Sadorexia: symptoms, causes and treatment

Anorexia nervosa is one of the most famous and dangerous mental disorders in the short term, with a high lethal potential for those who suffer if they are not treated.

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

However, in recent times a variant or course of this disorder has been detected which can be even more dangerous, as it includes self-harm as one of its symptoms. It’s sadorexia, Which we will talk about throughout this article.

    What is sadorexia?

    Sadorexia is a second generation eating disorder, Considered a variant or a very dangerous course of anorexia nervosa.

    In this variant, in addition to the symptoms of classic anorexia (the subject who suffers from it shows an intense restriction of the intake which leads to a gradual weight loss which goes beyond the minimum healthy weight, an intense fear of taking weight and significant body image distortions that lead to the performance of behaviors that may be cessation of ingestion or methods such as excessive use of exercise, laxatives or vomiting) the sufferer adopt self-injurious behaviors in order to avoid hunger or to punish possible excess.

    Sadorexia is a condition that requires the existence of anorexia in the first place and this means that it is added to more sadomasochistic symptoms. They usually suffer from adolescent girls or young adults, 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, they may experience dizziness, pain, fatigue and low energy levels, amenorrhea or loss of menstruation, skin problems, infections, stomach, liver and kidney problems.

    It is also common to appear an anxious and depressive clinic, a great emotional lability and a possible isolation from their environment, as well as a 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 common for the person to hide their skin so that the lesions are not visible.

    Over time and without treatment, the body will weaken more and more until it can suffer from arrhythmias, organ failures, catabolism (the body consumes itself), nervous disorders, coma and / or death.

      Self-harm as a method

      These self-injurious behaviors typically include intentional beating, cuts (often with sharp instruments), burns, or even fractures. In some cases, self-harm or amputation of body parts is performed.

      The acts of self-harm that are performed in this disorder can have several purposes, although the main and what identifies sadorexia is using pain as a mechanism for forgetting to be hungry and not to eat, As well as to reduce the anxiety felt before the feeling of hunger. In this sense, at the popular level, this procedure is also known as the Pain Relief Diet.

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

      All these acts are very dangerous in themselves and can directly end the life of the person, or even weaken an organism (for example due to blood loss) already fragile due to reduced consumption or the use of methods such as sports or laxatives. It also facilitates the appearance of infections, Both for open wounds and for the progressive weakening of the immune system.

      the causes

      Sadorexia is a disorder whose study is relatively recent (in fact it is not yet covered by major diagnostic textbooks and the first mention of this term dates back to 2007), and its causes are not fully known. However, it is considered to have not a single cause but a multifactorial origin.

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

      It is proposed that a possible cause is in the projection on the eating habits of the need for control over their life. 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 competition over their lives.

      To all this is added an overrated vision of the importance of the silhouette and appearance of the body, Largely acquired culturally and which can be introjected so that in interaction with other factors, it can generate insecurities to behavioral alterations such as those mentioned.


      Sadorexia is a condition that began to be studied as such very recently, and requires multidisciplinary work and the development of more specific protocols for its treatment. However, they can use adaptations of treatments used in anorexia nervosa and disorders that are associated with self-harm.

      Doing a treatment is very useful nutritional rehabilitation, Which aims in the first place to regain 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 their condition and to maintain control of their condition. 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 help the patient to take stock of the advantages, disadvantages and risks of their current situation.

      They will need to deal with bodily distortions with methods such as cognitive restructuring or exposure (e.g. 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 the importance of body image and figure can also be restructured, treating the subject as a hypothesis but trying to help generate more adaptive alternative interpretations. Training in stress and anxiety management as well as the acquisition of coping methods of these may be positive in order to reduce self-harm.

      Adaptation of typical dialectical behavior therapy methods to reduce self-injurious behaviors could also be considered. In this sense, it can be useful to work on aspects such as self-awareness, regulation of emotions and impulsivity, social skills, vital goals and the search for a more realistic, positive self-concept. and validating.

      Other tips for accompany therapy

      Family or social support can be essentialAs they can help generate and sustain change and prevent relapse. It is useful to conduct psychoeducation not only with the patient but also with their environment to provide guidelines and promote understanding of the process that their loved one is going through.

      too much care should be taken when using internet networksAs there are dangerous pages of people with this and other eating disorders in which users are given advice to limit their intake, which can make the situation of the person suffering worse.

      Bibliographical references:

      • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
      • Bermejo, B., Saül, LA and Jenaro, C. (2011). Anorexia and bulimia on the net: Ana and Mia, two “Bad Companies” for young women today. Psychological action, 8 (1), 71-84.

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