The phrase, "In hunger I am king" shows the psychological struggle of those suffering from anorexia nervosa syndrome. When Kazantzakis was in Spain he wrote about meeting a youth named Manola, who laid around all day and never worked to make money to eat and consequently never ate. When Kazantzakis asked him why he did not get up and work, he replied, "In hunger I am king." He believed that hunger was his kingdom, and as long as he was hungry he was king.
The symptoms of anorexia nervosa, also known as "the starving disease" , are dramatic loss of weight (up to twenty to twenty-five percent of normal body weight), an intense fear of becoming obese, a disturbance of body image, a refusal to maintain body weight over a minimal normal weight for age and height and no known physical illness accounting for weight loss (DSM - III - R, American Psychiatric Association, 1987).
The term anorexia nervosa literally means "nervous loss of appetite" , but there is not a loss of appetite, only a denial of it. Anorectics exhibit behaviors that are similar to starving people in general, such as, irritability, obsession with food, spaciness, difficulty concentrating, and hallucinations.
Anorexia is seen most in female patients; only five to ten percent of cases are males. It usually starts in adolescence, but can also occur in adulthood. Twenty-five percent of anorectics will alternate periods of starvation with excessive eating and self-induced vomiting. By doing this, they give into their hunger without fear of gaining weight.
Anorexia also has very serious physical characteristics. Anorectics live on an average of four-hundred calories per day. If the starvation continues, it can lead to medical problems such as, cardiac arrest, kidney failure, and malnourishment, which can be fatal. The mortality rate ranges from two to fifteen percent, depending on the seriousness of the case. Anorexia has the highest mortality rate of any psychiatric disease.