- Symptoms of
anorexia nervosa include obsessive calorie counting and having an intense fear of gaining weight. - Physical signs of anorexia may also include hair loss and weight loss.
- There are many risk factors for developing anorexia, such as having another mental
health disorder like anxiety or PTSD. - This article was medically reviewed by Mayra Mendez, PhD, LMFT, a psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center.
Anorexia nervosa is a type of
If left untreated, anorexia can result in long-term physical ramifications like anemia, osteoporosis, and heart failure. It can also cause debilitating mental health effects like worsening depression, increased anxiety, and increased suicide risk. People with anorexia, or those experiencing symptoms of the disorder, should seek treatment immediately to prevent long-term health effects.
Here's how you can tell if you or someone you love might have anorexia nervosa, and what you can do to get a diagnosis.
What is anorexia nervosa?
Anorexia nervosa is a type of mental health disorder that causes individuals to have an intense fear of gaining weight, despite being at a normal or below normal weight. Those with the disorder will restrict caloric intake to the point of significant weight loss or an inability to gain weight for individuals still growing. Those with anorexia often evaluate their self-worth by their body weight or shape, and may experience distorted perceptions of their weight and size.
People with anorexia nervosa may also experience symptoms commonly associated with other eating disorders such as excessive exercising, binge eating, or purging with laxatives or by vomiting.
About 0.9% to 2% of women and 0.1% to 0.3% of men will develop anorexia at some point in their life. While eating disorders are often associated with women, 25% of anorexia nervosa cases are in men. The misconception that men cannot have anorexia puts them at a higher risk of dying from the disease due to lack of diagnosis.
Anorexia nervosa is a progressive disorder. While it may start off as obsessively adhering to a strict diet, it can evolve into eating very few calories, extreme anxiety about foods, and developing fears about certain food groups. These increasingly dangerous developments are why early detection is so critical.
Early detection can help ward off long-term impacts or more dangerous symptoms like organ failure. "Without integrative treatment, individuals may face a lifetime of potentially irreversible health problems, which is why timely, professional help is critical," says Kristin Wilson, a licensed professional counselor and vice president of the Newport Institute, a youth mental health center.
Signs you have anorexia nervosa
Because each case of anorexia is unique, symptoms will vary between individuals. Most people with anorexia may not display all of the following symptoms, but some combination of a few. Symptoms span three categories: behavioral, emotional, and physical.
Behavioral symptoms are some of the earliest signs of anorexia nervosa. Meanwhile, emotional symptoms are those that have to do with the changes in thoughts, values, and overall mental health. Physical symptoms are those discovered through medical examinations or are visible to others.
According to Jessica Jaeger, a registered dietitian specializing in eating disorders, and Chelsea D. Woodard, a licensed counselor and site director of The Renfrew Center, an eating disorder treatment facility, symptoms of anorexia include:
Wilson points out that sudden weight loss is not the same as being thin, as some people with the disorder may be a normal weight. The misconception that everyone struggling with anorexia is very thin can cause some people to not seek treatment out of fear they are not thin enough.
What are the risk factors for developing anorexia nervosa?
Having another mental health disorder
About 33% of people with anorexia also have a mood dysregulation disorder like depressive or bipolar disorder. Additionally, about half also suffer from an anxiety disorder like obsessive-compulsive disorder (OCD).
"Our clients with anorexia often report that restricting their caloric intake helps them to feel better in the midst of anxiety and depression," says Woodard. However, in the long-term these limitations create compounding problems and stress for the body to deal with.
Developing post traumatic stress disorder (PTSD)
A 2014 report from the National Institute of Health found about 24.3% of people with an eating disorder also have PTSD. For individuals who have a diagnosis of PTSD, symptoms of anorexia may give them a sense of control, says Wilson. In tightly controlling their food intake, they feel a sense of power return to their life and choices.
Undergoing treatment for PTSD may help people recover from anorexia nervosa. In a 2007 study published by The Journal of Treatment and Prevention, researchers found that PTSD and its symptoms needed to be satisfactorily addressed in order for someone to also reap benefits of treatment and recovery from an eating disorder.
Having a family history of eating disorders
Family history is a good indicator of your risk for developing an eating disorder. In fact, researchers have found that 50% to 80% of the risk for anorexia and bulimia is genetic.
Living in a critical environment
Being exposed to negative ideas around weight and body image can also put you at an increased risk.
"If children grow up in an environment where dieting is encouraged, their parents dieted, or they experience body shame or weight-related teasing, they may be at a higher risk of developing eating disorder symptoms in general," says Jaeger.
According to Wilson, there are also a few demographics at a heightened risk for developing anorexia:
- Teens: Undergoing puberty causes drastic changes in the body that can cause teens to become more aware of societal expectations around weight and appearance.
- College students: As young adults move away from home, they may develop an eating disorder in response to a desire to fit in.
- Athletes: Athletes may also be at a higher risk of anorexia due to the incredible pressure put on their bodies to perform and look a specific way. This is common in sports like wrestling and gymnastics.
- LGBTQ+ individuals: In a 2018 study of 1,304 LGBTQ individuals aged 13 to 24, 54% reported being diagnosed with an eating disorder, compared to 5% of their heterosexual peers. The rates are even higher for straight transgender youth, with 71% reporting an eating disorder diagnosis, most commonly anorexia.
Though certain people are predisposed to the disease, Woodard notes, "anorexia nervosa does not discriminate: we know it affects people across all ages, races, sexes, genders, and socioeconomic statuses."
Challenges of self-diagnosis
Because individuals suffering from anorexia nervosa may be in denial about their condition, self-diagnosis is difficult. Even if they believe a problem exists, they may be reluctant to seek help.
This hesitation can be due to thinking they aren't sick enough or from a fear of gaining weight once in treatment. However, there is no such thing as being "sick enough" and anyone who is struggling should reach out to a healthcare provider.
How to get an anorexia nervosa diagnosis
If you have a
If a medical doctor believes a diagnosis of anorexia nervosa is likely, they may refer you for evaluation by a mental health professional to confirm your condition. The mental health professional will ask you a series of questions about your behavior, mental health state, and self-reflection. Once someone is diagnosed with anorexia nervosa, they will receive an individualized treatment plan which may involve techniques such as therapy, nutritional education, and medical intervention, says Wilson.
Takeaways
Anorexia nervosa is a serious and life-threatening mental health disorder that causes someone to fixate on weight and food restriction. Symptoms of the disorder vary and are both emotional, behavioral, and physical. Therefore, if you or someone you love might have symptoms suggestive of anorexia, it's important to reach out to a healthcare professional like a doctor or psychiatrist for treatment.
"Despite the many challenges clients with anorexia face, complete recovery is totally possible," says Woodard. "Clients who are courageously willing to engage in the therapeutic and nutritional work during treatment have a great chance of seeing full recovery in their future. Making the decision to regain your life from the grips of anorexia requires bravery, hard work, and commitment."