Anorexia nervosa is a grave psychiatric illness characterized by a distorted body image which triggers intensive self-starvation and — as a consequence — significantly diminished body weight. It can be fatal: the mortality rate is thought to be between 4% and 20%. The very essence of this eating disorder is a categorical refusal to be cured in conjunction with a profound denial of illness. The most peculiar aspect of anorexia nervosa that may account for the denial of illness and the difficulty patients have in accepting treatment is egosyntonicity. It means that the illness is highly valued by afflicted individuals and it is inextricably linked with their sense of identity. Thus this illness is existential. Some researchers describe anorexia nervosa as suicide, but the anorexic understanding of death seems to be more complicated. If anorexia is, for the patient, an avenue to a worthwhile life, then, giving up anorexia — gaining weight — can mean giving up the reason for living. Therefore the refusal of eating that in another patient might look suicidal, may for the anorexic patient be the only way of life. The article analyses various aspects of anorexic attitudes to death.
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