Anorexia Nervosa

What is anorexia nervosa
Symptoms of anorexia
A note about weight and anorexia
Emotional and behavioral signs of anorexia
Physical signs of anorexia
Health consequences of anorexia
Facts about anorexia

What is anorexia nervosa?

Anorexia nervosa (anorexia for short) is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss (or lack of appropriate weight gain in growing children). While people with anorexia generally restrict the number of calories and the types of food they eat, it is a misconception that people with anorexia never eat.

Symptoms of anorexia

  • Restriction of energy intake relative to requirements leading to a 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.
  • Binge-Eating/Purging type anorexia involves binge eating and/or purging behaviors during the last three months.
  • Restricting type anorexia does not involve binge eating or purging.

A note about weight and anorexia

When a person meets all the criteria above except for weight loss/low body weight, it’s called atypical anorexia. Atypical anorexia is actually very common since it’s estimated that only 6% of people with clinical eating disorders are underweight. Atypical anorexia should be taken just as seriously as anorexia because a person can still be malnourished at a “normal” or even higher BMI. Atypical anorexia is diagnosed under the category of Other Specified Feeding or Eating Disorders (OFSED), which is one of the most prevalent eating disorders today. If this is you, please know that yes, you ARE sick enough to deserve treatment, even if you’re not underweight.

Emotional and behavioral signs of anorexia can include:

  • Dramatic weight loss
  • Dresses in layers to hide weight loss or stay warm
  • Is preoccupied with weight, food, calories, fat grams, and dieting
  • Refuses to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
  • Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
  • Denies feeling hungry
  • Develops food rituals (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate)
  • Cooks meals for others without eating
  • Consistently makes excuses to avoid mealtimes or situations involving food
  • Expresses a need to “burn off” calories 
  • Maintains an excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury 
  • Withdraws from usual friends and activities and becomes more isolated, withdrawn, and secretive
  • Seems concerned about eating in public
  • Has limited social spontaneity
  • Resists or is unable to maintain a body weight appropriate for their age, height, and build 
  • Has intense fear of weight gain or being “fat,” even though underweight
  • Has disturbed experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight
  • Shows inflexible thinking

Physical signs of anorexia can include:

  • Stomach cramps, other gastrointestinal complaints (constipation, acid reflux, etc.)
  • Difficulties concentrating
  • Abnormal labs (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
  • Dizziness and/or fainting
  • Feeling cold all the time
  • Sleep problems
  • Menstrual irregularities—amenorrhea, irregular periods or only having a period while on contraceptives (this is not considered a “true” period)
  • Cuts and calluses across the top of finger joints (a result of inducing vomiting)
  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity
  • Dry skin
  • Dry and brittle nails
  • Swelling around area of salivary glands
  • Fine hair on body (lanugo)
  • Hair loss, dry and brittle hair 
  • Muscle weakness
  • Cold, mottled hands and feet or swelling of feet
  • Poor wound healing
  • Impaired immune functioning

Health consequences of anorexia

Because anorexia involves self-starvation, the body is denied the calories and essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This “slowing down” can have serious medical consequences, including:

  • Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
  • Reduction of bone density (osteoporosis), which results in dry, brittle bones.
  • Muscle loss and weakness.
  • Severe dehydration, which can result in kidney failure.
  • Fainting, fatigue, and overall weakness.

Facts about anorexia

  • Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities. 
  • Although the disorder most frequently begins during adolescence, an increasing number of children and older adults are also being diagnosed with anorexia. 
  • Anorexia is one of the most common psychiatric diagnoses in young women.
  • Anorexia has one of the highest death rates of any mental health condition.

Take the Eating Disorder Self-Test to find out if you might have an eating disorder like anorexia.

Please reach out for help and support.

If you think you are or someone you care about is struggling with anorexia, contact us here or click below to schedule an appointment online.