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.