Anorexia nervosa is a serious mental health condition and a potentially life threatening eating disorder. However, with the right treatment, recovery is possible.
Anorexia nervosa often involves emotional challenges, an unrealistic body image, and an exaggerated fear of gaining weight. However, it can affect people differently.
In some cases, an individual may lose a significant amount of weight and demonstrate the characteristic behaviors of anorexia but not have a very low body weight or body mass index (BMI).
Anorexia nervosa often appears during a person’s teenage years or early adulthood, but it can sometimes begin in the preteen years or later in life.
People often think of anorexia nervosa in connection with females, but it can affect people of any sex or gender.
Statistics show that males represent about 25% of people with anorexia and that the effects are more likely to be life threatening among males than females. The reason for this is that males often receive a later diagnosis due to the mistaken belief that it does not affect them.
Anorexia nervosa is different than anorexia. Anorexia means a loss of appetite or the inability to eat, and it can be a symptom of various diseases.
A person with anorexia nervosa will intentionally restrict their food intake as a way to help them manage emotional challenges. These often involve a fear of gaining weight or a desire to lose weight.
Dietary restrictions can lead to nutritional deficiencies, which can severely affect overall health and result in potentially life threatening complications.
The emotional and psychological challenges of anorexia nervosa can be hard for a person to overcome.
Therapy includes counseling, nutritional advice, and medical care. Some people may need treatment in the hospital.
There are many myths about eating disorders. These can lead to false assumptions and affect a person’s chances of seeking and getting help.
Anorexia nervosa is a complex condition. The main sign is significant weight loss or low body weight. In atypical anorexia nervosa, the person may still have a moderate weight despite substantial weight loss.
A lack of nutrients may lead to other physical signs and symptoms, including:
- severe loss of muscle mass
- listlessness, fatigue, or exhaustion
- low blood pressure
- lightheadedness or dizziness
- low body temperature with cold hands and feet or, possibly, hypothermia
- bloated or upset stomach
- dry skin
- swollen hands and feet
- hair loss
- loss of menstruation or less frequent periods
- loss of bone density, increasing the risk of fractures
- brittle nails
- irregular or abnormal heart rhythms
- lanugo, which is fine downy hair on the body
- increased facial hair
- bad breath and tooth decay, in people who vomit frequently
The person may also demonstrate certain behaviors, such as:
- limiting their overall food intake or the range of foods they consume
- showing excessive concern with weight, body size, dieting, calories, and food
- exercising a lot, taking laxatives, or inducing vomiting
- assessing their body weight and size frequently
- talking about being “fat” or having overweight
- denying feeling hungry or avoiding mealtimes
- developing food rituals, such as eating foods in a specific order
- cooking for others without eating
- withdrawing from friends and social interaction
- showing signs of depression
The person may associate food and eating with guilt. They may seem unaware that anything is wrong or be unwilling to recognize their issues around eating.
Anorexia nervosa affects people differently. Not everyone with the condition will behave in the same way, and some individuals may experience atypical anorexia nervosa, meaning that they will not have a low body weight.
Concerns about body weight and shape are often features of anorexia nervosa, but they may not be the main cause. Experts do not know exactly why the condition occurs, but genetic, environmental, biological, and other factors may play a role.
Some factors that may increase a person’s risk include:
- past criticism about their eating habits, weight, or body shape
- a history of teasing or bullying, especially about weight or body shape
- a sense of pressure from society or their profession to be slim
- low self-esteem
- having a personality that tends toward obsession or perfectionism
- sexual abuse
- a history of dieting
- pressure to fit in with cultural norms that are not their own
- historical trauma, such as racism
For some people, anorexia nervosa develops as a way of gaining control over an aspect of their life. As the person exerts control over their food intake, this feels like success, and so, the behavior continues.
Biological and genetic factors
A person may also have a higher chance of developing an eating disorder if:
- a close relative has had a similar disorder
- there is a family history of depression or other mental health issues
- they have type 1 diabetes
Early diagnosis and prompt treatment increase the chance of a good outcome.
The doctor may ask the person questions to get an idea of their eating habits, weight, and overall mental and physical health.
They may order tests to rule out other underlying medical conditions with similar signs and symptoms, such as malabsorption, cancer, and hormonal problems.
The National Eating Disorders Association state that the criteria below can help doctors make a diagnosis. However, they note that not everyone with a serious eating disorder will meet all these criteria.
- Restriction of energy intake and significantly low body weight for the person’s age, sex, and overall health.
- Intense fear of gaining weight or becoming fat, despite having underweight.
- Changes in the way the person experiences their body weight or shape, an undue impact of body weight or shape on the person’s self-image, or denial that their current low body weight is a problem.
A healthcare professional will make a comprehensive plan to address the individual’s specific needs.
It will involve a team of specialists who can help the person overcome the physical, emotional, social, and psychological challenges that they face.
- cognitive-behavioral therapy (CBT), which can help the person find new ways of thinking, behaving, and managing stress
- family and individual counseling, as appropriate
- nutritional therapy, which provides information on how to use food to build and maintain health
- medication to treat depression and anxiety
- supplements to resolve nutritional deficiencies
- hospital treatment, in some cases
It can be challenging for a person with anorexia nervosa to engage in treatment. As a result, the person’s participation in therapy may fluctuate. Relapses can occur, especially during the first
Family and friends can provide crucial support. If they can understand the condition and identify its signs and symptoms, they can support the individual during recovery and help prevent a relapse.
The person may need to spend time in the hospital if they have:
- a severely low BMI
- complications due to inadequate food intake
- a persistent refusal to eat
- a psychiatric emergency
Treatment will allow for a gradual increase in food intake to restore overall health.
Complications can affect every bodily system, and they can be severe.
They include problems with:
- the cardiovascular system
- the blood, such as a low white or red blood cell count
- the digestive system
- the kidneys
- hormonal imbalances
- bone strength
Some of these issues can be life threatening. In addition to the physical effects of poor nutrition, the person may have a high risk of suicide.
A post on the National Institute of Mental Health’s website in 2012 described anorexia nervosa as the mental health condition most likely to be fatal.
For this reason, early diagnosis and treatment are essential.
Maria Rago, Ph.D., the president of the National Association of Anorexia Nervosa and Associated Disorders (ANAD), offered Medical News Today the following tips for anyone who thinks that they or a loved one may have anorexia nervosa:
- Be kind and respectful rather than judgmental.
- Look into providers of treatment to find good matches, and meet with some of the people to decide who can best help.
- Consider a treatment team — including a dietitian, a therapist, and a psychiatrist — all of whom should specialize in eating disorders.
- Make sure to get all the education and support possible.
- Review the treatment plan and make changes when you think best.
Ms. Rago noted that ANAD have free support groups and mentoring programs for recovery and that they invite people to take advantage of the free services. “The right help can change your life, and even save your life,” she said.
Anorexia nervosa is an eating disorder and a serious mental health condition. It involves restricting food intake, which can lead to severe nutritional deficiencies.
The effects of anorexia nervosa can be life threatening, but counseling, medication, and treatment for underlying mental health issues can help people with this condition.
If a person has signs of anorexia nervosa, they should seek medical help. Early diagnosis and treatment are more likely to lead to a positive outcome.