Many people worry about gaining weight. But in some people, the worry becomes obsessive, resulting in a condition called anorexia nervosa.
Anorexia nervosa is an eating disorder that can result in severe weight loss. A person with anorexia is preoccupied with calorie intake and weight and may perceive their body as larger than it is.
People with anorexia eat an extremely low calorie diet and have an excessive fear of gaining weight. They often feel better about themselves after losing weight. They may also exercise excessively.
Anorexia is most commonly diagnosed in adolescent women, but it’s been diagnosed in older and younger women and in men.
Disordered eating and eating disorders can affect anyone, regardless of gender identity, race, age, socioeconomic status, or other identities.
They can be caused by any combination of biological, social, cultural, and environmental factors — not just by exposure to diet culture.
If you’re preoccupied with food or your weight, feel guilt about food choices, or engage in restrictive diets, consider reaching out for support.
The National Alliance for Eating Disorders offers a daytime helpline staffed by licensed therapists and an online search tool for treatment options. For general mental health support at any time, you can call the Substance Abuse and Mental Health Services Administration 24 hours a day at 1-800-662-4357 (or 1-800-487-4889 for TTY).
An estimated 9% of the U.S. population (28.8 million Americans) will have an eating disorder in their lifetime.
People with anorexia lose weight and maintain a low weight in different ways.
While some severely restrict their calorie intake, others exercise excessively. Some people employ a binge and purge method similar to that used by those with bulimia. Others use laxatives, vomiting, or diuretics to rid themselves of calories.
Symptoms of anorexia may include:
- inability to maintain a healthy weight
- fatigue
- insomnia
- skin that is yellow or blotchy and covered with soft, fine hairs
- hair thinning or falling out
- dry skin
- constipation
- more than 3 menstrual cycles without a period
- low blood pressure
Behaviors may include:
- excessive exercise
- pushing food around the plate instead of eating it, or cutting food into small pieces
- irritability
- withdrawal from social activities
- depressed mood
- hunger denial
- use of diuretics, laxatives, or diet pills
The exact cause of anorexia isn’t known. People who develop anorexia may have a negative body image. They may be focused on being “perfect.” They may be looking for ways to control their lives. Other factors, such as biology, environment, and psychology, are believed to play a role.
Biology
Genetics and hormones might have an effect on the development of anorexia. Some evidence suggests a link between anorexia and serotonin, a chemical produced in the brain.
Environment
Pressure from society to look thin may also contribute to the development of anorexia. Unrealistic body images from social media, magazines, and television can greatly influence young people and spark the desire to be thin.
During the COVID-19 pandemic, the number of hospitalized children and adolescents with anorexia nervosa
Psychology
Someone with obsessive-compulsive disorder (OCD) might be more predisposed to maintaining the strict diet and exercise regimen that those with anorexia often maintain. That’s because people with OCD are prone to obsessions and compulsions.
To diagnose anorexia, a healthcare professional will perform a physical exam to check blood pressure and heart rate, and note whether the individual’s body weight is significantly low for their height and age, and whether this is not due to another health condition or to the unavailability of food.
They will also do a psychological exam or refer you or your loved one to a mental health professional who will ask about eating habits and feelings. Doctors look for any criteria that show:
- restricted food intake
- fear of gaining weight
- unhealthy body image
A doctor may order blood tests to check electrolyte levels and liver and kidney function. In addition, they may check bone density and look for heart irregularities.
Doctors may also order other laboratory tests to rule out other possible causes for weight loss, such as celiac disease and inflammatory bowel disease.
If you have anorexia, one of the biggest obstacles in the treatment of anorexia is realizing that you need help. Many people with anorexia don’t believe they have a problem. That can make treatment difficult.
The main goal of treatment is to restore your body to a healthy weight and establish healthy, routine eating habits. A dietitian will help you learn how to eat properly. It might also be recommended that your family take part in therapy with you.
Therapy
Individual, family, and group therapies are often integral to treatment.
Individual therapy
A form of therapy called cognitive behavioral therapy (CBT) is often used to treat anorexia. CBT helps change unhealthy thoughts and behaviors. Its goal is to help you learn to cope with strong emotions and build healthy self-esteem.
Family therapy
Family therapy gets family members involved in keeping you on track with your healthy eating and lifestyle. Family therapy also helps resolve conflicts within the family. It can help create support for the family member learning to cope with anorexia.
Group therapy
Group therapy allows people with anorexia to interact with others who have the same disorder. But it can sometimes lead to competition to be the thinnest. To avoid that, it’s important to attend group therapy that is led by a qualified medical professional.
Medication
While there is no medication at this time that is proven to treat anorexia, antidepressants may be prescribed to manage the anxiety and depression common in those with anorexia. These may make you feel better. But antidepressants do not diminish the desire to lose weight.
Hospitalization
Depending on the severity of your weight loss, your healthcare professional may want to keep you in the hospital for a few days to treat the effects of your anorexia. A feeding tube and intravenous fluids may be recommended if your weight is too low or if you’re dehydrated.
If you continue to refuse to eat or exhibit psychiatric issues, your primary care provider may recommend inpatient hospitalization, which can include voluntary or involuntary admission.
Online therapy options
Read our review of the best online therapy options to find the right fit for you.
As many as two-thirds of people diagnosed with anorexia make a full recovery, but getting help as soon as possible gives the best chance of recovery.
For some people, overcoming anorexia takes lifelong treatment and maintenance. Joining a support group for anorexia can help increase the likelihood of recovery.
There’s no proven method to prevent anorexia. But looking out for symptoms of the disorder can help with quick diagnosis, treatment, and recovery.
If you or a loved one is obsessing about weight, exercising excessively, or is dissatisfied with your appearance, you may want to seek professional help.