Sadorexia: symptoms, causes and treatment

Anorexia nervosa is one of the best known and most dangerous mental disorders. in the short term, with a high lethal potential for the sufferer if treatment is not provided.

It is one of the eating disorders, and involves the obsession with achieving a figure that is considered by themselves to be perfect at the same time. that cognitive distortions appear that make them see themselves as excessively thick or even obese, reducing their intake and performing different behaviors to reduce their weight or prevent the possibility of gaining weight despite being underweight that can cause various problems and even lead them to death.

However, in recent times a variant or evolution of this disorder has been detected that can be even more dangerous, since it includes self-harm as one of its symptoms. It's about sadorexia, about which we are going to talk throughout this article.

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What is sadorexia?

Sadorexia is a second generation eating disorder, considered a highly dangerous variant or evolution of anorexia nervosa.

In this variant, in addition to the typical symptoms of classic anorexia (the subject who suffers from it manifests an intense restriction of intake that leads to a progressive weight loss that goes beyond the minimum healthy weight, an intense fear of gaining weight and significant distortions of body image which generate the performance of behaviors that can be the cessation of ingestion or methods such as the use of excessive exercise, laxatives or causing vomiting) the person who suffers from it performs self-injurious behaviors in order to avoid hunger or punish possible excesses.

Sadorexia is a condition that requires in the first place the existence of anorexia and that supposes that this is also added to sadomasochistic symptoms. Adolescent or young adult women usually suffer from it, although there are male cases.

In addition to the above, other symptoms of both disorders include excessive and rapid weight loss that can become incompatible with life. On a physical level, dizziness, pain, fatigue and low energy level can be observed, among other things. amenorrhea or loss of menstruation, skin problems, infections, gastric, liver and kidneys.

It is also common for anxious and depressive symptoms to appear, high emotional lability and possible isolation from their environment, as well such as concealment of their eating habits and a tendency to deceive, manipulate and lie so that their habits are not detected. In sadorexia too it may be customary for the person to hide their skin from view so that lesions are not visible.

Over time and without treatment, the body will become weaker and weaker until it can suffer arrhythmias, organic failure, catabolism (the body consumes itself), nervous disorders, coma and/or death.

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Self-harm as a method

These self-injurious behaviors often include willful hitting, cutting (often with sharp instruments), burning, or even breaking bones. In some cases, self-mutilation or amputation of parts of the body is reached.

The acts of self-harm that are carried out in this disorder can have various purposes, although the main one and the one that identifies sadorexia is the use of pain as a mechanism to forget about the feeling of hunger and not eat, as well as to reduce the anxiety felt by the feeling of hunger. In this sense, at the popular level this procedure is also known as a pain diet.

In addition to this, some people with sadorexia also use self-harm as a method of self-punishment when they eat what they consider excessive. Another possible trigger is the existence of aversive feelings such as suffering, sadness or guilt, before which they can provoke physical pain in order to distract themselves and avoid focusing on the sphere emotional.

All these acts are highly dangerous by themselves and can directly end the life of the person, or further weaken a organism (for example due to blood loss) that is already fragile due to reduced intake or the use of methods such as sports or laxatives. It also facilitates the appearance of infections, both due to open wounds and the progressive weakening of the immune system.

Causes

Sadorexia is a disorder whose study is relatively new (in fact it is not yet picked up by the main diagnostic manuals and the first mention of this term dates back to 2007), and its causes are not completely known. However, it is considered that it does not have a single cause but rather has a multifactorial origin.

It has been observed that people with this type of alteration may have different characteristics, but they are usually emotionally labile and insecure subjects. Another typical profile is found in people who are perfectionists, demanding, hyper-responsible, and with rigid and inflexible beliefs. It is not infrequent that they have had previous traumatic experiences (for example bullying) and that they have felt rejected or singled out because of their physical appearance and/or their weight.

It is proposed that a possible cause may lie in the projection on eating habits of the need for control over their lives. And it is often observed that those who suffer from anorexia and this type of sadistic turn called sadorexia often have feelings of lack of control and competence over their lives.

To all this is added an overrated view of the importance of body shape and appearance, to a large extent culturally acquired and that can be introjected in such a way that in interaction with other factors it can generate from insecurities to behavioral alterations such as those mentioned.

Treatment

Sadorexia is a condition that has begun to be investigated as such very recently, and requires for its treatment of a multidisciplinary work and the elaboration of protocols more specific. However, adaptations of the treatments used in anorexia nervosa and in disorders that occur with self-harm can be used.

It is very useful for treatment. nutritional rehabilitation, with which it is intended to achieve in the first place the recovery of a healthy weight and body mass (especially when the underweight is severe) and normalize eating habits.

It may be necessary to admit the patient to the hospital, in order to normalize her state of health and maintain control over her state. It is advisable to avoid access to sharp objects usable for self-harm. Motivation for change must be worked on with techniques such as motivational interviewing and contributing to the patient herself can draw up a balance with the advantages, disadvantages and risks of her current situation.

Body distortions should be treated with methods such as cognitive restructuring or exposure (for example with mirrors or virtual reality) with response prevention (in this case both self-harm and other possible measures that the person uses).

Beliefs about oneself or about the importance of image and body shape can also be restructured, treating the subject's own as a hypothesis but trying to contribute to generate alternative interpretations more adaptive. Training in stress and anxiety management as well as in the acquisition of coping methods of these can be positive in order to reduce self-harm.

It could also consider the adaptation of methods of the dialectical behavior therapy in order to reduce self-injurious behaviors. In this sense, it can be useful to work on aspects such as self-awareness, emotion regulation and impulsivity, social skills, life goals and the search for a more realistic, positive and self-concept validator.

Other tips to accompany therapy

Family or social support may be essential, since they can contribute to generate and maintain the change and avoid relapses. It is useful to carry out psychoeducation not only with the patient but also with her environment to provide guidelines and promote understanding of the process that her loved one is going through.

Also Caution should be exercised when using Internet networks, since there are some dangerous pages of people with this and other eating pathologies in which the Users provide each other with advice to limit intake, something that can worsen the situation of the person who uses it. suffers .

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Massón, Barcelona.
• Bermejo, B., Saul, L.A. and Genaro, C. (2011). Anorexia and bulimia online: Ana and Mia, two "Bad Companies" for young people today. Psychological Action, 8 (1), 71-84.