What do anorexic people die of

Former Miss Saxony has died : Anorexia - the dangerous delusion

When a beautiful young woman dies, a successful woman who also seemed to be lucky in love, at least had a prominent partner for several years, the public is particularly shocked. Henriette Hömke, who was named Miss Saxony in 2006 at the age of 18 and who met Schalke goalkeeper Ralf Fährmann shortly afterwards, was one such woman. Blond, tall, slim. As it became known on Wednesday, she died in April during a vacation in Egypt at the age of 29 - from the effects of her anorexia.

Some of the characteristics of this dangerous mental illness, which doctors misleadingly refer to as anorexia nervosa ("nervous loss of appetite"), immediately catch the eye: it is typical that those affected get thinner and thinner and then stay that way. One criterion for diagnosis is a body mass index (BMI - kilograms of body weight divided by height in square meters) of less than 17.5 - i.e. significantly underweight. If this already begins during the growth phase, the adolescents weigh too little for their age or - although they are getting older and taller - not gaining enough weight.

Significantly more women are affected than men

What is not so easily recognized and what those affected often deny to their surroundings: They want to lose weight, it is their ambition to consciously bring about this, and despite being severely underweight they still feel too fat. When this process takes on a life of its own, a diet that was planned for a limited period of time can become a permanent state of starvation. Often "supported" by laxatives, diuretic drugs or targeted vomiting. According to a representative study on adult health in Germany from 2013, 1.1 percent of women and 0.3 percent of men between the ages of 18 and 79 suffer from anorexia.

There is also a high risk that this process will take on a life of its own, because anorexia is a disease that begins early: it occurs most frequently in the 14 to 18 age group. It affects considerably more girls than boys. In an American study from 2012, an illness rate of 0.3 percent was determined for adolescents between 13 and 18 years of age.

That sounds like a problem that is at least numerically manageable. In recent years, however, concerns have arisen that TV shows and the theming of attractive aspects of "thinness" on social networks could exacerbate the problem. Girls at risk and affected often confirm to each other in words and pictures that they are on the right track. Who then becomes really pathologically anorexic has the mental illness with the highest risk of death.

Child and adolescent psychiatrists have long been concerned with personality traits that make adolescents and young adults susceptible to anorexia nervosa. Often, their ambition becomes their undoing, which can lead to perfectionism.

Doctors hope for new therapeutic approaches

What is certain, however, is that biological predisposition also plays a role. An international team led by Laramie Duncan from Stanford University in California, together with researchers from the Medical Faculty of the University of Duisburg-Essen, has just discovered something about this: When analyzing the data from more than 3,000 patients, the researchers found abnormalities in a gene on the chromosome 12, as they announced in the American Journal of Psychiatry at the end of May. This region has already been associated with various autoimmune diseases, and there is also evidence that it is also associated with sugar metabolism.

"These discoveries can permanently change the previous understanding of anorexia nervosa: A psychiatric disorder with a physiological background opens up completely new and previously unexpected therapy options," wrote the child and adolescent psychiatrist Anke Hinney from the University Hospital Duisburg-Essen in "German." Medical journal ". In principle, it could also relieve those affected that anorexia also has genetic causes.

Limiting yourself to the extreme when eating is one thing. But with anorexia, the head often tries to rule over the body in other ways as well: Around 40 percent of people with an eating disorder - including bulimia nervosa - also display unhealthy behavior during exercise, up to towards "sports addiction". The fun of running, cycling or swimming has become the compulsion to burn as much fat as possible.

Many patients with eating disorders also suffer from "sports addiction"

"Patients with anorexia or bulimia often move in a way that harms themselves and in which the otherwise positive influence of sport is completely lost," says psychosomatic professor Almut Zeek from the University Hospital in Freiburg. In therapy, these people are then usually advised to forego their usual exercise program completely. As part of a study, the Freiburg-based researchers are now trying a different path that is more feasible for those affected: In addition to psychotherapy, the participants take part in a special sports program, which also reflects on the limits of stress and motives for doing sports. Movement should become part of their carefree joie de vivre again.

Henriette Hömke, a sporty ex-girlfriend of a competitive athlete, who last started her own business as a fitness trainer for people with dogs, is said to have collapsed while doing sports in Egypt.

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