What is anorexia nervosa that caused death of Kerala’s water fasting teen?

Kannur: The recent death of 18-year-old Sreenanda from Kannur, Kerala, has drawn attention to the risks of anorexia nervosa. According to reports, she had been surviving only on water for six months, which led to severe malnutrition and eventual organ failure.

Sreenanda, a first-year degree student, was admitted to Thalassery Cooperative Hospital in a critically weakened state. She had been bedridden and extremely underweight upon admission. Her blood pressure and pulse were very weak, with blood sugar levels dangerously low, between 40-50 mg/dL, and electrolyte imbalances. Her internal organs, including the stomach and intestines, had sustained damage due to prolonged inadequate food intake. Despite receiving treatment for ten days, including four days on ventilator support, she succumbed to her condition.

This case highlights the growing concern around eating disorders in India and the need for better awareness and intervention.

Understanding Anorexia Nervosa

Anorexia nervosa is a psychiatric disorder that causes an intense fear of gaining weight and a distorted perception of body image. Individuals with the condition restrict their food intake to dangerous levels, often leading to serious health complications, including heart failure, weakened immunity, and multi-organ damage.

Dr. Siva Anoop Yella, a consultant psychiatrist at Aster Prime Hospital, explains that eating disorders are often misunderstood.

“Anorexia nervosa is not just about dieting or losing weight. It is a complex condition influenced by psychological factors, social pressures, and, in some cases, genetics. Early recognition and intervention are critical to preventing severe outcomes,” says Dr. Siva Anoop Yella.

Recognizing the Signs

Eating disorders can be difficult to identify, especially in their early stages. Some common warning signs include:

Rapid and extreme weight loss

Avoiding meals or making excuses not to eat

Preoccupation with food, calories, and dieting

Excessive exercise, even when physically weak

Social withdrawal, especially from events involving food

Dr. Yella emphasises the importance of early intervention:

“If someone is showing these signs, it is important to approach them with support rather than criticism. Professional help from psychiatrists, dietitians, and therapists can make a significant difference,” says Dr Yella.

Difference between unscientific dieting and Anorexia nervosa

While both unscientific dieting and anorexia nervosa can have severe health consequences, they are fundamentally different conditions.

Unscientific Dieting: Lack of Awareness, Not a Mental Health Condition

Unscientific dieting often stems from misinformation and a lack of expert guidance. It is not a psychological disorder but rather a misguided approach to weight loss.

Nutritionist Varsha, from Kerala, explains:

“Unscientific dieting is a result of inadequate knowledge about nutrition and the body’s needs. For example, if someone has an undiagnosed kidney problem and follows a high-protein diet recommended by a gym trainer, it could lead to serious complications, even kidney failure. Similarly, extreme calorie deficits inspired by influencers or peers can cause severe nutritional deficiencies. Without proper medical supervision, these practices can be dangerous," she says.

Many people engage in extreme diets due to personal motivation or external pressure. However, without proper medical and nutritional guidance, they risk harming their bodies. Before starting any diet, it is crucial to consult an expert and assess overall health, including a body panel test that evaluates organ function and nutrient levels.

Anorexia Nervosa: A Psychiatric Disorder

Unlike unscientific dieting, anorexia nervosa is a psychiatric condition recognized under the International Classification of Diseases (ICD). It is characterized by an intense fear of gaining weight and a distorted body image.

Varsha highlights the key differences:

"People with anorexia nervosa do not perceive their body accurately. Even if they are extremely thin, they see themselves as overweight. They may eat only a piece of bread or a small amount of fruit, showing little to no interest in food. Over time, this leads to severe malnutrition, muscle wasting, loss of menstruation in women, and eventually, multi-organ failure. Most patients do not realize they have the condition," she adds.

Anorexia requires professional medical intervention, including therapy and nutritional rehabilitation. Family members must be vigilant in recognizing symptoms such as drastic weight loss, food avoidance, and obsessive calorie counting. Early intervention by a psychiatrist and a multidisciplinary healthcare team is crucial for recovery.

Need for Awareness and Support

Eating disorders remain largely underdiagnosed in India, partly due to stigma and lack of awareness. Families may not recognize the severity of the condition until it becomes critical. The case in Kerala shows the need for better education about eating disorders and access to mental health resources.

If you or someone you know is struggling with an eating disorder, seeking professional help early can improve outcomes. Awareness, timely intervention, and a supportive environment play a key role in recovery.