The obsession with perfection can get to neurotic levels; likened to a Tsunami that leaves a pile of rubble in its wake. Oftentimes and at any cost, even at the expense of health, many are willing to sacrifice so much so that they are more agreeable than the next person in the eyes of the public. And when it comes to body weight where it has been taken a notch higher, many believe; albeit wrongly, that low body weight is healthier and more acceptable, and so there is an overwhelming desire for some to achieve this feat at any cost.

High body weight is detrimental to health but so is its opposite extreme, the balance has been tedious to define and hard to comprehend.

The learned detrimental behaviors and progressively growing low self-esteem have been part of the problem of an eating disorder known as Anorexia. This is often characterized by abnormally low body weight, food restriction, fear of gaining weight and strong desire to be thin. The affected individuals often weigh themselves frequently, eat small amounts, or only eat certain foods.

Anorexia is estimated to affect 0.9% to 4.3% of women and 0.2% to 0.3% of men in the western world. The figures in developing economies are still unclear. Signs and symptoms include: A low BMI (Body Mass Index), Amenorrhea for women usually after prolonged weight loss, fear of the slightest weight gain, rapid continuous weight loss, and an obsession with counting calories among others.

Many factors have fueled the disorder and these include:

1. Genetic predisposition: A high proportion of sufferers inherit the condition
2. Media: Popular culture may advance certain narratives of what is ‘ideal’, and the constant communication of this information can affect and fuel neurotic behavior that pressurizes many to place a very high importance upon being thin.
3. Psychological: Low self-esteem, perceived lack of control, depression, anxiety and loneliness can fuel this behavior. Obsessive compulsive traits that make sufferers highly perfectionistic and rigid in their thought patterns are also culpable.

Early intervention in management is important and treatment is designed to address three major areas:

1. Restoring body weight: Most often achieved through diet and must be customized to an individual’s needs. Adequate calorie intake at a measured and increasing rate is important.
2. Treating psychological disorders: There has been very little evidence to support use of antidepressants to treat anorexia but in cases of significant comorbidities, there has been a need to treat comorbidities.
3. Reducing or eliminating behaviors that originally led to disordered eating, and the teaching of new and healthier habits. Cognitive behavioral therapy has been useful in the achievement of new and healthy behaviors. Family-based therapy has shown marked success in improving outcome of therapy.