Prevention for anorexia nervosa

Anorexia Nervosa Prevention

Written by WebMD Editorial Contributors

If you know someone with anorexia, you may wonder if you could have prevented it. The simple answer is probably not. Doctors don’t know what causes anorexia or how to stop someone from getting it.

What they do know is when someone has it, they don’t eat enough food because they’re often trying to be perfect by being thin. They develop symptoms that make them sick and even threaten their life.

Who’s at Risk for Anorexia?

Even though doctors don’t know why someone gets anorexia, they do know what makes one person more likely to have it than another, including:

  • Being female (eating disorders also affect males, but are most common in young women)
  • Higher childhood body mass index (body fat measure based on height and weight)
  • Heredity and genes (eating disorders tend to run in families)
  • An abnormal functioning of brain chemicals and circuits that control hunger and eating
  • Social pressure to be thin
  • Difficulty expressing feelings
  • History of being teased because of weight or size
  • History of sexual or physical abuse
  • Perfectionism, or setting unrealistic standards
  • Unhappiness with body image
  • A lack of social or family support
  • Low self-esteem
  • Depression, anxiety, stress, anger, or loneliness
  • Belief that a thinner body is ideal, sometimes because of social standards, such as  pictures in fashion magazines
  • Dieting a lot
  • Social problems in general, including withdrawal
  • A history of psychiatric disorders
  • Premature birth, low birth weight, or being part of a multiple birth

Can I Help Stop Anorexia?

There are many things that you, your friends, family, and teachers can do to help ease the pressures that could lead your loved one developing anorexia, including the following:

  • Tell them being extremely thin isn’t better
  • Put more importance on their personality than their looks
  • Encourage them to be honest about their feelings
  • Build their self-esteem
  • Teach them about the dangers of dieting
  • Let them know that you don’t expect them to be perfect because perfection doesn’t exist

Detecting Anorexia Early

Before your loved one develops anorexia, they will likely start showing warning signs of the eating disorder, such as dramatic weight loss, constantly complaining about being fat, avoiding mealtimes, and excessively exercising. Here are ways you can help them from getting worse:

Get educated. Start by learning about anorexia, especially the differences between the myths and facts.

Talk to them. Discuss your worries with them. And don’t wait until their symptoms become severe. The sooner you talk about it, the sooner they can get help.

Get medical help. Encourage them to see a primary care doctor or a psychiatrist. They can prevent their anorexia from getting worse.

Give them support. Tell them you love them. People with anorexia often have a hard time trusting others. Go out of your way to show them that they can trust you.

Praise and compliment them. Tell them how wonderful they are, and remind them that true beauty comes from inside. It’s good for them to hear that someone thinks they are great just the way they are.

Build a support network. Share your concerns with other people who care about them. The best thing for both of you is to have support.

Be their role model. Eat and exercise in positive ways. They need to see you practice strong habits. They could inspire them to follow your lead.

Next In Anorexia Nervosa


Anorexia Nervosa | Johns Hopkins Medicine

What is anorexia nervosa?

Anorexia nervosa, also known as just anorexia, is an eating disorder. This disorder makes you obsess about your weight and food. If you have this problem, you may have a warped body image. You may see yourself as fat even though you have a very low body weight.

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

This problem affects more women than men. It often starts during the teenage years. The number of young women between the ages of 15 to 19 who have anorexia nervosa has increased every 10 years since 1930.

What causes anorexia nervosa?

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 usually 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.

What are the risk factors for anorexia nervosa?

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.

Other 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 nervosa?

Anorexia can cause a variety of symptoms. They may be related to food or weight. They may be physical or emotional.

Food or weight-related symptoms can include:

  • Altered body image
  • Low body weight
  • Extreme fear of becoming fat
  • Excessive physical activity
  • Denial of hunger
  • Fixation with food preparation
  • Unusual eating behaviors

Physical symptoms can include:

  • Poor nutritional status
  • Dehydration
  • Being very thin
  • Stomach pain or bloating
  • Constipation
  • Lethargy or fatigue
  • Unable to handle cold temperatures
  • Fine, downy body hair (called lanugo)
  • Dry or yellowish skin
  • Thinning hair
  • Brittle nails

Emotional symptoms can include:

  • Withdrawal from social situations
  • Loss of interest in sex
  • Irritability
  • Mood changes
  • Depression

How is anorexia nervosa 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 medical history. He or she will give you a physical exam. Your healthcare provider may advise psychological testing. Talking with family members and other concerned adults can also help.

How is anorexia nervosa treated?

Treatment for anorexia can depend on your age, overall health, medical history, symptoms, and other factors. 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 emotions. 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. Some medicines can also help to treat mental health problems such as depression and anxiety.

What are the complications of anorexia nervosa?

Anorexia is very harmful on the body, and can lead to serious problems such as:

  • Anemia
  • Heart problems (arrhythmias, slow heart rate, heart failure, and mitral valve prolapse)
  • Low blood pressure
  • Kidney problems
  • Electrolyte imbalance
  • Lack of menstruation in women
  • Low testosterone in men
  • Bone loss
  • Death

Can anorexia nervosa be prevented?

Experts don't know how to prevent anorexia nervosa. 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 various ways. This includes academics, hobbies, and volunteer work. Focus on activities that aren't related to the way a person looks.

Living with anorexia nervosa

If you have anorexia, 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 to not weigh yourself all the time. You will also need to not spend a lot of time alone. It's also important to learn and avoid things that 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.

Key points about anorexia nervosa

  • Anorexia nervosa is an eating disorder that causes a severe and strong fear of gaining weight. You may have an altered view of being 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, therapy, and medicines.
  • A stay in a hospital may be needed. This is to help make sure the person is 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.
  • Both individual and group therapy can help in treating this disorder.

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 provider if you have questions.

Prevention of eating disorders


Prevention of eating disorders

Do not think that anorexia and bulimia cannot affect your family. Dissatisfaction with their own weight and appearance is characteristic of almost all high school students.

These disorders are not limited to girls: researchers estimate that about one million teenage boys suffer from eating disorders. An increasing number of young people are practicing intense training and also resorting to the dangerous practice of using illegal steroids (purchased without a doctor's prescription) to build muscle. In today's culture, it is very difficult for most people to have a good opinion of their bodies. The results of a survey of two thousand teenage girls conducted by Seventeen magazine showed that 46 percent of them are unhappy with their bodies, and 35 percent would like to get plastic surgery. A study conducted in 1995 among adult women showed that three minutes of looking at photos of models in a fashion magazine made seven out of ten women feel depressed, guilty and ashamed. Given our culture's obsession with thinness, it's no surprise that losing weight becomes a top goal for most teenage girls. The formation of a positive image of one's own body begins long before adolescence. But it is during the high school period that the discussion of these topics becomes especially important. Do not forget that teenagers at this age have a so-called "imaginary audience": it seems to them that everyone is looking at them. The Eating Disorders Prevention Program has developed the following checklist for building a positive body image: nine0003

· Clear, objective perception of one's own body;

· Positive attitude and respect for your body;

· Understanding that appearance says very little about the character and virtues of a person;

Pride in one's body and acceptance of one's own unique body;

· Refusing to spend an inordinate amount of time worrying about food, weight, and calories; nine0003

· Physical exercise for the purpose of getting the joy of movement and a sense of one's own strength;

Young people with a negative body image are more prone to low self-esteem and depression.

Let's be frank. How do you feel about your own body? Does your relationship with your body meet the criteria for a positive body image?

Very often, parents who tell me about their concerns about their teenager being underweight or anorexic are themselves the source of the wrong attitude about their own weight. If a mother is constantly on a diet, constantly exercising to lose weight, and talking about weight all the time, she thereby tells her children that they should also be concerned about their appearance. When we try to regulate our children's diets and encourage them to exercise, we go one step further: we are laying the foundation for eating disorders. Here are some tips that can help parents build a positive body image in their teen: nine0003

Educate your teenager about the importance of a nutritious, balanced diet and moderate exercise. Do not separate food into "good/safe" and "bad/dangerous";

· Talk to your teen about healthy eating. Every day, a teenager should eat three to five servings of vegetables; two to four servings of fruit; six to eleven servings of bread, cereal, rice, or pasta; three or more servings of milk, yogurt and cheese; two to three servings of protein foods. In addition, iron should be included in the daily diet of a teenager. Boys need 12 milligrams of iron per day to meet the needs of a rapidly growing body, and girls need 15 milligrams per day to compensate for iron losses during menstruation; nine0003

· Don't try to regulate your child's diet. Don't comment on how much they eat;

Analyze your attitude towards slimness and weight loss. If your child is overweight, it does not mean that you are a bad parent or that your children are lazy or bad. Remind both the children and yourself that weight and physical shape say nothing about a person's character and merits. Be careful not to send messages to your child that you will love him more if he is thin, or that he will feel like a more worthy person when he loses weight; nine0003

Teach your child to be critical of media images of ideal bodies. Talk about the images you see on television and in magazines, especially in advertisements. Remind teens (and yourself!) that magazine photos show models with professional make-up. Famous words of Cindy Crawford: "Even I don't look like Cindy Crawford in real life";

· Learn about the genetic causes of differences in fitness and weight and explain them to your teenager. A teenager should understand that weight gain in early adolescence is normal and necessary. Remind your daughter that if she inherited her grandmother's massive calves, all the exercise and diet in the world won't change them. And then remind her that it doesn't really matter; nine0003

· Encourage your teenager to exercise regularly and enjoy the possibilities of his body. Make sure your child has a choice of different types of physical activity; Remember that good physical shape and small clothing size are not the same thing;

· Avoid negative comments about your body and food. If you constantly complain about your own body, your child is likely to be critical of his own body too; nine0003

· Do not control the weight and nutrition of a teenager. Make sure he eats something for breakfast, lunch, and dinner, but let him figure out his own portion sizes. Keep healthy foods at home. Ask your teen what foods they would like to see in the fridge. Ask him to go shopping with you, ask him for advice on what to cook for lunch or dinner. It is also important to pay attention to the early symptoms of anorexia, bulimia, and compulsive overeating. Parents can help teens recognize eating disorders before they get out of hand. nine0003

Anorexia most often appears in early or middle adolescence. Signs of anorexia nervosa include: significant weight loss - by 25 percent or more - not associated with the disease; a sharp reduction in the amount of food consumed; denial of hunger; exclusion of carbohydrates and fats from the diet; long workouts despite fatigue and weakness; and a strong fear of gaining weight.

In contrast, people with bulimia seem to eat normally and maintain a normal weight. They often overeat alone, quickly eating high-calorie foods in large quantities, followed by vomiting or taking laxatives. Bulimics tend to be older than anorexics; bulimia typically begins in late adolescence, and some researchers estimate that 20% to 30% of adult girls may experience bulimic behavior. The signs of bulimia include: intermittent consumption of extremely large amounts of high-calorie foods, alternating with periods of fasting, self-condemnation and depression. Unfortunately, bulimia is more difficult to detect than anorexia, as bulimics tend to hide the fact that they vomit, take laxatives or diuretics. nine0003

Binge eaters behave like bulimics, but they don't fast, vomit, or take laxatives. They regularly consume high-calorie foods in large volumes. A binge eating teen may eat a carton of ice cream with chocolate topping and whipped cream in the evening. Unlike those with bulimia, these adolescents tend to be significantly overweight; you may think that they are eating normally, because they eat the usual portions at dinner, but at the same time they continue to gain weight. nine0003

If you experience these symptoms, talk to your child's doctor or an eating disorder specialist. Don't wait for your teen to come to you for help. In one study, six out of ten girls with eating disorder symptoms said they did not need professional help. The reality is that eating disorders can be fatal; 5 to 15 percent of young people with eating disorders die. Eating disorders can also cause chronic kidney disease, arrhythmias, gastrointestinal problems, parotid tumors, and dental problems. You must take control of the situation and contact a specialist who can help your son or daughter. nine0003

causes, symptoms, diagnosis and treatment

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Anorexia: causes, symptoms, diagnosis and treatment.


Anorexia nervosa, or anorexia nervosa (Twiggy's syndrome), is a serious mental eating disorder characterized by a craving for weight loss, a fear of obesity, and a distorted perception of one's body. Its mortality in some countries reaches 18%.

Anorexia affects predominantly women, and, as a rule, young people - age 95% of patients is 12-30 years old.

There is evidence that in recent years the percentage of patients with anorexia among young men has been growing in economically developed countries. The disease is often accompanied by other mental disorders.

Causes of anorexia

Anorexia can be caused by many factors.

  • Family. There is evidence that in approximately 42% of cases in patients diagnosed with anorexia, family relationships were characterized by a high level of conflict or one of the parents suffered from alcoholism. Eating disorders in relatives increase the likelihood of the child's disease, as well as their tendency to be overweight. nine0067
  • Biological. In people with obesity, early menarche, anorexia is more often detected due to hormonal dysfunction (excessive production of leptin and dysfunction of the neurotransmitters serotonin, dopamine, norepinephrine).
  • Cultural. The modern fashion for thinness, which since childhood has caused increased concern about their weight and appearance, leads women and girls to resort to strict diets.
  • Stress. nine0105 Anorexia can be triggered by any stressful situations (death of a loved one, divorce, sexual abuse, etc.).
  • Social. Difficulties in social adjustment, ridicule at school or bad relationship experience can be a trigger for the development of anorexia. Modern social networks enable girls who are fond of unhealthy weight loss to unite in groups and feel supported.
  • Genetic. Research is currently underway to link the genetic predisposition to anorexia and other emotional disorders.

Classification of the disease

There are two types of anorexia nervosa:

  • Restrictive type - characterized by a sharp restriction in food, episodes of overeating that do not end artificially with vomiting. Often patients exhaust themselves with excessive physical exertion. nine0067
  • Cleansing type - patients with this type of anorexia constantly overeat and induce vomiting, take laxatives, diuretics, enemas.

According to the severity anorexia nervosa is classified based on body mass index (BMI):

  • mild - BMI is 17-17.99;
  • moderate - BMI is 16-16.99;
  • severe - BMI is 15-15.99;
  • nine0072 extreme - BMI less than 15.

Symptoms of anorexia

The disease is divided into periods, each of which is characterized by certain symptoms:

Dysmorphomanic – this period is characterized by the predominance of thoughts about one's own imperfection over actions. A person is depressed, feels anxiety, can look at himself in the mirror for a long time. The first restrictions on food with the help of diets begin.

Anorexia is defined as persistent starvation when the loss of body weight is 20-50% of the original weight. Patients feel the joy of the effect of losing weight and tighten the diet even more.

Significant weight loss is accompanied by dizziness, weakness, slowing of the heart rate, and a decrease in blood pressure.

Due to the systematically induced vomiting, dehydration occurs. At this stage, secondary diseases of the gastrointestinal tract appear - gastroenterocolitis, gastroenteroptosis, so refusal to eat is now associated not only with the fear of gaining weight, but also with the fear of pain in the abdomen. In addition, dry skin appears, hair loss increases, the menstrual cycle in women and spermatogenesis in men are upset, and libido decreases. nine0003

The cachexic period is characterized by irreversible dystrophy of the internal organs, and the loss of body weight is already more than 50% of the initial weight. The changes that occur can lead to death, although patients still believe that they are overweight and refuse to eat, which is regarded as a delusional disorder.

Reduction of anorexia nervosa . If the disease is diagnosed on time and the correct treatment is carried out, then the mental and somatic state gradually normalizes and the patient recovers. nine0003

Diagnosis of anorexia

Diagnosis of anorexia nervosa is primarily based on a careful history taking. The doctor finds out the duration of the change in eating behavior, the presence of allergies, a detailed diet, the dynamics of growth, weight, body mass index, whether vomiting was practiced, the use of enemas, the use of drugs for weight loss, the presence of increased physical activity, the frequency of episodes of bulimia, evaluates the characteristics of menstrual cycle. nine0003

A thorough examination of the patient is carried out in order to determine the general condition of the body and identify concomitant pathologies.

  • Blood test to detect anemia.

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  • Blood chemistry (total protein, protein fractions, short lived proteins (transferrin/ferritin, prealbumin if available), creatinine, urea, uric acid, bilirubin, cholesterol, triglycerides, electrolytes (calcium, potassium, sodium, magnesium, phosphorus) , iron, AST, ALT, alkaline phosphatase, GGT, amylase, CPK, acute phase proteins (C-reactive protein).These studies assess the function of the liver and kidneys, metabolism, water-salt balance and microelement composition.
  • Blood biochemistry: advanced profile

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  • Clinical urinalysis to assess kidney function.
  • General urinalysis (Urine analysis with sediment microscopy)

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  • ECG to detect cardiac disorders.
  • ECG with interpretation0003

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  • Diuresis control.
  • Gastroscopy to assess the condition of the stomach and duodenum.
  • Gastroscopy

    Examination of the mucous membrane of the upper gastrointestinal tract with the possibility of performing a biopsy or endoscopic removal of small pathological. ..

    4 440 rubles Sign up nine0003

  • An MRI of the brain may be required if organic brain damage is suspected.
  • MRI of the brain

    Safe and informative scanning of brain structures for the diagnosis of its pathologies.

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  • ECHO-KG is performed to rule out valvular heart disease and assess myocardial contractility. nine0067


    Examination to assess functional and organic changes in the heart, its contractility, as well as the condition of the valvular apparatus.

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    Which doctors to contact

    If you suspect anorexia nervosa, you should consult a psychiatrist.

    Other specialists may need to be consulted after diagnosis: endocrinologist, gynecologist, gastroenterologist, nutritionist. nine0003

    Treatment of anorexia

    Treatment of anorexia takes place in two stages:

    • Rehabilitation . Treatment does not end with discharge from the hospital - psychotherapy and diet therapy should be continued further, and depending on the initial condition of the patient, recovery can take from several months to several years.


    Without timely help, anorexia can lead to many somatic complications, such as growth retardation and sexual development, degenerative changes in the skin and muscles, chronic constipation, secondary amenorrhea, osteoporosis, bone fractures, myocardial dystrophy. In addition, there is a high risk of substance abuse and depression, which increase the likelihood of suicide. nine0003

    Mortality in severe cases of anorexia reaches 7%.

    Anorexia prevention

    Prevention of anorexia can only be at the level of society and family. It is important to reduce the risk factors that can lead to the development of anorexia, and to identify the disease in the early stages, preventing the disease from causing significant damage to the patient's physical and mental health.


    1. Clinical guidelines (protocols for managing patients) developed by the chief freelance specialists of the Moscow City Health Department "Protocol (algorithm) for managing patients with anorexia nervosa in a hospital setting". - M.: KST Interforum LLC, 2015 - 16 p. nine0067
    2. Pichikov A.A., Popov. Anorexia nervosa in adolescent girls: course options, relapse factors and suicidal risk in the early stages of therapy // Review of Psychiatry and Medical Psychology. No. 4, 2017, pp. 41-50.
    3. Zakharova L.I. Anorexia nervosa: prevalence, diagnostic criteria and psychosomatic correlations (review) // Scientific results of biomedical research. 2019. V. 5, No. 1. S. 108-121. DOI: 10.18413/2313-8955-2019-5-1-0-8
    4. nine0335


      The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
      For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes. nine0003


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