Anorexia Nervosa

Introduction

Anorexia nervosa is a serious eating disorder and mental health condition characterized by an intense fear of gaining weight, a distorted body image, and extreme restriction of food intake. It often leads to severe weight loss and can affect both physical and emotional health, making early awareness and proper treatment essential.

Anorexics who are thin may feel overweight because they are afraid of gaining weight. In an effort to maintain their weight reduction or avoid regaining it, anorexics may restrict their food consumption. They employ extreme techniques that can seriously impair their lives because they place a high priority on maintaining their weight and shape.

Malnutrition, often referred to as severely inadequate nutrition, can alter the brain in individuals with anorexia. When people fail to consume the nutrients their bodies require to stay healthy, this occurs. Consequently, there is no choice but to continue the dangerous behaviour.

Uncontrolled weight loss puts anorexics at risk for serious physical harm or even death. Drug overdoses are the only mental illness that has a worse death rate than anorexia. Suicide and cardiac issues account for the majority of deaths associated with anorexia.

Anorexia can take over a person’s life and is extremely challenging to treat, much like other eating disorders. Anorexia is not really about eating or looking a certain way, and behaviours are not choices because the condition is associated with alterations in the brain. People with anorexia who receive effective therapy can regain a healthy weight, adopt more balanced eating practices, and address some of the main physical and mental health issues associated with the disorder.

What is Anorexia Nervosa?

A mental health and eating disorder called anorexia nervosa causes a person to severely restrict their caloric intake. Anorexics adhere to rigorous food guidelines to maintain the lowest attainable body weight. This leads to malnutrition and often (though not always) an extremely low BMI.

The medical word for not wanting to eat is “anorexia.” When “nervosa” is included, anorexia is classified as a mental disorder. This suggests that the disease is rooted in your neurological system, which encompasses your brain, nerves, impulses, and thoughts. It arises from unfavorable ideas and emotions regarding eating, weight, and body image.

It’s common to consider, worry about, and attempt to deal with these issues. But if you suffer from anorexia nervosa, they both immensely inspire and oppress you. As a result, your physical and mental well-being may suffer significantly. It may be fatal if left untreated.

Types of Anorexia Nervosa

There are two types of anorexia nervosa based on the eating patterns involved:

• Restrictive anorexia: includes only rigorous calorie restriction.
• Binge-purge anorexia: Uncontrolled overeating episodes.

When anorexia is present in an individual who is not (yet) underweight, it is more challenging to diagnose atypical anorexia.

Symptoms Of Anorexia Nervosa

Physical symptoms

Medically, anorexia nervosa can show up as irregular heartbeats, low blood pressure, and dehydration. When your body doesn’t receive enough water and other fluids to function correctly, dehydration occurs.

Your fingers could look blue, and your skin might be dry. You can observe a shift in your skin’s colour, like yellowing. You may experience hair loss, thinning, or breakage. You can also have smooth, downy hair all over your body.

Other physical signs consist of:

• severe weight loss or inability to put on weight in line with age expectations.
• Being weak and exhausted.
• Fainting or dizziness.
• Experiencing stomach aches and difficulty passing stool.
• Not able to withstand the cold, or feeling cold when others feel fantastic.
• Swelling of the legs or arms.
• wearing down your teeth and developing calluses on your hands from throwing up.
• Stomach pains.
• Either never feeling hungry or feeling hungry but being satisfied right away after eating a little.
• Having trouble focusing or paying attention.
• Bad mood.
• A rise in anxiety.
• Decreasing bone mass or stress fractures.

Cognitive impairments

• A fixation with tracking food ingredients and counting calories
• Obsession with food, recipes, or cooking may prepare wonderful meals for guests. Still, they either don’t eat them themselves or only eat a tiny piece, which may be done to divert attention from the condition.
• Admiration for thinner people
• Feelings of being overweight or not thin enough
• A changed mental image of one’s body, Impaired theory of mind, made worse by depression, and a lower body mass index
• Loss of memory
• Challenges with problem-solving and intellectual thought
• Inflexible and rigid thinking
• Inadequate self-worth
• Perfectionism and overly critical thinking

Emotional symptoms

• Sadness
• Self-conscious about one’s body
• Disorders of anxiety
• Quick changes in mood
• Emotional dysfunction
• Alexithymia.

Behavioral symptoms

• An obsession with weight
• Regular physical examination
• Restrictions on the type and quantity of food (e.g., macronutrient categories)
• Food rituals include hiding or discarding food, refusing to eat in public, and chopping and measuring food into tiny pieces.
• Self-induced vomiting, laxatives, diet medications, emetics, diuretics, or exercise can all cause purging. Purging is done for a variety of reasons, including avoiding weight gain, feeling guilty or impure, and discomfort from the physical sensation of being full or bloated. Some patient actions just include restricting their food intake; purging is not always the case.
• Excessive physical activity or obsessive motions, such as pacing
• Self-destruction or self-loathing
• Social disengagement and isolation caused  by avoiding friends, relatives, and gatherings where food might be served
• Drinking too much water gives the idea that you’re full.
• Overindulgence in caffeine

Perceptual symptoms

• Anosognosia, or the lack of awareness or denial of the seriousness of a sickness, might keep some people from trying to get better.
• Believing oneself to be larger or fatter than one actually is is known as a body image disorder.
• A skewed and unconscious view of one’s body size and shape that affects how a person experiences their body when engaging in physical activity is known as an altered body schema. A patient suffering from anorexia nervosa, for instance, can actually worry that they won’t be able to fit through a small space. But because of their malnutrition, their body are much smaller than those of a person with a normal BMI, who would actually find it difficult to fit through the same space. The patient’s altered body schema causes them to see their body as larger than it actually is, while having a small frame.

Symptoms of anorexia nervosa can be physical, psychological, or behavioral. These may consist of:

Considerable weight reduction over a few weeks or months
below-average BMI (≤18.5) in relation to height

• Unexpected shifts in a child’s growth-related height and weight balance
• intense attention to food types and amounts, and/or calorie counting
• Regularly expressing negative opinions about one’s appearance and weight.
• Overuse of medications such as laxatives, appetite suppressants, and diuretics
• Extended, obsessive workouts, particularly after eating
• Frequently using the restroom immediately after eating.

Furthermore, in the later phases of anorexia, undernutrition could be an indication. Among them could be:

• Arrhythmias, or irregular heartbeats
• lightheadedness, fainting, or dizziness
• Physical weakness and fatigue
• Always feeling chilled
• Feeling agitated
• Losing hair
• Periods of irregularity or absence
• Your limbs’ swelling

Causes Of Anorexia

Anorexia nervosa has no single cause, but several biological, psychological, and social factors could be at play:

• Differences in the brain: Researchers have found that anorexics have altered brain structure and function. For example, they differ in the amounts of neurotransmitters like dopamine and serotonin, which can influence mood, hunger, impulse control, and the reward system in your brain.
• Family and heredity: If you have a first-degree relative who suffers from an eating problem, your chances of getting one yourself are significantly higher. You may have inherited some of these genes from your parents when you were born. A portion of it could also be found in the habits and ideals you pick up from your family as a child.
• peer pressure: Peer pressure, both social and professional, may be powerful forces, particularly if your body image affects your social or career position. It is the foundation of careers for actors, dancers, athletes, and models. Adolescents have a tendency to be quite critical of one another and themselves.
• Psychology: Low self-esteem or the idea that keeping a healthy weight is crucial to one’s worth might lead to an eating disorder. These emotions might occasionally be a result of past trauma or mood disorders like sadness and anxiety.

Complications of anorexia nervosa

Malnutrition and starvation may affect nearly every tissue and organ in your body. Severe organ damage may be irreversible even when anorexia is treated. Anorexia can have a very negative impact on your relationships as well as your mental and emotional health. Even after starting treatment, these side effects may not go away right away.

• Amenorrhea
• Delayed puberty
• Hypercarotenemia
• Hypothermia
• Hypoglycemia
• Osteoporosis
• Failure to thrive
• Cardiomyopathy
• Bradycardia
• Arrhythmias
• Renal failure
• Constipation
• Peripheral neuropathy
• Pancytopenia
• Infertility

Anorexia left untreated can result in:

• Degradation of dental enamel and loss of bone mass (osteoporosis)
• Skeletal muscle breakdown that happens quickly (rhabdomyolysis)
• Hepatic and renal impairment
• Heart arrest or failure of the heart
• delayed growth and puberty in children
• Infertility in grown-ups
• Suicidal thoughts, poor mental health, and self-harm

Anorexia Diagnosed

The Diagnostic and Statistical Manual of Mental Disorders’ criteria are used by medical professionals to diagnose anorexia nervosa (DSM-5). Among the three standards are:

• Self-induced calorie restriction causes growing youngsters to lose a substantial amount of weight or not gain any weight at all. a low body weight in relation to height, age, sex, and growth stage.
• Unusual obsession with body weight and extreme worry about gaining weight or becoming “fat.”
• A false sense of self or an incapacity to recognise the gravity of their condition.

A medical professional will perform a physical examination and obtain a thorough medical history, including your mental health history, if you exhibit signs and symptoms of anorexia. After that, they will interrogate you in-depth about your eating patterns, exercise regimen, use of weight-loss drugs, and associated attitudes and beliefs.

To assess the physical impacts of anorexia, your doctor may prescribe tests. Tests could consist of:

• Test for bone density
• total blood count
• EKG, or electrocardiogram
• Electrolyte panel
• Tests for kidney function
• Tests for liver function
• Blood testing for thyroid
• Urinalysis

Anorexia Management and Treatment

Anorexia nervosa treatment is individualized for each patient. Among the treatment’s objectives are:

• Regaining a healthy diet
• Maintaining weight reduction
• Getting rid of unhealthy eating habits
• Taking care of underlying psychological issues

The most difficult aspect of treating anorexia is helping them realize that they have a serious medical condition. Many anorexics refuse to acknowledge that they have an eating disorder and only seek treatment when their condition is life-threatening. Early diagnosis and therapy are crucial as a result.

Your doctor will create a personalized treatment plan that could consist of:

• Hospitalization,
• medication,
• psychotherapy,
• nutritional treatment

Treatment for severe malnutrition or other major health issues may need hospitalization. If you have serious mental health problems, you could also need to stay in the hospital. Sometimes these issues can be treated with medication. Psychotherapy is the long-term treatment for anorexia nervosa.

Therapy

The cognitive and behavioural processes linked to eating disorders can be altered by psychotherapy, sometimes known as talk therapy. It can help you develop more favourable views towards food, body image, and weight. It can also give you better coping mechanisms and techniques for controlling stress and negative thoughts.

Anorexia may worsen in certain individuals with co-occurring mental health issues. Together with anorexia, these disorders must be treated. Nevertheless, even in the absence of another disease, anorexia is a mental health issue in and of itself. Addressing the underlying cause of the disorder is necessary.

Psychotherapy such as:

• Acceptance and commitment therapy: This method focuses on developing the motivation to change your behaviour, regardless of your emotions or thoughts.
• Cognitive behavioral therapy (CBT): This method focuses on altering behavior as well as addressing false beliefs and attitudes about form, weight, and appearance.
• Cognitive remediation therapy: This method enhances your executive and mental functions, as well as your ability to manage your life, through targeted exercises and activities.
• Dialectical behavior therapy (DBT): Among the particular skills you’ll learn in DBT are developing mindfulness, strengthening relationships, managing emotions, and handling stress.
• Family therapy: The effectiveness of anorexia treatment depends on the support of family members. The Maudsley Method is a family-based treatment for anorexia that assigns your family to be in charge of your diet.
• Interpersonal psychotherapy (IPT): IPT focuses on improving your communication and relationships to reduce the symptoms of your eating disorder.
• Psychodynamic psychotherapy: This type of treatment involves looking at the root reasons of anorexia as the key to your recovery.

FAQs

References:

• Anorexia nervosa – Symptoms and causes. (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591
• Anorexia nervosa. (2025, August 27). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa
• Wikipedia contributors. (2026, January 19). Anorexia nervosa. Wikipedia. https://en.wikipedia.org/wiki/Anorexia_nervosa