Anorexia nervosa is an eating disorder that causes people to obsess about their weight and the food they eat. People with anorexia nervosa attempt to maintain a weight that's far below normal for their age and height. To prevent weight gain or to continue losing weight, people with anorexia nervosa may starve themselves or exercise excessively.
Anorexia (an-oh-REK-see-uh) nervosa isn't really about food. It's an unhealthy way to try to cope with emotional problems. When you have anorexia nervosa, you often equate thinness with self-worth.
Anorexia nervosa can be 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.
Some people with anorexia lose weight mainly through severely restricting the amount of food they eat. They may also try to lose weight by exercising excessively. Others with anorexia engage in binging and purging, similar to bulimia. They control calorie intake by vomiting after eating or by misusing laxatives, diuretics or enemas.
No matter how weight loss is achieved, anorexia has a number of physical, emotional and behavioral signs and symptoms.
Physical anorexia symptoms
Emotional and behavioral anorexia symptoms
Anorexia red flags to watch for
If you're concerned that a loved one may have anorexia, watch for these possible red flags:
When to see doctor
If you're experiencing any of these problems, 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 confidant you can talk to about what's going on.
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.
It's not known specifically what causes some people to develop anorexia. As with many diseases, it's likely a combination of biological, psychological and sociocultural factors.
Certain risk factors increase the risk of anorexia, including:
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.
Complications of anorexia include:
If a person with anorexia becomes severely malnourished, every organ in the body can sustain damage, 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 disorders as well. They may include:
Preparing for your appointment
Treatment of anorexia is generally done using a team approach that includes medical providers, mental health providers and dietitians, all with experience in eating disorders.
Here's some information to help you get ready for your appointments, and what to expect from your doctor and other health providers.
What you can do
Some potential questions you might want to ask your doctor or other health care provider include:
In addition to the questions that you've prepared to ask, don't hesitate to ask questions of any of your providers anytime that you don't understand something.
What to expect from your doctor
Tests and diagnosis
When doctors suspect someone has anorexia, they typically run a battery of tests and exams to help pinpoint a diagnosis, rule out medical causes for the weight loss and also check for any related complications.
These exams and tests generally include:
Diagnostic criteria for anorexia
DSM diagnostic criteria for anorexia are:
Some medical professionals believe these criteria are too strict or don't accurately reflect symptoms in some people. Some people may not meet all of these criteria but still have an eating disorder and need professional help.
Treatments and drugs
When you have anorexia, you may need several types of treatment. If your life is in immediate danger, you may need treatment in a hospital emergency department for such issues as a heart rhythm disturbance, dehydration, electrolyte imbalances or psychiatric problems.
Here's a look at what's commonly involved in treating people with anorexia:
Restoring a healthy weight
Treatment challenges in anorexia
Even if you do want to get better, the pull of anorexia can be difficult to overcome. Anorexia is often an ongoing, lifelong battle. Although symptoms may subside, you remain vulnerable and may have a relapse during periods of high stress or during triggering situations. For example, anorexia symptoms may subside during pregnancy only to return once your baby has been delivered. Ongoing therapy or periodic appointments during times of stress may be helpful.
Lifestyle and home remedies
When you have anorexia, it can be difficult to take care of yourself properly. In addition to professional treatment, follow these steps:
Although yoga has not yet been well studied as a treatment for people with eating disorders, some research has found that yoga may be beneficial as an additional treatment. It may help people with eating disorders by increasing a sense of well-being and promoting relaxation.
Coping and support
You may find it difficult to cope with anorexia when you're hit with mixed messages by the media, culture, and perhaps your own family or friends. You may even have heard people joke that they wish they could have anorexia for a while so that they could lose weight.
So how do you cope with a disease that can be deadly when you may be getting messages that being thin is a sign of success?
If you're interested in joining a support group, ask your doctor if he or she knows if there's a group in your area, or call the National Association of Anorexia Nervosa and Associated Eating Disorders' (ANAD) helpline at 630-577-1330. (This is not a free phone call.) You can also find information on its Web site.
There's no guaranteed way to prevent anorexia or other eating disorders. Primary care physicians (pediatricians, family physicians and internists) may be in a good position to identify early indicators of an eating disorder and prevent the development of full-blown illness. They can ask questions about eating habits and satisfaction with appearance during routine medical appointments, for instance.
If you notice a family member or friend with low self-esteem, severe dieting 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.
Last Updated: 2009-12-19
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