An obsessive fear of weight can lead to eating disorders and anorexia nervosa. This condition occurs more frequently in females than males, particularly during puberty.
Exhausted from obsessive fear of getting fat.
Patient NKMA, 16 years old, was brought to the Institute of Mental Health (Bach Mai Hospital) by relatives in a state of fatigue, with her weight dropping from 47 kg to only 36 kg, despite being 1.57 m tall.
A.'s mother said that previously, A. was always cheerful and sociable, but for about four months now, she has been losing weight and recently has been unable to eat or vomits after eating. A.'s academic performance has also declined, and she has become increasingly withdrawn.
A young female patient suffering from anorexia nervosa received consultation and examination from a doctor.
According to the patient's mother, A. had previously said she wanted to lose weight to have a slim figure like her idol. Since her weight started to drop rapidly, for more than three months, the patient has also missed her period. At the hospital, despite being very thin, this 10th-grade student always claimed she was perfectly normal. A. was diagnosed with anorexia nervosa.
According to Dr. Nguyen Phuong Linh, from the Department of Treatment of Emotional and Mental Disorders at the Institute of Mental Health, doctors there have just completed a treatment course lasting over a month for a 13-year-old male patient (from Hanoi ). More than a year ago, the boy weighed 67 kg and was 1.56 m tall. While playing, he was teased by his friends for being overweight, which caused him to overthink and feel insecure. Afterward, he researched weight loss methods on social media, drastically reduced his food intake, and simultaneously engaged in high-intensity fat-burning exercises.
At this time, T. entered puberty, his height increased rapidly, his weight decreased, and his body became more balanced. Despite this, he continued his diet and exercise routine. T. gradually became thin, but he was always obsessed with the idea that his arms, legs, and stomach were still fat. When he went to the hospital for examination, he was 1.73 m tall and weighed 50 kg. Although his parents advised him to stop dieting and exercising, the boy didn't listen, eating almost no meat or fish, very few vegetables, and only a few spoonfuls of rice at lunch and dinner. Furthermore, if he didn't exercise, T. felt distressed, restless, and anxious…
Seeing T. looking thin, tired, and sluggish, his family took him to Bach Mai Hospital for examination and consultation. However, his condition did not improve upon returning home. The family then took him back to the hospital, where he was referred for further psychiatric evaluation. He was admitted with a diagnosis of anorexia nervosa/sinus bradycardia (a type of heart rhythm disorder). After more than a month of treatment, T. began to show an interest in eating, his food intake at main meals was satisfactory, and he no longer feared gaining weight. Recently, during a follow-up visit, he was in good health and emotionally stable.
Teenagers are more susceptible to this condition.
Dr. Vu Son Tung, Deputy Head of the Department of Treatment of Emotional and Mental Disorders at the Institute of Mental Health, stated that there are two types of anorexia nervosa. The first is restricted eating: patients limit their food intake by eating as little as possible. The second is eat-and-excrete: patients eat but then vomit or use laxatives to expel the food. Patients experience fear about weight gain and body image. They believe they are overweight while their weight is perfectly normal, and despite feeling hungry, they refuse food. Due to symptoms related to digestion, cardiovascular system, endocrine system, etc., anorexia nervosa is often misdiagnosed.
According to Dr. Tung, this disease usually begins during puberty and causes changes in appearance. The incidence rate is three times higher in females than in males, with 85% of patients aged 13-18. Notably, the number of people under 15 years old contracting the disease is increasing.
There are cases where prolonged fasting for weight loss also leads to amenorrhea, requiring months, even years, of intensive nutritional support and psychological treatment to return to normal. Some individuals are already very thin but still try every method to lose weight by fasting, inducing vomiting, taking laxatives, increasing exercise, etc. The consequences are fatigue, anemia, elevated liver enzymes, electrolyte imbalances, and endocrine disorders.
Explaining why anorexia nervosa often begins during puberty, Dr. Vu Son Tung said that at this age, teenagers often compare themselves to their friends' bodies and sometimes develop negative perceptions of their appearance. This leads them to decide to diet, increasing the risk of developing eating disorders. Furthermore, the prevalence of films and magazines promoting the ideal of a slim and slender physique makes it a trend among many young people.
"For adolescents, mental disorders stemming from anorexia nervosa can seriously impact future personality development. Therefore, these cases require examination and treatment by a qualified psychiatrist to identify the underlying cause and achieve effective results."
20%-25% of people with anorexia nervosa want to commit suicide.
Dr. Nguyen Phuong Linh warns that anorexia nervosa affects multiple organs of the body. Patients may experience symptoms such as fatigue; insomnia; dizziness or fainting; thinning, brittle, or falling hair; amenorrhea or menstrual irregularities; dehydration… Patients have a distorted perception of their own weight, they are wary of food, refuse to eat, or even deny being hungry; fear weight gain, become irritable; have decreased libido; and exhibit self-destructive behavior, suicidal thoughts, and behaviors.
Studies also indicate that approximately 22% of anorexia nervosa patients have at least once self-harmed through methods such as cutting, scratching, or burning themselves with tobacco. Around 20%-25% of anorexia nervosa patients have a history of attempted suicide.
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