What does it mean to be anorexic
Anorexia nervosa - Symptoms and causes
Overview
Anorexia (an-o-REK-see-uh) nervosa — often simply called anorexia — is an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight. People with anorexia place a high value on controlling their weight and shape, using extreme efforts that tend to significantly interfere with their lives.
To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat. They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics or enemas. They may also try to lose weight by exercising excessively. No matter how much weight is lost, the person continues to fear weight gain.
Anorexia isn't really about food. It's an extremely unhealthy and sometimes life-threatening way to try to cope with emotional problems. When you have anorexia, you often equate thinness with self-worth.
Anorexia, like other eating disorders, can take over your life and can be very difficult to overcome. But with treatment, you can gain a better sense of who you are, return to healthier eating habits and reverse some of anorexia's serious complications.
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Symptoms
The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioral issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.
It may be difficult to notice signs and symptoms because what is considered a low body weight is different for each person, and some individuals may not appear extremely thin. Also, people with anorexia often disguise their thinness, eating habits or physical problems.
Physical symptoms
Physical signs and symptoms of anorexia may include:
- Extreme weight loss or not making expected developmental weight gains
- Thin appearance
- Abnormal blood counts
- Fatigue
- Insomnia
- Dizziness or fainting
- Bluish discoloration of the fingers
- Hair that thins, breaks or falls out
- Soft, downy hair covering the body
- Absence of menstruation
- Constipation and abdominal pain
- Dry or yellowish skin
- Intolerance of cold
- Irregular heart rhythms
- Low blood pressure
- Dehydration
- Swelling of arms or legs
- Eroded teeth and calluses on the knuckles from induced vomiting
Some people who have anorexia binge and purge, similar to individuals who have bulimia.
But people with anorexia generally struggle with an abnormally low body weight, while individuals with bulimia typically are normal to above normal weight.
Emotional and behavioral symptoms
Behavioral symptoms of anorexia may include attempts to lose weight by:
- Severely restricting food intake through dieting or fasting
- Exercising excessively
- Bingeing and self-induced vomiting to get rid of food, which may include the use of laxatives, enemas, diet aids or herbal products
Emotional and behavioral signs and symptoms may include:
- Preoccupation with food, which sometimes includes cooking elaborate meals for others but not eating them
- Frequently skipping meals or refusing to eat
- Denial of hunger or making excuses for not eating
- Eating only a few certain "safe" foods, usually those low in fat and calories
- Adopting rigid meal or eating rituals, such as spitting food out after chewing
- Not wanting to eat in public
- Lying about how much food has been eaten
- Fear of gaining weight that may include repeated weighing or measuring the body
- Frequent checking in the mirror for perceived flaws
- Complaining about being fat or having parts of the body that are fat
- Covering up in layers of clothing
- Flat mood (lack of emotion)
- Social withdrawal
- Irritability
- Insomnia
- Reduced interest in sex
When to see a doctor
Unfortunately, many people with anorexia don't want treatment, at least initially.
Their desire to remain thin overrides concerns about their health. If you have a loved one you're worried about, urge her or him to talk to a doctor.
If you're experiencing any of the problems listed above, or if you think you may have an eating disorder, get help. If you're hiding your anorexia from loved ones, try to find a person you trust to talk to about what's going on.
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Causes
The exact cause of anorexia is unknown. As with many diseases, it's probably a combination of biological, psychological and environmental factors.
- Biological. Although it's not yet clear which genes are involved, there may be genetic changes that make some people at higher risk of developing anorexia. Some people may have a genetic tendency toward perfectionism, sensitivity and perseverance — all traits associated with anorexia.
- Psychological. Some people with anorexia may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry.
They may have an extreme drive for perfectionism, which causes them to think they're never thin enough. And they may have high levels of anxiety and engage in restrictive eating to reduce it. - Environmental. Modern Western culture emphasizes thinness. Success and worth are often equated with being thin. Peer pressure may help fuel the desire to be thin, particularly among young girls.
Risk factors
Anorexia is more common in girls and women. However, boys and men have increasingly developed eating disorders, possibly related to growing social pressures.
Anorexia is also more common among teenagers. Still, people of any age can develop this eating disorder, though it's rare in those over 40. Teens may be more at risk because of all the changes their bodies go through during puberty. They may also face increased peer pressure and be more sensitive to criticism or even casual comments about weight or body shape.
Certain factors increase the risk of anorexia, including:
- Genetics.
Changes in specific genes may put certain people at higher risk of anorexia. Those with a first-degree relative — a parent, sibling or child — who had the disorder have a much higher risk of anorexia. - Dieting and starvation. Dieting is a risk factor for developing an eating disorder. There is strong evidence that many of the symptoms of anorexia are actually symptoms of starvation. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. Starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.
- Transitions. Whether it's a new school, home or job; a relationship breakup; or the death or illness of a loved one, change can bring emotional stress and increase the risk of anorexia.
Complications
Anorexia can have numerous complications.
At its most severe, it can be fatal. Death may occur suddenly — even when someone is not severely underweight. This may result from abnormal heart rhythms (arrhythmias) or an imbalance of electrolytes — minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body.
Other complications of anorexia include:
- Anemia
- Heart problems, such as mitral valve prolapse, abnormal heart rhythms or heart failure
- Bone loss (osteoporosis), increasing the risk of fractures
- Loss of muscle
- In females, absence of a period
- In males, decreased testosterone
- Gastrointestinal problems, such as constipation, bloating or nausea
- Electrolyte abnormalities, such as low blood potassium, sodium and chloride
- Kidney problems
If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys.
This damage may not be fully reversible, even when the anorexia is under control.
In addition to the host of physical complications, people with anorexia also commonly have other mental health disorders as well. They may include:
- Depression, anxiety and other mood disorders
- Personality disorders
- Obsessive-compulsive disorders
- Alcohol and substance misuse
- Self-injury, suicidal thoughts or suicide attempts
Prevention
There's no guaranteed way to prevent anorexia nervosa. Primary care physicians (pediatricians, family physicians and internists) may be in a good position to identify early indicators of anorexia and prevent the development of full-blown illness. For instance, they can ask questions about eating habits and satisfaction with appearance during routine medical appointments.
If you notice that a family member or friend has low self-esteem, severe dieting habits and dissatisfaction with appearance, consider talking to him or her about these issues.
Although you may not be able to prevent an eating disorder from developing, you can talk about healthier behavior or treatment options.
By Mayo Clinic Staff
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Overview - Anorexia - NHS
Anorexia is an eating disorder and serious mental health condition.
People who have anorexia try to keep their weight as low as possible by not eating enough food or exercising too much, or both. This can make them very ill because they start to starve.
They often have a distorted image of their bodies, thinking they're fat even when they're underweight.
Men and women of any age can get anorexia, but it's most common in young women and typically starts in the mid-teens.
Signs and symptoms of anorexia
Signs and symptoms of anorexia include:
- if you're under 18, your weight and height being lower than expected for your age
- if you're an adult, having an unusually low body mass index (BMI)
- missing meals, eating very little or avoiding eating any foods you see as fattening
- believing you're fat when you're a healthy weight or underweight
- taking medicine to reduce your hunger (appetite suppressants)
- your periods stopping (in women who have not reached menopause) or not starting (in younger women and girls)
- physical problems, such as feeling lightheaded or dizzy, hair loss or dry skin
Some people with anorexia may also make themselves sick, do an extreme amount of exercise, or use medicine to help them poo (laxatives) or to make them pee (diuretics) to try to stop themselves gaining weight from any food they do eat.
Getting help for anorexia
Getting help and support as soon as possible gives you the best chance of recovering from anorexia.
If you think you may have anorexia, even if you're not sure, see a GP as soon as you can.
They will ask you questions about your eating habits and how you're feeling, and will check your overall health and weight.
They may also refer you for some blood tests to make sure your weight loss is not caused by something else.
If they think you may have anorexia, or another eating disorder, they should refer you to an eating disorder specialist or team of specialists.
It can be very hard to admit you have a problem and to ask for help. It may make things easier if you bring a friend or loved one with you to your appointment.
You can also talk in confidence to an adviser from eating disorders charity Beat by calling its adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711.
Getting help for someone else
If you're concerned that a family member or friend may have anorexia, let them know you're worried about them and encourage them to see a GP. You could offer to go along with them.
Read more about talking to your child about eating disorders and supporting someone with an eating disorder.
Treatment for anorexia
You can recover from anorexia, but it may take time and recovery will be different for everyone.
Your treatment plan will be tailored to you and should consider any other support you might need, such as for depression or anxiety.
If you're over 18, you should be offered a type of talking therapy to help you manage your feelings about food and eating so that you are able to eat enough to be healthy. Talking therapies that are commonly used to treat anorexia in adults include:
- cognitive behavioural therapy (CBT)
- Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
- specialist supportive clinical management (SSCM)
If you're under 18, you should be offered family therapy.
You may also be offered another type of talking therapy, such as CBT or adolescent-focused psychotherapy.
Health risks of anorexia
Long-term anorexia can lead to severe health problems associated with not getting the right nutrients (malnutrition). But these will usually start to improve once your eating habits return to normal.
Possible complications include:
- problems with muscles and bones – including feeling tired and weak, osteoporosis, and problems with physical development in children and young adults
- fertility problems
- loss of sex drive
- problems with the heart and blood vessels – including poor circulation, an irregular heartbeat, low blood pressure, heart valve disease, heart failure, and swelling in the feet, hands or face (oedema)
- problems with the brain and nerves – including fits (seizures), and difficulties with concentration and memory
- kidney or bowel problems
- having a weakened immune system or anaemia
Anorexia can also put your life at risk.
It's one of the leading causes of deaths related to mental health problems. Deaths from anorexia may be due to physical complications or suicide.
Causes of anorexia
We do not know exactly what causes anorexia and other eating disorders. You may be more likely to get an eating disorder if:
- you or a member of your family has a history of eating disorders, depression, or alcohol or drug addiction
- you have been criticised for your eating habits, body shape or weight
- you're overly concerned with being slim, particularly if you also feel pressure from society or your job – for example, ballet dancers, jockeys, models or athletes
- you have anxiety, low self-esteem, an obsessive personality or are a perfectionist
- you have been sexually abused
Video: Anorexia – Katie's story
In this video, Katie shares her experiences of life with anorexia and explains how she recovered.
Media last reviewed: 14 August 2020
Media review due: 14 August 2023
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Anorexia | Tervisliku toitumise informatsioon
Anorexia ( anorexia nervosa ) is an eating disorder in which a person tries to achieve the lowest possible body weight. Despite dangerously low weight, a person feels fat and is afraid to gain weight.
The disorder manifests itself in malnutrition and associated mental and physical complications. As a result of this disease, a person eats low-calorie, often monotonous foods to avoid weight gain. The focus is on weight, appearance, nutrition. Often this becomes the main activity, negatively affecting all other important areas of a person’s life. Violated close relationships, deteriorating ability to learn and work.
Anorexia usually develops in early adolescence. Most often, young girls get sick. Anorexia occurs in 1% of women and 0.
1% of men. The genetic predisposition for anorexia is higher than for other eating disorders. The influence of heredity on this disease is estimated at 40-60%. The presence of a close relative with anorexia increases the risk of the disease by 11 times. As with all eating disorders, biological factors and the environment play an important role.
Symptoms of anorexia:
- underweight - significantly lower than should be for age, sex and height diarrhoea, abuse of appetite suppressants or laxatives
- a distorted view of the body, a perception of being larger than one actually is.
- Fear of weight gain, very strict weight restrictions
- Concomitant hormonal, metabolic, physical complications
- Normal physical development is disturbed in children and adolescents, developmental delay occurs
Complications of anorexia:
- , osteoporosis)
- amenorrhea or absence of menstrual bleeding
- damage to the cardiovascular system, arrhythmias, palpitations, decreased performance
- kidney, liver and pancreas dysfunction
- gastrointestinal disorders that may be associated with constipation or diarrhea, bloating, abdominal pain
- damage to nails and skin, thinning hair
- chronic fatigue, weakness and loss of strength, decreased exercise tolerance, dizziness, shortness of breath, fainting
- difficulty concentrating, memory problems
- Anorexia is often associated with affective and anxiety disorders, sleep disorders
Treatment options for anorexia
Treatment of anorexia is often time-consuming and complex.
