What is anorexia nervosa?

Anorexia nervosa is also called anorexia. It is a serious medical illness It's not a lifestyle choice. This eating disorder makes you obsess about your weight and food. If you have this problem, you may have a distorted body image. You may see yourself as overweight even though you have a very low body weight.  

With anorexia, you may use abnormal eating habits to cope with stress, anxiety, and low self-esteem. Limiting food may give you a sense of control over your life.

Anorexia can affect people of all ages, racial and ethnic backgrounds, body weights, and genders. This problem affects more women than men. It often starts during the teen years. But it can also develop during childhood or in later years, such as age 40 and older. The number of young women ages 15 to 19 who have anorexia has increased every 10 years since 1930.

What causes anorexia?

Experts don’t know what causes anorexia. It often begins as regular dieting. Over time it can lead to extreme and unhealthy weight loss. You may use extreme dieting and food limiting tricks due to fear of getting fat.

Anorexia has two subtypes:

• Restrictor type. People with this type of anorexia severely limit how much food they eat. This often includes foods high in carbohydrates and fats.

• Bulimic (binging and purging) type. People with bulimia eat too much food and then make themselves throw up. They may take large amounts of laxatives or other methods to clear their bowels.  

Who is at risk for anorexia?

A person with anorexia is more likely to come from a family with a history of certain health problems. These include weight problems, physical illness, and mental health problems. Mental health problems may include depression and substance abuse. Research suggests that a combination of many factors can increase the risk for anorexia. They include genetic, biological, behavioral, psychological, and social factors.

Things that may play a role in anorexia are:

• Social attitudes

• Family influences

• Genetics

• Brain chemical imbalances

• Developmental issues

You may also be at risk if you take part in certain sports and activities that focus on body shape and size. These include:

• Ballet

• Bodybuilding

• Cheerleading

• Figure skating

• Gymnastics

• Jockeying

• Modeling

• Wrestling

What are the symptoms of anorexia?

Anorexia can cause many symptoms. They may be related to food or weight. They may be physical or emotional.

Food or weight-related symptoms can include:

• Changed body image

• Low body weight

• Extreme fear of becoming fat

• Excessive physical activity

• Denial of hunger

• Fixation with making food

• Abnormal, obsessive, or ritualized eating behaviors

Physical symptoms can include:

• Poor nutritional status

• Fluid loss (dehydration)

• Being very thin

• Stomach pain or bloating

• Constipation

• Lethargy or extreme tiredness (fatigue)

• Unable to handle cold temperatures

• Fine, downy body hair (called lanugo)

• Dry or yellowish skin

• Thinning hair

• Brittle nails

• Infertility

Emotional symptoms can include:

• Withdrawal from social situations

• Loss of interest in sex

• Grouchiness

• Mood changes

• Depression

How is anorexia diagnosed?

When you have anorexia, you may try to hide your problem from others. Over time, family members, teachers, and coaches may start to worry about your weight and behavior. Early treatment can help prevent serious health problems. Your healthcare provider will ask you about your health history. They will give you a physical exam. Your provider may advise psychological testing. Talking with family members and other concerned adults can also help.

How is anorexia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how bad the condition is. Urgent medical care may be needed for physical problems. Nutrition counseling can help you learn how to make healthy food choices. It can also help bring you back to a healthy weight.

Therapy can help you learn how to deal with feelings. It can also help you improve your coping skills and adopt healthy habits. Therapy can be done one-on-one, with your family, or with a group. Certain medicines can also help to treat mental health problems, such as depression and anxiety.

What are possible complications of anorexia?

Anorexia can be fatal. It has the highest death rate of any mental health disorder. It's very harmful on the body, and can lead to serious, long-term health problems. These include:

• Low red blood cell count (anemia)

• Heart problems (arrhythmias, slow heart rate, heart failure, and mitral valve prolapse)

• Low blood pressure

• Kidney problems

• Electrolyte imbalance

• Lack of menstrual periods in women

• Low testosterone in men

• Bone loss

• Brain damage

• Multi-organ failure

• Death

How can I help prevent anorexia?

Experts don’t know how to prevent anorexia. It may help if family members have healthy attitudes and actions around weight, food, exercise, and appearance. Adults can help children and teens build self-esteem in many ways. This includes academics, hobbies, and volunteer work. Focus on activities that aren’t related to the way a person looks.

Living with anorexia

Anorexia is a very serious problem. Talk with your healthcare provider. You can recover from anorexia and get back your health. To do this you will need to follow a full treatment plan. During recovery, you will need not to weigh yourself all the time. You will also need not to spend a lot of time alone. It’s also important to learn and stay away from things that lead to your anorexic behaviors. Dietary supplements will help make sure you get enough nourishment. Relaxation methods, such as yoga, may also help ease symptoms. You may need ongoing therapy to help maintain your progress and provide support. Support groups are sometimes helpful.

Key points about anorexia

• Anorexia is an eating disorder that causes a severe and strong fear of gaining weight. You may have a distorted view that you are fat even when you are dangerously thin.

• You may use extreme exercise, calorie and food limitations, or binging and purging to control your weight. It may give you a sense of control in your life.

• This problem is dangerous because it can cause organ damage and can be fatal.

• Treatment can include nutrition aids, individual, group, and family therapy, and medicines.

• A stay in a hospital may be needed. This is to help make sure you are eating enough and not exercising too much.

• This problem is more common in women than men. It may be more common for those who take part in sports and activities that focus on body shape and size. This can include modeling, dancing, and other athletic areas.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.