Anorexia (anorexia nervosa) is an eating disorder in which people tend to restrict calories and the types of foods they eat. They may also compulsively exercise, purge by vomiting or using laxatives, or binge eat.
People who have anorexia usually feel extremely anxious and fearful about gaining weight. They often perceive themselves as fat, even if they are underweight, and will avoid eating even when they are hungry. Even though they eat too little, they often spend a lot of time thinking about food and dieting. They may create strict rules about food and eating, and may skip meals or avoid eating in public.
Emotional and behavioral symptoms of anorexia include:
- Significant weight loss
- Preoccupation with weight, food, calories, fat grams, and dieting
- Denying feeling hungry
- Creating rituals around food (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate)
- Constant excuses to avoid mealtimes or situations involving food
- Preparing meals for others without eating
- Concern about eating in public
- Dressing in layers to hide weight loss or to stay warm
- Refusing to eat certain foods and restrictions against eating whole categories of food
- Intense fear of weight gain or being “fat,” even though they are underweight
- Frequent comments about feeling “fat” or overweight despite weight loss
- Feeling need to “burn off” calories consumed
- Having an excessive, rigid exercise regimen that is maintained despite weather, fatigue, illness, or injury
- Withdrawing from friends and activities
- Becoming more isolated, withdrawn, and secretive
- Resistance or inability to maintain an appropriate body weight for their age, height, and build
- Distorted image of body weight or shape, and weight or shape has an out-sized influence on self-esteem
- Denying of the seriousness of low body weight
- Loss of menstrual periods
- Strong need for control
- Inflexible thinking
- Overly restrained initiative and emotional expression
Physical symptoms of anorexia include:
- Abdominal pain, stomach cramps, and other gastrointestinal problems (constipation, acid reflux, etc.)
- Feeling cold/cold intolerance
- Lethargy
- Excess energy
- Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
- Menstrual irregularities
- Dizziness
- Difficulty concentrating
- Irritability
- Mood changes
- Fainting
- Sleep problems
- Muscle weakness
- Cuts and calluses across the top of finger joints (a result of inducing vomiting)
- Dental problems, such as enamel erosion, cavities, tooth sensitivity, or discoloration of teeth, from vomiting
- Dry and brittle nails
- Dry skin
- Dry and brittle hair, thinning of hair on head
- Fine hair on body (lanugo)
- Swelling around area of salivary glands
- Yellow skin (if eating large amounts of carrots)
- Cold, mottled hands and feet or swelling of feet
- Poor wound healing
- Diminished immune functioning
What Causes Anorexia?
It is not completely understood what causes anorexia nervosa. Factors that may contribute to developing the condition include:
- Psychological factors
- Perfectionism
- Obsessive-compulsive personality traits
- Feelings of limited control in life
- Low self-esteem
- Tendency towards depression and anxiety
- Poor reaction to stress
- Environmental factors
- Onset of puberty
- Stressful life events
- Relationship problems
- Cultural pressures to be thin that may come from media and pop culture
- Occupations that demand a thin physique
- Certain sports
- Ballet
- Television, film, and fashion industries
- Brain chemistry
- Extreme dieting can affect the balance of hormones in the body, affecting how the brain functions
- Genetic predisposition
- Often runs in families
How Is Anorexia Diagnosed?
Anorexia nervosa is diagnosed with a patient history and physical examination. There is not a specific test to diagnose anorexia, but a doctor will measure a person’s height and weight and body mass index (BMI) to see if they are a healthy weight for their age, height, and gender.
Anorexia nervosa may also be diagnosed using The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), in which the following criteria must be met in order to make a diagnosis:
- Restriction of energy intake relative to requirements leading to significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
- Intense fear of gaining weight or becoming fat, even though underweight.
- Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
Some people may not meet all DSM-5 criteria for anorexia, but may still have an eating disorder.
If anorexia nervosa is suspected, tests may be needed to diagnose other health conditions, because anorexia can lead to many health problems. Tests may include:
- Blood tests
- Urine tests
- Electrocardiogram (ECG or EKG)
What Is the Treatment for Anorexia?
If you or a loved one is suffering from an eating disorder, contact the National Eating Disorders Association (NEDA) helpline for assistance:
Speak with Someone
- Online Chat
- Monday—Thursday 9am—9pm ET
- Friday 9am—5pm ET
Call
- (800) 931-2237
- Monday—Thursday 11am—9pm ET
- Friday 11am—5pm ET
- Translation services are available on the phone.
Text
- (800) 931-2237
- Pilot hours: Monday—Thursday 3pm—6pm ET
- Standard text messaging rates may apply.
Treatment for anorexia nervosa can take years, and involves:
- Gaining weight
- A doctor and dietitian will help patients create meal plans to help them gain weight safely and slowly
- Psychotherapy
- Hospitalization
- While some people can be treated at home, others need to be treated in the hospital depending on the person's weight, symptoms, and health problems
What Are Complications of Anorexia?
Anorexia nervosa can cause a number of health problems, such as:
- Problems with the brain, heart, lungs, liver, kidney, and glands
- Bone loss and muscle weakness
- Bloating
- Constipation
- Thinning hair
- Nails that break easily
- Feeling cold all the time
- Tiredness
- Depression or thoughts of self-harm
- If you or someone you know are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.
- Anxiety
- Alcohol or drug abuse
- Problems with memory, thinking, or attention
- Trouble sleeping
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https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia
https://www.healthdirect.gov.au/anorexia-nervosa