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  • Anorexia Realis

    For reasons unconnected to my own health I got very interested in Anorexia Nervosa about a year ago. While I was doing that I discovered something interesting: that Anorexia Nervosa is a new disease, really discovered only in the 1860s and made known in the 1870s.

    There are a few clear cut cases before that, like Timothy Dwight: https://en.wikipedia.org/wiki/Histor...Timothy_Dwight

    But, basically Anorexia Nervosa hardly existed. But there was a similar condition in its place, Anorexia Miribalis. Same age group, same sex-bias (many more females than males), same symptoms, same outcome - either they got better or died - but totally different. The motivation was religious - holy fasting. Nothing to do with body image, nor as far as we can tell anything to do with wanting to be thin or to lose weight. They did it out of piety. Different but really the same.

    Now I come across something called Orthorexia Nervosa. This is not a medically recognised condition, but it is put forward as an obsession with eating the right foods. Pure foods, free of chemical additives, unmanufactured, or free of animal products, or raw, or without pesticide, etc. It is the same effects as the other variants, affects the same age-group, has the same bias towards but not exclusive to girls, and has the same risks, and people also become obsessed, malnourished and also sometimes die from it. Like Anorexia Miribalis, it is different from Anorexia Nervosa, but really it is the same.

    I propose these are three manifestations of the same illness (in time order):
    https://en.wikipedia.org/wiki/Anorexia_mirabilis
    https://en.wikipedia.org/wiki/Anorexia_nervosa
    https://en.wikipedia.org/wiki/Orthorexia_nervosa

    I propose that this is really one illness, that should be rightly called Anorexia Realis, an underlying condition currently unknown - neither what it is nor why it happens. In fact, all the explanations so far contradict each other, yet they describe what is clearly the same condition. Like Australia, this condition now has a name before being discovered itself.

    What I want to know is:

    1. What real cause? - As opposed to the fake and contradictory causes currently held.
    2. What other variants are there that we haven't noticed yet? Once you have three of a kind there are bound to be more.

  • #2
    I recently read an excellent book called 'Mad, Bad and Sad' about women and mental illnes through history. In the 1800s was the phenomena of hysteria. It was widespread amongst young women and filled the asylums and hospitals. Now it has disppeared, and instead we have anorexia and also (more recently, in the last 15 years, self-harm). These are the illnesses of the young.

    And I agree about the three anorexias being the same. Sort of. I'm tired now but am interestd in this post. Will have a closer look at your links and get back to you. it's very interesting and I think these illneses are a statment about society and the ways in which trauma and body image are dealt with in families and within a culture.

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    • #3
      I actually would totally rule out body image. The other two known types (the non-medically recognized Orthorexia and the Mirabilis variant) don't appear to involve body image at all but are clearly the same thing.

      Do you know how they treated Hysteria? NSFW

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      • #4
        Originally posted by billp View Post
        Do you know how they treated Hysteria? NSFW
        If that's the treatment I think it is, I would imagine the attractiveness of it increased the rate of complaints of hysteria.

        Comment


        • #5
          The popular perception is that anorexia nervosa and bulimia nervosa are about body image, but that's not entirely accurate. Although body image plays a role, there is also a need to assert some control over something, and for a lot of young women, the thing they most have power over is their body.

          I agree that mirabilis and nervosa are at their root likely the same--exerting power over the body as an attempt to conform to a kind of idealized perfection or purity. But in essence, anorexia, bulimia, and binge eating disorder are all strongly related, as would be ED-NOS (eating disorder not otherwise specified), which is a category used in the DSM for something that's clearly an eating disorder but does not fit all of the diagnostic criteria for one of the named disorders (this is actually where orthorexia nervosa would likely fit under the current standards).

          Sadly, young men also experience eating/body image disorders, but they are not as recognized in boys and men and often don't take the same form. You will see young men overexercising and obsessing over body image and body fat percentage, and some of these guys end up abusing steroids at young ages, for example. Males may be underdiagnosed with EDs because we strongly associate eating disorders with females, but men are as likely as women to be diagnosed with body dysmorphic disorder and more likely to be diagnosed with muscle dysmorphia.
          “If I didn't define myself for myself, I would be crunched into other people's fantasies for me and eaten alive.” --Audre Lorde

          Owly's Journal

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          • #6
            Originally posted by orielwen View Post
            If that's the treatment I think it is, I would imagine the attractiveness of it increased the rate of complaints of hysteria.
            Oh yes. Especially when carried out vigorously by strapping young doctors - as it often was, allowing them to retain a greater proportion of the fee.

            One of the ways medicine as regressed in the last hundred years. In 1910 the newspaper we full of adverts for, er, vibrating medical equipment needed to, er, cure this, er, complaint. And people think they used to be repressed in the past!

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            • #7
              It's caused by cultural stupidity.

              Comment


              • #8
                I disagree about the same origins in every case of Orthorexia Nervosa, as that can arise from wanting to avoid foods that cause inflammation, IBS and various autoimmune problems.

                These problems are more common among young women than among any other age group, as they have the strongest immune systems.
                F 5 ft 3. HW: 196 lbs. Primal SW (May 2011): 182 lbs (42% BF)... W June '12: 160 lbs (29% BF) (UK size 12, US size 8). GW: ~24% BF - have ditched the scales til I fit into a pair of UK size 10 bootcut jeans. Currently aligning towards 'The Perfect Health Diet' having swapped some fat for potatoes.

                Comment


                • #9
                  Originally posted by paleo-bunny View Post
                  I disagree about the same origins in every case of Orthorexia Nervosa, as that can arise from wanting to avoid foods that cause inflammation, IBS and various autoimmune problems.

                  These problems are more common among young women than among any other age group, as they have the strongest immune systems.
                  I would argue that eating carefully because of a health condition does not make one orthorexic. As a celiac, I'm extremely careful about my food, but that would not qualify me as orthorexic since there is clear justification for my choices. Orthorexia nervosa would be when it becomes an obsessive tendency rather than rational self-protection. It's a question of degree, just like exercising sensibly as part of a weight loss plan is different from exercising as a purging aspect of bulimia.
                  “If I didn't define myself for myself, I would be crunched into other people's fantasies for me and eaten alive.” --Audre Lorde

                  Owly's Journal

                  Comment


                  • #10
                    Originally posted by Owly View Post
                    I would argue that eating carefully because of a health condition does not make one orthorexic. As a celiac, I'm extremely careful about my food, but that would not qualify me as orthorexic since there is clear justification for my choices. Orthorexia nervosa would be when it becomes an obsessive tendency rather than rational self-protection. It's a question of degree, just like exercising sensibly as part of a weight loss plan is different from exercising as a purging aspect of bulimia.
                    I agree with that. It's a question of definition. I'm often accused of orthorexia by people who don't believe that my food intolerances exist. But in truth I'm not orthorexic and am prepared to compromise as long as certain foods I have to eat only give me mild symptoms. And I'm not underweight or malnourished.
                    F 5 ft 3. HW: 196 lbs. Primal SW (May 2011): 182 lbs (42% BF)... W June '12: 160 lbs (29% BF) (UK size 12, US size 8). GW: ~24% BF - have ditched the scales til I fit into a pair of UK size 10 bootcut jeans. Currently aligning towards 'The Perfect Health Diet' having swapped some fat for potatoes.

                    Comment


                    • #11
                      Without writing a dissertation….

                      Originally posted by Owly View Post
                      I agree that mirabilis and nervosa are at their root likely the same--exerting power over the body as an attempt to conform to a kind of idealized perfection or purity. But in essence, anorexia, bulimia, and binge eating disorder are all strongly related, as would be ED-NOS (eating disorder not otherwise specified), which is a category used in the DSM for something that's clearly an eating disorder but does not fit all of the diagnostic criteria for one of the named disorders (this is actually where orthorexia nervosa would likely fit under the current standards).
                      I agree that Anorexia Nervosa and Mirabilis are the same disease. I would recommend reading the first chapter of Crazy Like Us. It gives an interesting take on the rise and fall of various psychological “women’s” diseases including anorexia and hysteria. Basically it argues that the mode of diseases varies based on how disease is commonly held to be expressed. However, while I agree that orthorexia CAN start from a similar place, I think that orthorexia has at least as much, if not more, in common with OCD than ED. (Obviously comorbidity between the two can, and I’m sure often does, occur.)

                      Originally posted by Owly View Post
                      Orthorexia nervosa would be when it becomes an obsessive tendency rather than rational self-protection. It's a question of degree, just like exercising sensibly as part of a weight loss plan is different from exercising as a purging aspect of bulimia.
                      Agreed. Orthorexia is when “I eat organic foods because I don’t want to ingest pesticides” becomes, “I can only eat this one particular brand of carrot because it is the only of that is safe. Everything else is poison. If I eat that other carrot I will die.”
                      No disease that can be treated by diet should be treated with any other means.
                      -Maimonodies

                      The cure for anything is salt water - sweat, tears, or the sea.

                      Babes with BBQ

                      Comment


                      • #12
                        Originally posted by paleo-bunny View Post
                        I disagree about the same origins in every case of Orthorexia Nervosa, as that can arise from wanting to avoid foods that cause inflammation, IBS and various autoimmune problems.

                        These problems are more common among young women than among any other age group, as they have the strongest immune systems.
                        Women's immune systems are stong but we also are more prone to autoimmune disease. Our immune systems have to be able to adapt and almost completely drop off when we get pregnant so the fetus doesn't get attacked by it. That's why alot of auto-immune diseases begin with pregnancy. It's such a delicate balance.
                        I believe all mental illness begins with a chemical imbalance. One slight deficient or over abundance of one mineral or vitamin causes so many other chain reactions to occur. The first thing that will effect the mental state is hormonal changes which are huge in us women. We are constantly cycling and changes in hormones are a given but when we are talking huge declines or increases in one or more hormone it is major.
                        Histaria as was fixed by certain doctors with certain vibrating devices back in the 1800's (since thier husbands weren't taking care of "thier wife's business" apparantly) could be compared to mens Histaria when testosterone levels were really high during something called "blue balls." Women also get an increase of sex hormones and need a..........release or things like "Histaria" might occur. Who wouldn't get histerical at a time like that
                        Something as simple as a copper deficiency can cause an imbalance of estrogen quite easily. A zinc deficiency can cause progesterone to drop. Then you throw a change in testosterone in the mix and things get way worse. All of these hormones in turn can also cause other minerals and vitamins to become imbalanced and walla......chemical imbalance is born. Then on top of all this we also have drop dead gorgeous movie stars (most of whom have had help with that) being displayed across every magazine and commercial you see.
                        (Minerals and vitimins+/-hormonal changes+/-body image disruption = mental illness)
                        F/37yr/5' 5"
                        SW: 154 March 2011
                        CW: 140 July to Oct 2011
                        PB: 145 gained 5lbs in first 4 months March to July 2012
                        With a combo of PB and IF-ing 5 days a week (1 x 1200 calorie meal per day) I have lost 15 lbs PB/IF = 130 lbs July 2012 to current
                        GW: 120
                        Ultimate Goals ar to be: Happy/ Fit/ Energetic/ Feel great/ Balanced/ cure my thyroid and adrenals

                        Comment


                        • #13
                          Originally posted by mom5booklover View Post
                          Women's immune systems are stong but we also are more prone to autoimmune disease. Our immune systems have to be able to adapt and almost completely drop off when we get pregnant so the fetus doesn't get attacked by it. That's why alot of auto-immune diseases begin with pregnancy. It's such a delicate balance.
                          I believe all mental illness begins with a chemical imbalance. One slight deficient or over abundance of one mineral or vitamin causes so many other chain reactions to occur. The first thing that will effect the mental state is hormonal changes which are huge in us women. We are constantly cycling and changes in hormones are a given but when we are talking huge declines or increases in one or more hormone it is major.
                          Histaria as was fixed by certain doctors with certain vibrating devices back in the 1800's (since thier husbands weren't taking care of "thier wife's business" apparantly) could be compared to mens Histaria when testosterone levels were really high during something called "blue balls." Women also get an increase of sex hormones and need a..........release or things like "Histaria" might occur. Who wouldn't get histerical at a time like that
                          Something as simple as a copper deficiency can cause an imbalance of estrogen quite easily. A zinc deficiency can cause progesterone to drop. Then you throw a change in testosterone in the mix and things get way worse. All of these hormones in turn can also cause other minerals and vitamins to become imbalanced and walla......chemical imbalance is born. Then on top of all this we also have drop dead gorgeous movie stars (most of whom have had help with that) being displayed across every magazine and commercial you see.
                          (Minerals and vitimins+/-hormonal changes+/-body image disruption = mental illness)
                          Interesting history - coincidentally I was reading about those devices only earlier today, as there's a highly acclaimed play currently showing near me about that very subject - interpreted as a comedy.

                          I agree that a chemical imbalance is a factor in a lot of cases, though not necessarily a primary cause.

                          A lack of support regarding diagnosis or treatment by doctors doesn't help regarding a lot of autoimmune problems related to diet, such as IBS, chronic fatigue. The NHS has been useless in my experience. There's nothing worse than being told 'go away there's nothing wrong with you' when you're in constant agonising pain, or have chronic debilitating symptoms every single day.

                          No wonder so many young women become orthorexic. I'm sure that in many cases, the primary cause is often a lack of diagnosis of the foods and other environmental factors that are causing their illness. Eliminating more foods than is strictly necessary can of course lead to the deficiencies and imbalances that you mention, so it's a downward spiral, and food paranoia ensues.
                          Last edited by paleo-bunny; 06-07-2012, 02:29 PM.
                          F 5 ft 3. HW: 196 lbs. Primal SW (May 2011): 182 lbs (42% BF)... W June '12: 160 lbs (29% BF) (UK size 12, US size 8). GW: ~24% BF - have ditched the scales til I fit into a pair of UK size 10 bootcut jeans. Currently aligning towards 'The Perfect Health Diet' having swapped some fat for potatoes.

                          Comment


                          • #14
                            I think that all types of anorexia are basically a reaction to starvation - once you start starving yourself, for whatever reason, you get a bit weird/obsessive about food and about whatever else it is that you're focusing on (religion, body image, whatever), and then it becomes a self-perpetuating cycle of illness. It may be some sort of vitamin/mineral deficiency, maybe. I vaguely remember reading about zinc deficiency causing part of the symptoms.

                            Generally, I think that any sort of food deprivation - whether orthorexia, anorexia, or whatever - is going to set off weird obsessive symptoms in some people, even when it's "healthy" for you physically. Something that we all need to be aware of. This is the reason for Mark's recommendation of 80/20, I'm sure.

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                            • #15
                              Originally posted by meepster View Post
                              I think that all types of anorexia are basically a reaction to starvation - once you start starving yourself, for whatever reason, you get a bit weird/obsessive about food and about whatever else it is that you're focusing on (religion, body image, whatever), and then it becomes a self-perpetuating cycle of illness.
                              Yep, I'm sure of it. I think that is because normally that is the right response to starvation. This is what I wrote about starvation:
                              Please help, I need advice - Page 23 | Mark's Daily Apple Health and Fitness Forum page 23

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