Anorexia, also called anorexia nervosa, is an eating disorder that causes people to obsess about their weight and what they eat.
In this blog article we will discuss the signs and symptoms of anorexia nervosa, treatment options, and how to get help or support a loved one with the disorder.
TRIGGER WARNING: The following blog article contains content and images that may disturb some readers.
Please exercise caution before reading this article.
What is anorexia?
Anorexia nervosa, or anorexia, is an eating disorder characterized by unhealthily low body weight, an intense fear of gaining weight, and a distorted perception of weight.
People diagnosed with anorexia tend to go to extreme lengths to control their weight and this often significantly interferes with their daily lives.
People with anorexia usually restrict the amount of food they eat in order to lose weight or prevent weight gain.
They may also vomit after eating, abuse laxatives, or exercise excessively.
This disorder is more about using control over food to cope with underlying issues.
What are the signs and symptoms of anorexia?
There are both physical and emotional/behavioral symptoms of anorexia.
It may be difficult to tell when someone is suffering from anorexia because they may disguise their eating habits or weight by wearing baggy clothes.
The following are common physical symptoms of anorexia:
· Extreme weight loss or not making expected developmentally appropriate weight gain
· Thin appearance
· Abnormal blood counts
· Difficulty sleeping (insomnia)
· Discolored fingers, usually blue in appearance
· Thinning or breaking hair
· Hair falling out
· Soft hair covering the body
· Absence of menstruation in women (amenorrhea)
· Constipation and abdominal pain
· Cold intolerance
· Irregular heartbeat
· Dry skin
· Skin that is yellowish in color
· Swelling of arms or legs
· Low blood pressure
· Eroded teeth from induced vomiting
· Calloused knuckles from induced vomiting
People who have anorexia can binge and purge similar to those with bulimia, however anorexics tend to be low in body weight whereas bulimics can be normal or above normal weight.
The following are emotional and behavioral symptoms of anorexia:
· Severely restricting food intake through dieting or fasting
· Excessive exercise
· Bingeing and self-induced vomiting to get rid of eaten food (can include the use of laxatives, enemas, diet supplements, or herbal products)
· Preoccupation with food (i.e., cooking or baking elaborate meals or desserts for others but not eating them)
· Frequently skipping meals or refusing to eat
· Making excuses for not eating (i.e., “I already ate so much earlier today so I am not hungry”)
· Denial of hunger
· Adopting rigid meal or eating rituals (i.e., spitting food out after chewing or hiding food)
· Fear of eating in public
· Lying about how much food has been consumed
· Intense fear of gaining weight that might include behaviors such as repeated weighing or measuring of the body
· Covering up in layers of clothing to hide weight loss
· Lack of affect (flat mood or lack of emotion)
· Withdrawal from social activities, sometimes to avoid eating
· Reduced sex drive
What are the causes of anorexia nervosa?
It is unknown what exactly causes anorexia nervosa, however, it is likely a combination of genetic, psychological and environmental factors.
Genetics:There has not been a specific gene identified that is directly correlated to the development of anorexia nervosa, but there may be specific genes that put certain people at a higher risk.
Some people have a genetic tendency toward perfectionism, which is a trait associated with anorexia.
Psychological factors: Some people with anorexia nervosa may have obsessive-compulsive tendencies that make them more likely to stick to restrictive diets and refuse to eat food despite being hungry.
These people may have an extreme drive for perfectionism, which causes them to believe that they will never be thin enough.
In addition, intense food restriction may help people with anorexia nervosa reduce high levels of anxiety.
Environmental factors: Unfortunately, thinness is plastered all over the internet, movies, and magazines in modern Western culture.
Self-worth and success are often equated with thinness.
In addition, peer pressure, especially among young girls, may fuel a strong desire to be thin.
Who is at risk for developing anorexia nervosa?
Anorexia is more common in women and girls compared to boys and men.
However, men are increasingly developing anorexia nervosa and other eating disorders, potentially due to social and media pressures to remain in good shape.
People are most likely to develop anorexia nervosa during adolescence, but still people of any age can develop it.
It is rare to develop anorexia nervosa past the age of 40.
Teenagers may be more at risk because of all the physical changes during puberty, and they also may face peer pressure or be more sensitive to comments and criticism about body weight or shape.
Those with an immediate relative who had anorexia nervosa are much more likely to develop the disorder themselves.
Changes in specific genes may also put certain people at higher risk for developing anorexia nervosa.
People who begin dieting are at higher risk to develop anorexia nervosa. Many of the symptoms of anorexia nervosa are actually symptoms of starvation, which affects the brain.
Starvation can cause mood changes, rigidity in thinking, anxiety, and loss of appetite. The weight loss may change the brain works in certain vulnerable people and this may make it more difficult to return to healthy eating habits.
Life transitions and major changes can cause intense emotional stress and increase the risk for development of anorexia nervosa.
Some major life stressors include a new school, home, or job, a relationship breakup, or the death or illness of a close family member or friend.
What are complications of anorexia nervosa?
Anorexia is a dangerous illness and can cause many complications. It can be fatal due to abnormal heartbeat (cardiac arrhythmias) or an imbalance in electrolytes.
Malnourishment from chronic starvation can damage all organs in the body including the brain, heart, and kidneys.
This damage may be permanent even if the person recovers.
Other serious complications of anorexia include:
· Anemia (low iron)
· Heart problems (i.e., mitral valve prolapse, abnormal heart rhythms, or heart failure)
· Bone loss (osteoporosis), which increases the risk of bone fractures
· Loss of muscle
· Absence of menstruation in females (amenorrhea)
· Decreased testosterone in males
· Gastrointestinal problems such as nausea, constipation, or bloating
· Electrolyte imbalances (i.e., low blood potassium, sodium, and chloride)
· Kidney problems
People with anorexia may also have other mental health disorders including:
· Depression, anxiety, and other mood disorders
· Personality disorders
· Obsessive-compulsive disorders (OCD or OCD-related disorders)
· Alcohol or drug abuse
· Self-harm, suicidal ideation, or suicide attempts.
If you or someone you know is thinking of self-harm or suicide, seek immediate help.
Can anorexia nervosa be prevented?
Anorexia cannot be prevented, but primary care physicians can identify early indicators of anorexia nervosa such as strict eating habits or satisfaction of appearance.
In addition, if a trusted family member or friend notices signs of anorexia, he or she can notify a doctor or therapist for early intervention.
How is anorexia nervosa treated?
A team of specialists usually come together to treat a patient with anorexia nervosa.
Ongoing therapy with doctors, mental health professionals, and dieticians are usually needed to aid the patient with recovery.
Sometimes hospitalization is required to treat electrolyte imbalances or heart problems associated with extreme starvation.
There are also inpatient programs to help patients relearn healthy eating habits and partake in group or individual therapy.
Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.
Currently, there are no medications specifically approved for the treatment of anorexia, however antidepressants or other anti-anxiety medications can help treat underlying depression or anxiety that contribute to the disorder.
How can I support a loved one with anorexia?
If you notice a family member or friend with low self-esteem, strict dieting habits, or dissatisfaction with appearance, consider talking to them about these issues.
You can also notify a primary care physician or psychiatrist who specializes in eating disorders.
Frequently asked questions (FAQs) about anorexia:
1. What is the difference between anorexia and anorexia nervosa?
Anorexia nervosa is different from anorexia, which is characterized by a loss of appetite or inability to eat.
Anorexia nervosa is a diagnosed psychological disorder that involves disordered eating.
Symptoms include an abnormally low body mass index (BMI), refusal to eat, and extreme attempts to lose weight or prevent weight gain.
2. What is orthorexia?
Orthorexia is a term that includes symptoms of obsessive behavior in pursuit of a healthy diet.
A person diagnosed with orthorexia is fixated on maintaining a perfect diet rather than a low body weight.
3. Who is most likely to suffer from anorexia nervosa?
Anorexia nervosa has become much more prevalent over the past 20 years.
Approximately 90% of patients with anorexia nervosa are women between 12 and 25 years of age.
4. How do doctors test for anorexia?
Doctors usually perform a physical examination which includes measuring height and weight, checking vital signs (i.e., heart rate, blood pressure and temperature).
Some patients may be asked to fill out a psychological self-assessment questionnaire.
Doctors may also check for skin and nail problems, listen to heart and lungs, and examine the abdomen.
In addition, some lab tests may be performed such as a complete blood count (CBC), thyroid, liver, and kidney function, as well as electrolyte counts.
X-rays may be taken to test bone density, stress fractures, or broken bones.
Electrocardiograms may also be done to look for heart abnormalities.
5. What does drunkorexia mean?
Drunkorexia is a colloquial term that describes people who starve themselves or binge and purge in combination with alcohol abuse.
People with drunkorexia usually go to extreme lengths like starvation or purging in order to compensate for planned binge drinking.
6. What is EDNOS?
EDNOS, or eating disorder not otherwise specified, is now called other specified feeding or eating disorder (OSFED) by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
OSFED is defined by feeding and eating disorders that are clinically severe but do not meet the diagnostic criteria for anorexia nervosa, bulimia nervosa, or other eating disorders.
7. Can you be cured of anorexia?
People diagnosed with anorexia nervosa early on are more likely to have better treatment outcomes.
The disorder can be treated and the person diagnosed can return to a healthy weight, however, there are some people with anorexia who deny they have a problem and refuse to seek treatment. Unfortunately, the risk of relapse is high.
Want to learn more about anorexia? Try these books!
8 Keys to Recovery from an Eating Disorder: Effective Strategies from Therapeutic Practice and Personal Experience
The authors of this book share their own stories of suffering from and eventually overcoming eating disorders.
Carolyn Costin and Gwen Schubert Grabb walk you through the recovery process including therapy and all the emotions experiences.
If you are suffering from an eating disorder and are seeking help, this book will assure you that you are not alone on this journey and can supplement your therapy and other treatment plans.
A Cognitive-Interpersonal Therapy Workbook for Treating Anorexia Nervosa
This workbook provides adults with anorexia nervosa and the professionals who are helping them recover with a great resource to work on together.
This manual includes modules such as nutrition, developing specific treatment goals, thinking styles, and developing an identity beyond the disorder.
I am not in recovery. I am in discovery: Journaling my mental illness
Journaling is a great way to help process and keep track of your experiences and feelings while you are going through the debilitating trials and tribulations of anorexia nervosa.
This journal contains 94 daily templates to aid in your discovery process.
Have more questions or comments about anorexia? Post below!
What we recommend for eating disorders
If you are suffering from an eating disorder then ongoing professional counselling may be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.
Anorexia nervosa.Mayo Clinic. February 20th, 2018.