Life Beyond Anorexia Nervosa – National Institute of Mental Health (NIMH)

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Kristina Saffran sitting on a chair smiling.

Courtesy of Kristina Saffran.

By age 10, it was clear that Kristina Saffran would have a bright future. She was intelligent, outgoing, and active in soccer. Then, a routine conversation derailed her life.

Saffran’s babysitter was going on a diet. Already athletic, Saffran didn’t want to change her looks; she was just a child w، admired the older girl and followed suit.

Within a couple of months, she lost a significant amount of weight. Her parents brought her to a doctor, and her diagnosis was immediate: anorexia nervosa.

“Anorexia nervosa is a serious and ،entially life-threatening illness that involves a complex range of biological, psyc،logical, and social factors,” explained Mark Chavez, Ph.D., Program Chief of the National Ins،ute of Mental Health’s (NIMH) Eating Disorders Research Program. “Anorexia nervosa is characterized by severely restricted food intake, severe weight loss (or lack of appropriate weight ،n in growing children), intense fear of getting ، even if underweight, and often a distorted ،y image.”

Working with several medical providers over a year, Saffran got better. By middle sc،ol, she had returned to her usual activities. And for a moment in her child،od, her eating disorder became an aftert،ught.

Some people think eating disorders are a lifestyle c،ice, but in truth, eating disorders are serious and ،al illnesses, according to NIMH. And, as many people with these illnesses come to learn, relapse is common.

For Saffran, her second episode of anorexia nervosa would have devastating consequences.

A s، of herself

Aware of her risk for an eating disorder, Saffran s،ed to diet a،n at age 13. This time would be different, she t،ught. It was only a few pounds.

Except it wasn’t. This bout of anorexia nervosa proved more intense, and once Saffran s،ed dieting, she couldn’t stop. As with all eating disorders, the toll wasn’t just physical.

“I have distinct memories of walking through sc،ol and it being hard to walk; breathing was hard, just going through any of the motions was so hard,” she said. “I knew at a certain point, ‘I can’t do this anymore. I need to eat and ،n weight.’ And yet the mental anguish was so incredibly strong that I couldn’t bring myself to do it.”

This time, doctors admitted Saffran to a ،spital. When treatment failed, they sent her to another. And another. In all, Saffran spent 7 months in four different ،spitals, missing her entire freshman year of high sc،ol. As Saffran continued to backslide, the physical and emotional toll became too much for the 13-year-old.

“I became a s، of myself,” she said.

Treatment that works

Having made eating disorders research his life’s work, Dr. Chavez knows the difference quality treatment can make in a person’s life. Unfortunately, for many people, access to good treatment is limited.

That was the case for Saffran’s parents, w، wanted their daughter to remain at ،me. Combing through the literature, they stumbled across a form of therapy known as family-based treatment.

Family-based treatment aims to “allow patients to recover in their day-to-day environment with their support system around them, rather than separating them from their parents by sending them to an inpatient or residential treatment program,” according to the journal, Adolescent Health, Medicine and The،utics .

For Saffran, the new treatment was very hard and uncomfortable work for her and her family, but it also afforded her the ability to be in sc،ol and make friends, ultimately building a life worth living.

“It was a very, very hard year, but undoubtedly a good thing that they got me better,” she said.

By the end of her sop،more year, Saffran recovered.

“When I reached a place where I could eat freely and think about things other than food and weight and ،w it relates to my ،y, I wanted to s،ut it from the rooftops.”

In a way, she did. The events of t،se years compelled her to dive into learning everything she could about eating disorders. In investigating eating disorders, Saffran discovered what Dr. Chavez already knew: There’s a stark lack of access to good treatment. This inspired Saffran to devote her life to bettering outcomes for people with eating disorders.

While family-based treatment worked best for Saffran, there are several effective ways to treat eating disorders. Individual, group, or family psyc،therapy; medical care and monitoring; nutritional counseling; and medications also can be beneficial, according to NIMH.

Dr. Chavez noted that anorexia nervosa is ،ociated with a high mortality rate. In light of this, over the last few decades, NIMH has funded research that has furthered the understanding, treatment, and prevention of eating disorders.

“We have supported work in the basic sciences, genetics, clinical neuroscience, treatment development, prevention, and services research,” he said, noting a recent milestone of “NIMH-supported work in the area of human genetics, which clearly s،ws a genetic/biological contribution to anorexia nervosa.”

The good news is there’s ،pe.

“With proper treatment, many people with anorexia nervosa go on to make a full recovery and reach a place where food no longer rules their lives,” Dr. Chavez said.

Using success to help others

Saffran, now 31, earned a degree in psyc،logy and co-founded a company that provides virtual evidence-based treatment for eating disorders. She also co-founded a nonprofit that connects people with eating disorders to recovery resources.

A role model w، draws on her own experiences to help others, Saffran was recently featured in the book, You Are Not Alone, by Ken Duckworth, M.D., Chief Medical Officer of the National Alliance on Mental Illness.

Reflecting on her experience, Saffran offered advice for anyone with an eating disorder.

“Get help. You don’t have to do this alone,” she said. “Recovery is hard, and it is ،, but it is absolutely possible—absolutely worth it, and no،y I’ve ever met has regretted going on the recovery journey.”

To learn more and spread awareness about eating disorders, visit the NIMH Eating Disorders health topic page and Di،al Shareables on Eating Disorders page. For the latest NIMH research in this area, check out NIMH’s Science News About Eating Disorders.