Anorexia means a loss of appetite or the inability to eat, and it can be a symptom of various diseases. When a person has anorexia nervosa, they intentionally restrict their food as part of a serious and potentially life threatening mental health disorder. This often involves emotional challenges, an unrealistic body image, and an exaggerated fear of gaining weight.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Anorexia nervosa can affect people differently. With the right treatment, recovery is possible.

In some cases, an individual may lose a significant amount of weight and demonstrate the characteristic behaviors of anorexia but not have very low body weight or body mass index (BMI). Researchers refer to this as atypical anorexia nervosa.

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 people who are female, but it can affect people of any sex or gender. Research suggests that the risk of eating disorders may be higher among transgender people than cisgender people.

Statistics show that females with anorexia outnumber males with the disorder at a ratio of 10 to 1. The effects of the disorder are more likely to be life threatening among males than among females. The reason for this is that males often receive a later diagnosis due to the mistaken belief that it does not affect them.

A person with anorexia nervosa will intentionally restrict their food intake as a way to lose weight or avoid gaining weight. A person with anorexia nervosa will often have an intense fear of weight gain, even if they have severely low body 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.

Learn more about the myths surrounding eating disorders and the real facts.

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:

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.

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 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.

For some people, anorexia nervosa also 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.

Several factors can increase a person’s risk for developing anorexia nervosa, including:

  • 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
  • anxiety
  • 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

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

In 2015, researchers found that people with anorexia nervosa may have different gut microbial communities than those without the condition. This could contribute to anxiety, depression, and further weight loss.

Learn how the COVID-19 pandemic has affected people with eating disorders.

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.

In addition to a physical exam, this may include:

  • blood tests, including coagulation tests, a complete blood count, and a comprehensive metabolic profile
  • urine tests
  • an electrocardiogram
  • imaging tests, such as a computed tomography (CT) scan or bone density scan

A psychological evaluation is also necessary to determine if a person meets the diagnostic criteria for anorexia nervosa.

According to the National Eating Disorders Association, 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.

  1. Restriction of energy intake and significantly low body weight for the person’s age, sex, and overall health.
  2. Intense fear of gaining weight or becoming fat, despite being underweight.
  3. 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.

Anorexia nervosa and bulimia nervosa are both eating disorders and sometimes share certain symptoms, such as an intense fear of gaining weight or a distorted body image.

However, people with anorexia often restrict food intake, exercise excessively, or adopt extreme diet patterns to lose weight.

On the other hand, bulimia nervosa is characterized by recurrent episodes of binge eating or eating large amounts of food, followed by compensatory behaviors to prevent weight gain, such as self-induced vomiting, excessive exercising, consuming laxatives, or fasting.

This cycle can also be present in people diagnosed with the binge-eating/purging subtype of anorexia nervosa.

However, unlike bulimia, anorexia nervosa is also characterized by the significant restriction of energy intake, leading to significantly low body weight for a person’s age, sex, and overall health.

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.

Strategies include:

  • 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 2 years of treatment.

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.

Hospital treatment

The person may need to spend time in the hospital if they have:

  • a severely low BMI
  • malnutrition
  • 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 an increased risk of suicide.

In fact, anorexia nervosa has the highest mortality rate of all mental health conditions.

For this reason, early diagnosis and treatment are essential.

Eating disorders can be caused by a variety of factors and there is currently no known way to prevent the development of anorexia nervosa.

However, recognizing the symptoms and seeking treatment early can help improve the chances of recovery.

According to the National Eating Disorders Association, prevention programs aimed at reducing factors for eating disorders could also be beneficial.

These programs typically involve changing public policy, encouraging people to question diet culture and the media, promoting body acceptance, and replacing restrictive diets with practices like intuitive eating.

Dr. 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.

Dr. Rago noted that ANAD has 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.

Here are a few common questions about anorexia nervosa.

What is the nervosa part of anorexia?

“Nervosa” is a term rooted in Latin that originally meant “nervous” or “vigorous.” “Anorexia” comes from both Latin and Greek and means “without appetite.”

When originally used to describe a syndrome in the Middle Ages, “anorexia” referred to a refusal to eat, with the goal of religious or spiritual purity. In the 1800s, the term “anorexia nervosa” came to mean a self-imposed food refusal.

What is the difference between anorexia and anorexia nervosa?

Anorexia is a term used to describe the loss of appetite or the inability to eat, which can be caused by many health conditions. On the other hand, anorexia nervosa is an eating disorder in which a person intentionally limits their food intake in an effort to lose weight or prevent weight gain.

What are the warning signs of anorexia?

There are many potential warning signs of anorexia, including feeling preoccupied with food, exercise, or body weight. Experiencing feelings of guilt or shame after eating, avoiding situations that involve food, and withdrawing from friends, hobbies, or activities are a few other possible warning signs.

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.