Lam, who weighed 65 kg with a normal body mass index (BMI), constantly worried about his appearance, feeling "not thin enough." Starting early last year, Lam began eating less, skipping meals, and exercising one hour daily. By the end of the year, he had lost 30 kg but experienced exhaustion, prolonged anxiety, and reduced concentration. Upon examination at Tam Anh Cau Giay General Clinic, Lam was severely emaciated, with a BMI of only 13,7 (the average range is 18,5 - 22,9), showing reduced blood cells and elevated liver enzymes.

Master Doctor Nguyen Huong Quynh from the Psychology - Mental Health Clinic diagnosed Lam with anorexia nervosa. This mental disorder is characterized by an intense fear of weight gain, prompting patients to severely restrict their food intake despite their bodies lacking energy.

Doctor Quynh consults a patient. Photo: Tam Anh Cau Giay General Clinic

According to Doctor Quynh, anorexia nervosa is one of the most dangerous eating disorders, with a high mortality rate among mental illnesses. While it is often observed in adolescent females, recent years have shown an increasing prevalence in males, attributed to societal pressures regarding appearance and body image. Patients typically exhibit prolonged food restriction, an extreme fear of weight gain, and a distorted perception of their own body. Even when severely underweight, they often believe their body is "not thin enough."

Anorexia nervosa develops from a combination of factors. Biologically, imbalances in neurotransmitters can affect hunger, satiety, and emotional regulation. Psychologically, individuals with the disorder are often perfectionists, set high self-standards, and are susceptible to external judgments. Social factors, particularly unrealistic beauty standards, also contribute to an increased risk. Prolonged energy deficiency caused by anorexia nervosa forces the body's organs to reduce activity to sustain life. This leads to decreased blood cell production, liver dysfunction, impacts the brain, and fosters negative thoughts, intensifying the obsession with weight.

Doctors developed a gradual nutritional plan for Lam, ensuring safety and preventing refeeding syndrome—a series of metabolic disturbances that can occur when chronically starved or severely malnourished individuals are re-fed. Concurrently, Lam received medication to improve his sleep, reduce anxiety, and stabilize his mood. As his sleep recovered, his ability to regulate emotions and his cognitive functions also improved.

Through therapy sessions, Lam learned to identify distorted thoughts. "We do not force patients to eat; instead, we help them understand and overcome their fear of eating", Doctor Quynh said, adding that when perception changes, behavior will follow.

After two months of treatment, Lam gained 10 kg, and his BMI reached 17,91. His blood count and liver enzyme levels returned to normal. His mental state improved significantly; he communicated more, experienced reduced anxiety, and was no longer obsessed with eating.

Doctor Quynh advises parents to closely monitor changes in their adolescents' eating habits, weight, and psychological state. Signs such as rapid weight loss, an obsession with appearance, sleep disturbances, social withdrawal, or prolonged anxiety require immediate attention. Early detection significantly increases the chances of successful treatment and reduces the risk of complications.

Thanh Ba