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Anorexia Nervosa

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Anorexia is one of the most common eating disorders. If you would like information about other eating disorders, see the topics Bulimia and Binge Eating Disorder.

What is anorexia nervosa?

Anorexia nervosa (say "an-uh-RECK-see-uh nur-VOH-suh") is a type of eating disorder. People who have anorexia have an intense fear of gaining weight. They severely limit the amount of food they eat and can become dangerously thin.

Anorexia affects both the body and the mind. It may start as dieting, but it gets out of control. You think about food, dieting, and weight all the time. You have a distorted body image . Other people say you are too thin, but when you look in the mirror, you see a fat person.

Anorexia usually starts in the teen years. Early treatment can be very effective. But, if not treated early, anorexia can become a lifelong problem. Untreated anorexia can lead to starvation and serious health problems, such as bone thinning (osteoporosis), kidney damage, and heart problems. Some people die from these problems.

If you or someone you know has anorexia, get help right away. The longer this problem goes on, the harder it is to overcome. With treatment, a person with anorexia can feel better and stay at a healthy weight.

What causes anorexia?

Eating disorders are complex, and experts don't really know what causes them. But they may be due to a mix of family history, social factors, and personality traits. You may be more likely to have anorexia if:

• Other people in your family are obese, have an eating disorder, or have a mood disorder such as depression or anxiety.
• You have a job or do a sport that stresses body size, such as ballet, modeling, or gymnastics.
• You are the type of person who tries to be perfect all the time, never feels good enough, or worries a lot.
• You are dealing with stressful life events, such as divorce, moving to a new town or school, or losing a loved one.

Anorexia affects less than 1 percent of the population. It is most common in:

• Teens. Like other eating disorders, anorexia usually starts in the teen years with strict dieting and rapid weight loss. But it can start even earlier or in adulthood.
• Women. About 9 out of 10 people with anorexia are female. But some boys and men have it too.¹

Many people who have anorexia are white and come from wealthy families. But it can happen to anyone.

What are the symptoms?

People who have anorexia often strongly deny that they have a problem. They do not see or believe that they do. It is usually up to their loved ones to get help for them. If you are worried about someone, you can look for certain signs.

People who have anorexia:

• Weigh much less than is healthy or normal.
• Are very afraid of gaining weight.
• Refuse to stay at a normal weight.
• Think they are overweight even when they are very thin.

Their lives become focused on controlling their weight. They may:

• Obsess about food, weight, and dieting.
• Strictly limit their food intake. For example, they may limit themselves to just a few hundred calories a day or refuse to eat certain foods, such as anything with fat or sugar.
• Exercise a lot, even when they are sick.
• Vomit or use laxatives or water pills (diuretics) to avoid weight gain.
• Develop odd habits about food, like cutting all their food into tiny pieces or chewing every bite a certain number of times.
• Become secretive. They may pull away from family and friends, make excuses not to eat around other people, and lie about their eating habits.

As starvation sets in, they start to develop signs of serious problems throughout the body. For instance, they may:

• Feel weak, tired, or faint.
• Have thinning hair, dry skin, and brittle nails.
• Stop having menstrual periods.
• Feel cold all the time.
• Have low blood pressure and a slow heartbeat.
• Have purplish skin color on their arms and legs from poor blood flow.
• Have swollen feet and hands.
• Grow a layer of baby-fine hair all over their body.

How is anorexia diagnosed?

If your doctor thinks that you may have an eating disorder, he or she will compare your weight with the expected weight for someone of your height and age. He or she will also check your heart, lungs, blood pressure, skin, and hair to look for problems caused by not eating enough. You may also have blood tests or X-rays.

Your doctor may ask questions about how you feel. It is common for a treatable mental health problem such as depression or anxiety to play a part in an eating disorder.

How is it treated?

All people who have anorexia need treatment. Even if you or someone you care about has only a couple of the signs of an eating disorder, get help now. Early treatment gives the best chance of overcoming anorexia.

Treatment can help you get back to and stay at a healthy weight, learn good eating habits, and learn to feel better about yourself. Because anorexia is both a physical and emotional problem, you may work with a doctor, a dietitian, and a counselor.

There are no medicines to treat anorexia. But if you are depressed or anxious, your doctor may prescribe an antidepressant medicine.

If your weight has dropped too low, you will need to be treated in a hospital. People who have lost a large portion of their weight need to take part in a live-in (inpatient) treatment program for people with eating disorders. This type of treatment can be costly, but it gives the best chance of recovery.

Anorexia can take a long time to overcome, and it is common to fall back into unhealthy habits. If you are having problems, don't try to handle them on your own. Get help now.

What should you do if you think someone has anorexia?

It can be very scary to realize that someone you care about has an eating disorder. If you think a friend or loved one has anorexia, you can help.

• Talk to her. Tell her why you are worried. Let her know that you care.
• Urge her to talk to someone who can help, like a doctor or counselor. Offer to go with her.
• Tell someone who can make a difference—like a parent, teacher, counselor, or doctor. A person with anorexia may insist that she does not need help, but she does. The sooner she gets treatment, the sooner she will be healthy again.

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