Sadorexia: symptoms, causes and treatment

This variant of anorexia is related to the use of pain to relieve discomfort.

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 not treated. It is one of the most well-known and most dangerous mental disorders in the short term, with a high lethal potential for the sufferer if left untreated.

It is one of the eating disorders, and involves an obsession with achieving a figure that is considered by themselves as perfect while 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, which can generate various problems and even lead 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. This is sadorexiaabout which we are going to speak throughout this article.

What is sadorexia?

Sadorexia is an eating disorder of the second generationconsidered a highly dangerous variant or evolution of anorexia nervosa.

In this variant, in addition to the symptoms typical of classic anorexia (the sufferer manifests an intense restriction of intake leading to a progressive weight loss that goes beyond the minimum healthy weight, an intense fear of gaining weight and important distortions of the body image which generate the realization of behaviors that can be the cessation of intake or methods such as the use of excessive exercise, laxatives or induce vomiting) the sufferer performs self-injurious behaviors in order to avoid hunger or to punish possible excesses..

Sadorexia is a condition that requires in the first place the existence of anorexia and that supposes that to this one is added in addition symptomatology of sadomasochistic type. It is usually suffered by adolescent or young adult women, 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, amenorrhea or loss of menstruation, skin problems, infections, gastric, hepatic and renal problems, among others, can be observed.

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

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

Self-injury as a method

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

The acts of self-harm performed 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 the sensation of hunger and not to eat, as well as to reduce the anxiety felt by the patient.as well as to reduce the anxiety felt before the sensation of hunger. In this sense, this procedure is also popularly known as pain diet.

In addition to this, some people with sadorexia also use self-injury as a method of self-punishment when they feel hungry. as a method of self-punishment when they make an intake that they consider excessive.. Another possible trigger is the existence of aversive feelings such as suffering, sadness or guilt, in the face of which physical pain may be provoked in order to distract oneself and avoid focusing on the emotional sphere.

All these acts are very dangerous in themselves and can either kill the person directly, or further weaken an organism (e.g. through Blood loss) that is already fragile due to reduced intake or the use of methods such as sports or laxatives. It also facilitates the development of infectionsinfections, both from open wounds and from the progressive weakening of the immune system.

Causes

Sadorexia is a disorder whose study is relatively new (in fact it is not yet included in the main diagnostic manuals and the first mention of this term dates back to 2007), and its causes are not fully known. However, it is considered that it does not have a single cause but 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. but they are usually emotionally labile and insecure individuals.. Another typical profile is found in perfectionist, demanding, hyper-responsible people with rigid and inflexible beliefs. It is not uncommon to have had previous traumatic experiences (e.g. bullying) and to have felt rejected or singled out because of their physical appearance and/or weight.

It is proposed that a possible cause may be the projection of the need for control over their lives onto their eating habits. It is often observed that those suffering from anorexia and this type of sadistic shift called sadorexia often have feelings of lack of control and competence over their lives.

In addition to all this an overvalued vision of the importance of body shape and appearance, largely culturally acquired and that can be introjected in such a way that in interaction with other factorsThis is largely culturally acquired and 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 above.

Treatment

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

In order to carry out a treatment, it is very useful nutritional rehabilitationThe first aim is to achieve the recovery of a healthy weight and body mass (especially when the underweight is severe) and to 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 condition. It is advisable to avoid access to sharp objects that can be used for self-injury. used for self-injury. Motivation to change should be worked on using techniques such as motivational interviewing and helping the patient herself to draw up a balance sheet with the advantages, disadvantages and risks of her current situation.

Body distortions should be treated with methods such as cognitive restructuring or exposure (e.g. with mirrors or virtual reality) with response prevention (in this case both self-injury and other possible measures used by the person).

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

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

Other tips to accompany therapy

Family or social support may be essentialThey can help to generate and maintain the change and avoid relapses. It is useful to carry out psychoeducation not only with the patient but also with the patient's environment to provide guidelines and promote understanding of the process their loved one is going through.

Also Caution should also be exercised with the use of Internet networksThere are some dangerous pages of people with this and other feeding pathologies in which the users give each other advice to limit the intake, something that can worsen the situation of the person who suffers from it.

Bibliographical references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
• Bermejo, B., Saúl, L.A. and Jenaro, C. (2011). Anorexia and bulimia online: Ana and Mia, two "Bad Company" for today's young women. Acción psicológica, 8 (1), 71-84.