossible to find ephedrine in its pure form, but ephedrine-containing drugs are easy to find: for example, Broncholitin cough syrup. The standard composition of the cocktail is 25 mg of ephedrine, 250 mg of caffeine and 250 mg of aspirin. Girls take this mixture three times a day. Supposedly it helps burn fat at lightning speed. This naturally has an adverse effect on the cardiovascular system.

Motivator from the 40 kg community

Laxatives and diuretics

The principle of action of these drugs is clear: the first help to empty the intestines, the second have a diuretic effect - due to this, the illusion of weight loss is created. Naturally, neither the volume of muscle mass nor the volume of fat changes from taking these drugs. But problems with the gastrointestinal tract begin from the constant use of laxatives. Diuretics cannot be used at all without a doctor’s prescription: they remove potassium, calcium and magnesium ions from the body. It is very difficult to restore their balance without the supervision of a doctor and under the condition of a semi-starvation diet.

Lack of body weight is a reason to consult a doctor to determine the causes and ways of weight correction.

Body Mass Index (BMI) Calculator

Signs of anorexia: psychological changes

Despite the conspicuous low weight, the main symptoms of anorexia are still psychological. It is in the consciousness of a girl with anorexia that the most significant changes occur, which lead to mental disorder.

What prevents her from stopping losing weight?

Find out more: What are the characteristics of teenage anorexia?

Physiological symptoms of anorexia

problems with the menstrual cycle
constant weakness
hair loss, brittle nails

Read further: physiological disorders in anorexia

When to see a doctor for anorexia?

As with most diseases, with anorexia the rule is true: the earlier treatment is started, the easier and faster the patient can be cured.
If in the first stage of anorexia it is possible to do without medications, only with outpatient treatment, then in the last stages the patient ends up in intensive care, with a body weight below 35-40 kg and the risk of death. According to statistics, the mortality rate for anorexia without therapy is 5-10%.

Anorexia? We are ready to help you!

voted: 1

Video (click to play).

Reduxin

In any pharmacy you can safely purchase the drug “Reduxin-Lite” - this is not a medicine, but a food additive (dietary supplement), the main active component of which is linoleic acid. The drug Reduxin is a completely different matter. This is a prescription drug. The active ingredient is sibutramine, an anorexigenic drug. The drug artificially induces a feeling of satiety, due to which an obese patient ceases to exceed the daily calorie intake. True, sibutramine can only be used in complex therapy, under the constant supervision of a doctor, and if other methods of combating obesity have not worked, and the patient is at high risk of developing diseases associated with excess body weight. Anorexics, of course, are not obese, but they are underweight. And this body, already weakened, is forced to deal with the side effects of sibutramine.

Fluoxetine

Popular

ECA

Motivator from the 40 kg community

Laxatives and diuretics

Diets

The most popular two-week diet for anorexics contains practically no food at all: 6 apples and 2 cucumbers are the only solid food that is allowed to be eaten in 2 weeks!

1 day - green tea;
Day 2 - 4 cups of kefir;
Day 3 - 1 bottle of mineral water;
Day 4 - 1 apple;
Day 5 - 4 glasses of milk;
Day 6 – green tea;
Day 7 - 4 glasses of milk;
Day 8 - 2 apples;
Day 9 - liter of kefir;
Day 10 - 2 cucumbers;
Day 11 – green tea;
Day 12 - liter of milk;
Day 13 - 3 apples;
Day 14 - mineral water.

Motivator from the 40 kg community

On the so-called “drinking” diet, you cannot eat solid food at all. Liquid only. 10 days. For the most persistent - 14.

Between diets, the girls switch to a “healthy diet”: thin slices of whole grain bread, 20 grams of dark chocolate (99% cocoa), a pinch of oatmeal, seasoned with grated green apple for sweetness - the usual menu for the day.

Self-torture

Naturally, the body still tries to fight hunger, and girls, despite taking medications, have “breakdowns.” What they call “gluttony,” but which is essentially trying to eat a normal portion of regular food - after all, after a long fast, eating more than the usual portion is problematic. It hurts.

Motivator from the “40 kg” community

And failures always come with punishment. That is, self-torture. Posting photos of yourself with the caption “I’m fat” is the mildest possible punishment. You can also post the photo in an album for criticism and receive a dose of insults. You can punish yourself with a dry fast. Dry means you can’t even drink. No food, no water.

When obsessive thoughts about food arise, anorexics are advised to imagine something terrible instead of food: worms, rotting corpses or excrement. Do unpleasant things. Punish yourself with hard physical work.

And the last method is cuts. Anorexics cut themselves (mostly their legs, many then post photos of cuts on their thighs online). In fact, the problem of self-harm is not the problem of anorexia. Self-harm is an unhealthy attempt to relieve emotional pain, intense anger and frustration. It can bring short-term relief both on an emotional and physical level: on the one hand, there is a feeling of control over one’s own body, on the other, the cut provides a surge of adrenaline, which, in turn, makes past experiences unimportant. But not for long. Then the feeling of guilt, shame and the return of previously experienced emotions comes again.

They always do an excellent job of counting calories in food, but their ideas about what their diet should be are usually completely wrong. Most of them believe, for example, that fats and carbohydrates should be completely excluded from the diet. Therefore, at the beginning of therapy, explanations and advice on a balanced healthy diet are required. It is extremely important to convince the patient of the need to eat a varied diet.

In stationary conditions, it is advisable to first conduct observation for 1-3 days to study patient's eating habits. For severe cachexia, tube feeding is recommended; this procedure usually improves the condition quickly.

Example of weight and nutrition adjustments for anorexia nervosa

Patient 17 years old 178 cm tall and weighing 36 kg, upon admission to the hospital, reported that in recent weeks she had completely stopped sleeping. She was bothered by obsessive thoughts that the next day she would have to eat half an apple or a whole apple and one or two tablespoons of yogurt (daily diet!). These thoughts led to severe sleep disorders. The patient was fed through a tube, and as she gained weight, her sleep disturbances and obsessive thoughts disappeared.

Weight gain should be gradual, but not too much fast. Excessively rapid weight gain is prognostically unfavorable and makes it difficult to develop and normalize the perception of one’s own body (Remschmidt et al.).

The figure shows body weight dynamics(BMI) for inpatient treatment lasting 12 weeks. Patient V. experienced rapid weight gain. However, a follow-up study (3 months after discharge) showed that in patient Y., whose weight increased gradually, the success of therapy was significantly more stable. Patient V., on the contrary, experienced new, critical weight loss.

Of these observations(Remschmidt et al.) we can conclude that during inpatient treatment one should strive for the optimal, desired weight gain, which, along with other factors, is important for the prognosis.

Most patients need detailed instructions regarding quantities of food, timing and duration of food intake, preferably in the form of a meal plan.

According to the plan, reception write happens 6 times a day. Thanks to this, the portions are not too large and are tolerated normally by patients. The number of calories consumed is based on weight gain; According to this increase, an increase in activity is planned.

IN first phase of treatment Operant methods aimed primarily at increasing weight have proven themselves well. Both food intake and weight gain are subject to operant conditioning. Operant reinforcement of weight gain turned out to be practically effective. Reinforcing weight gain has a number of advantages (Steinhausen): patients can take responsibility and make their own decisions regarding eating behavior; the likelihood of typical struggles between staff or parents and patients regarding eating behavior is reduced; the reinforcement criterion can be precisely and relatively independently controlled at specific time intervals.

In practice with patient a behavioral plan resulting from reinforcement deprivation in a hospital setting is agreed upon; Having achieved a certain weight gain, the patient receives additional privileges that act as positive reinforcement.

Operant weight reinforcement as a goal of behavioral therapy is fraught with danger of manipulation on the part of the patient. Common methods of such manipulation are drinking water or eating large amounts of food before measuring weight (even to the point of risking provoking a bulimic attack). Reinforcers should be gradually withdrawn before therapy ends.

Treatment are planned in such a way that the patient gradually strengthens her own control over food intake and achieves the desired behavior, first in a hospital setting, and then at home. By extending treatment holidays, the sustainability of this behavior can be tested.

Along with behavioral therapy psychotherapeutic measures The first phase of treatment includes establishing supportive, empathic contact. But problems and conflicts are not yet directly discussed, since many patients in a state of extreme weight loss cannot yet accept psychotherapeutic offers; this is due to cognitive changes caused by fasting and cachexia.

Video anorexia - documentary

If you have problems watching, download the video from the page