Actually, we rarely treat anorexic patients in our intensive care unit, i.e. those with anorexia. Recently, however, we have treated two cases with this disease. My impression is that more and more people are getting it – perhaps also due to the influence of various challenges on social media, where, for example, your own waist should not be wider than the narrow side of a DIN A4 sheet of paper.
Anorexia often begins in adolescence, which both of our cases had in common. When they came to us, both were hypoglycemic and weighed less than 30 kilos – their condition was life-threatening.
One patient was in her 30s and had been anorexic for well over half of her life. On her first day we wanted to put her on for a while when her head fell back. She didn’t manage to get him back up on her own. Eventually the woman died – her organs and bodily functions were already too badly damaged by the disease.
At the age of less than 20, an anorexic patient had cardiac arrhythmias
The other patient was a male, not even 20 years old. His way to anorexia was through sport: when his scales showed three kilos more after a lot of muscle training and thus the opposite of what he wanted, he left out more and more food and calculated after each meal how much exercise is necessary to reduce the weight burn calories again. In no time he was in the middle of an eating disorder and ended up with us with cardiac arrhythmia.
I once asked the young man if he didn’t know that muscle weighs more than fat, so it’s normal to gain weight when you exercise a lot. He owed me an answer.
Intensive care specialist Pola Gülberg from the Ebersberger district clinic.
(Photo: Peter Hinz-Rosin)
Again and again I experience that people tend to speak reproachfully about those affected like our two patients, i.e. say something like “it’s your own fault, they should just eat more”. Such statements fail to recognize an important aspect: Anorexic people suffer from a perceptual disorder. When you look in the mirror, you don’t see the image that others have of you. Anorexia is a mental illness, but it is physically visible.
Such patients should actually be cared for in special clinics, where they can also get psychological help. We can’t do that in our intensive care unit, for us it’s all about stabilizing bodily functions. But: Special clinics are not only full and the waiting times are often very long, those affected must also show a willingness to receive therapy. A vicious circle, because in order to be ready for therapy, you have to recognize that you are ill. This is very difficult without professional psychological help. So the condition of those affected continues to deteriorate – until they eventually come to us in the intensive care unit.
Much more educational work and early therapy offers are needed, also for relatives. Because anorexia is a disease that affects the entire family.
Pola Gülberg is an intensive care nurse. In this column, the 38-year-old talks about her work at the district clinic in Ebersberg every week. The collected texts are below sueddeutsche.de/thema/Auf Station to find.