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Anorexia Nervosa
Anorexia nervosa is an eating disorder and psychological condition marked by extreme self-starvation due to a distorted body image. People with anorexia think they are fat, regardless of how much they weigh, and are obsessive about monitoring their weight and the food they consume. They may regularly refuse to eat or eat only minimal amounts of food.
In spite of the health risks associated with being severely underweight, those with anorexia cannot see it as a problem. Yet those with the condition can and do starve themselves to death.
Anorexia is closely linked to perfectionism, depression, and suicidality. Although young women account for most cases, anorexia can affect anyone, at any time. But treatment can help individuals suffering from eating disorders make a lasting recovery.
For more on causes, symptoms and treatments, see our Diagnosis Dictionary.
Identifying eating disorders as early as possible is critical, because it raises the chance of a successful recovery. Although young women account for many cases of anorexia, the disorder can strike anyone, of any gender, race, or age. Symptoms encompass an altered relationship to food, weight, and exercise, whether that be severe weight loss, seemingly peculiar food choices, or an intense exercise regimen.
Warning signs of anorexia include rapid weight loss, an obsession with weight, food, or dieting, developing rituals and rules about when and what foods can be eaten, excessive exercise, eating alone and broader social withdrawal, and physical symptoms such as stomach pain, constipation, or exhaustion.
Women are three times more likely to experience anorexia in their lifetime than men. Older women also face eating disorders, and ethnic minority women and White women suffer from eating disorders at equal rates, research shows. Understanding who develops eating disorders can help people suffering come forward and help clinicians to recognize and treat the condition.
Anorexia and all eating disorders affect both psychological and physical health. Anorexia can lead to cardiovascular disease, osteoporosis, and gastrointestinal problems, including stomach pain, constipation, and vomiting. Anorexia can lead to hormone changes that stop menstruation, as well as the growth of fine “lanugo” hair on the body, dry skin, brittle hair, and more.
Yes. Eating disorders have the highest mortality rate of any mental illness. Research shows that about 10 percent of people with anorexia pass away. If you think that a loved one is in immediate danger, contact a helpline or call 911. Know that there are people who can help guide your loved one to recovery.
Five signs that children may be developing an eating disorder are: weight loss, unusual food rituals (cutting food into tiny pieces, using large quantities of condiments, insisting on particular cutlery), a sudden interest in cooking but not eating, compulsive exercise, and increased anxiety. If these behaviors occur, parents should broach the topic with their child and with their pediatrician.
Anorexia nervosa and other eating disorders are commonly found in cultures and settings where "being thin" is seen as desirable. Stressful life events can play a role in triggering the disorder, as can temperamental factors, such as perfectionism and obsessional traits. Biology and heredity seem to contribute to vulnerability as well, as individuals are more likely to develop the disorder if another family member has experienced it.
Anorexia emerges due to genetics, personality traits, and environmental factors. An individual is more likely to develop it if a family member has the disorder, showing its genetic underpinnings, while environmental influences such as stressful transitions and beauty ideals also contribute. Traits linked to anorexia include perfectionism, obsessiveness, and anxiety.
Anorexia cannot be definitively prevented, yet taking note of early warning signs can help. If someone struggles with self-esteem or body image, or begins a stringent diet, they may be on the cusp of developing an eating disorder. Discussing their emotions, providing support, and offering treatment options may prevent the condition from progressing.
Western culture tends to emphasize thinness and often equates it with beauty and success, which can conflate weight and self-worth. Research also finds that unlike other mental health conditions, celebrity disclosures of anorexia may actually increase traffic to pro-eating disorder websites. This may be because people struggling with eating disorders feel envy or admiration of the person’s “discipline” and thinness.
Eating disorders often don’t have to do with food as much as they have to do with concerns of self-esteem and control. Body dissatisfaction and low self-esteem can contribute to the desire to severely control food intake, as can trauma and stressful life events that seem overwhelming and uncontrollable.
People with anorexia may have diminished sensitivity to the internal cues that communicate hunger, research suggests, a phenomenon known more broadly as interoceptive awareness. They also show a stronger ability to delay rewards than those without an eating disorder. This combination may lead to a different experience of hunger—however people with anorexia still experience intense hunger.
Counseling and therapy, coupled with medical attention to health and nutritional needs, are important aspects of treatment. Treating anorexia involves three main goals: restoring weight lost to severe dieting and purging, treating psychological disturbances associated with body image distortions, and achieving long-term remission and rehabilitation or a full recovery.
Psychotherapy is the first-line treatment for anorexia. Cognitive behavioral therapy (CBT) and specifically enhanced cognitive behavioral therapy (CBT-E) involves recognizing and changing distorted beliefs that one has about eating and body image in order to ultimately develop normal eating patterns and arrive at a healthy weight. Family therapy is also widely used, as parental support is a key component of treatment and recovery for adolescents.
No medications specifically treat anorexia, but drugs may be prescribed to combat co-occurring problems such as depression and anxiety. Some drugs prompt weight gain, but none are currently approved to treat anorexia because patients rarely participate in these clinical trials and likely wouldn’t take medication without therapy to address underlying beliefs about body image.
People can be treated for eating disorders at an inpatient, residential, or outpatient facility based on their medical and psychological stability. Most people with anorexia are treated as outpatients, but hospital admission may be necessary if outpatient care doesn’t lead to sufficient change, if mental or physical health deteriorates sharply, or if there’s significant risk of self-harm.
Parents may be scared to raise the topic, but beginning the conversation can allow their child to heal. Parents can research eating disorders thoroughly, prepare what to say beforehand, communicate openly and honestly, avoid judgmental language, and encourage the child to seek professional help. In the case of an emergency, parents should seek medical attention or call 911.
Around 50 percent of people with anorexia nervosa fully recover and 35 percent show significant improvement. Approximately 20 percent will struggle with anorexia long-term, but with proper support and intervention there is always hope for improvement.
Recovery is a long, continuous process, throughout which relapse can occur. Elements of successful recovery include a strong support system and understanding the roots of one’s eating disorder, such as processing a trauma or developing healthy coping mechanisms for emotional distress.
