What Is Anorexia?

Anorexia nervosa, more commonly known as anorexia, is both an eating disorder and a metabolic condition that results in excessive weight loss and extreme thinness caused by self-starvation.

It is estimated that approximately 2% of American females and 0.3% of males will develop anorexia during their lifetime, based on research collected by the National Eating Disorders Association. Though it most commonly affects adolescent girls and women, anorexia can develop in anyone of any gender, age, race, or cultural background. Athletes, dancers, and anyone who works or studies in an industry that emphasizes lean physiques are at particularly high risk, and extremely thin people are sometimes presumed to be anorexic.

In addition to extreme thinness and fear of gaining weight, common signs and symptoms of anorexia include skipping meals, refusal to eat in public, frequent references or complaints about weight gain, intense exercise regimens, and covering up in layers of clothing to disguise thinness. If you suffer from anorexia, you are consumed by your own efforts to control your body shape and size.

What Causes Anorexia?

Although eating disorders circle around food, the root of the problem is psychological. With anorexia, you severely restrict food and obsessively control your weight because you equate thinness with self-worth. In your mind, the thinner you are, the more value you have, so you can never be thin enough. Unfortunately, this distorted sense of what your body should look like can make you very sick.

How Does Anorexia Develop?

As with other eating disorders, there is no single known cause, but many factors play into the development of anorexia. How does anorexia start? It’s not totally clear but your risk increases if you have a close family member, such as a parent or sibling, with an eating disorder. Obsessive-compulsive personality traits, such as perfectionism and sensitivity, are usually associated with anorexia.

Genetics appear to play a major role, though researchers are just beginning to figure out which genes are involved and what type of changes to those genes put people at higher risk of developing anorexia. Genetic scientists have pinpointed genes linking anorexia to depression, anxiety, and obsessive-compulsive disorder. Researchers have also discovered that certain metabolism genes linked to fat burning, physical activity, and resistance to type 2 diabetes appear to combine with those genes linked to psychiatric conditions, and that combination appears to increase the risk of developing anorexia.

While interesting, these discoveries are really just a drop in the research bucket, since there are likely to be hundreds of thousands of genes involved in the development of anorexia, just as there are in the development of so many other diseases and disorders.

How Anorexia Affects Your Health and Well-Being

Anorexia stems from and can cause, a variety of physical, psychological, and emotional problems. Ultimately, starving yourself can cause serious physical complications, such as:

  • Abnormally slow heart rate
  • Drop in blood pressure
  • Abnormal blood count
  • Increased risk of heart failure
  • Increased risk of bone loss (osteopenia or osteoporosis)
  • Loss of muscle tone
  • Dehydration which, in extreme cases, can lead to kidney failure
  • Irregular periods in women
  • Lower testosterone in men
  • Feeling weak, fatigued, or dizzy, or experiencing fainting spells
  • Dry skin that may also take on yellowish tint
  • Bluish color on the tips of the fingers
  • Dry hair and hair loss
  • Downy hair that grows over the skin in order to keep warm

You are also likely to experience some or all of the psychological and emotional problems associated with anorexia, including:

  • Lying about your eating habits
  • Irritability
  • Withdrawing from social activities
  • Emotional flat-lining
  • Obsessive thoughts and behavior concerning weight gain
  • Feeling insecure about the way you look
  • Decreased interest in sex
  • Anxiety and depression
  • Suicidal thoughts

Where to Get Help for Anorexia and What to Except

Anorexia nervosa is a serious, and sometimes lethal, physical and mental health condition that requires proper diagnosis and treatment. Once a diagnosis is established, a combination of psychotherapy, medical treatment, and nutrition counseling may be prescribed.

If you’re not already working with a mental health care provider, you can start by speaking to your primary care physician. Describe your symptoms and the feelings that you associate with your behavior. It may be helpful to make a list of symptoms that you are experiencing before the appointment. Be sure to include all relevant personal information, like any family history of eating disorders, major stress, recent life changes, and a typical day’s eating patterns.

In addition to a physical exam, including tests to evaluate whether you are suffering any physical effects from binge eating, your PCP may ask questions about your daily food habits, your thoughts, and your thoughts and feelings about your weight and appearance. Don’t hesitate to discuss your emotions, thoughts, or other information that may seem unrelated to binge eating; it is important to give your provider a full picture of your mental and physical health.

If your physician suspects a diagnosis of anorexia, they should be able to refer you to a licensed mental health professional. It is important to seek treatment from someone with the appropriate education, training, and experience to treat your specific condition.

Anorexia Treatment

Be sure you agree with their approach to treating anorexia, and understand their proposed treatment plan and what they see as your primary goal for recovery. If you are not satisfied with their answers or feel comfortable working with this person, consider seeking a second opinion.

Mental health professionals who treat anorexia may draw from different styles of therapy and use various tools to help you move on to a state of recovery. The first line of treatment is usually individual cognitive behavioral therapy (CBT), a one-on-one, relatively short-term form of talk therapy that can help you understand how your negative thoughts and feelings about yourself and about food are connected to your eating disorder. Your therapist can teach you to manage your feelings and help you develop new ways of thinking and behaving around food.

At the same time, CBT can help you learn to cope with stress and address any of your broader concerns and conflict, such as your self-esteem, and your relationships with family, friends, and coworkers. Finally, CBT can help you learn to recognize and deal with triggers that can lead to relapses. At some point, in addition to individual counseling, your therapist might recommend group therapy or a support group.

In addition to psychological counseling, other treatments and approaches can help alleviate some of the symptoms and improve the behaviors associated with anorexia.

Although no drugs have been shown to improve symptoms of anorexia, your physician may prescribe medication for depression or anxiety, if necessary. A registered dietitian or clinical nutritionist can help you achieve or maintain a healthy weight by teaching you more about good nutrition and helping you develop and follow a balanced eating plan. Your health care providers may also suggest adjunctive therapies like movement classes, meditation and mindfulness instruction, yoga, equine therapy, or art therapy. These programs won’t cure anorexia, but they can help lower your stress levels, elevate your mood, improve your body image, and teach you to have a better sense of control over your life.

The level of care for anorexia ranges from simple to intensive outpatient support to part-time and full-time (residential) inpatient programs housed within a hospital, clinic, or eating disorders treatment center. The severity of your symptoms will determine the level and type of care you need.

If you need help and you cannot get it from someone in your immediate support circle, call the National Eating Disorders Association helpline toll-free at 1-800-931-2237.

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Last Updated: Sep 10, 2021