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What is Anorexia?

Anorexia nervosa [an-uh-REK-see-uh ner-VOH-suh] is often called anorexia. It is an eating disorder. It involves self-starvation (not eating on purpose) which leads to severe weight loss. It causes a person to have a low weight that is unhealthy for their age and height. It can lead to serious health problems and death.

If you have anorexia, you might feel that you are fat when you your weight is normal. You might also fear gaining any weight. There are several different kinds of anorexia:

  • Restricting. You may eat so little food that you become dangerously thin. This type is called “restricting” because you restrict, or limit, calories by following drastic diets, fasting, or exercising too much.
  • Binge-eating and purging. A binge is when you eat a large amount of food, usually in a short time. Afterward, you purge the food from your body. You might do this by making yourself throw up or using laxatives.

Anorexia can have severe physical health risks. These can include:

  • Slow heart rate and muscle loss, which lead to fainting, low energy, weakness, and possible heart failure
  • Weakening bones, which leads to bone breaks
  • Dehydration and loss of nutrients, which lead to irregular heartbeat, heart or kidney failure, and sometimes death

Other risks are emotional. They include having a hard time with daily life. School, work, and normal tasks can become overwhelming, and people with anorexia can be depressed and have anxiety or other mental health issues.

Anyone can have anorexia, but it is more common in females than males. It most often begins during the pre-teen through young adult years. With the right approach, anorexia can be treated. Treatment will include working with your doctor to keep track of your health.

Symptoms

The signs of anorexia include:

  • Low body weight
  • Limiting what you eat
  • A need to be thin
  • A deep fear of gaining weight or becoming fat
  • Denial of how serious your low weight is
  • Body dysmorphia [dis-MOR-fee-uh] (thinking you look a certain way when you don’t)

In females, the menstrual cycle can be affected, resulting in:

  • Irregular periods
  • No periods
  • Periods that don’t start by age 15

Over time, you may develop other physical signs, including:

  • Bone loss
  • Brittle hair and nails
  • Dry, blotchy, or yellowish skin
  • Fine hair all over your body (lanugo)
  • Dry mouth
  • Tooth decay
  • Weakness from muscle loss
  • Swelling in joints
  • Exhaustion
  • Dizziness
  • Constipation
  • Anemia
  • Poor memory
  • Low blood pressure
  • Low body temperature
  • Infertility
  • Seizures
  • Heart damage
  • Brain damage
  • Multi-organ failure

You may experience other conditions, such as:

  • Mood disorders
  • Depression
  • Anxiety
  • Obsessive compulsive disorder
  • Substance abuse
  • Suicidal thoughts

With anorexia, you may also change the way you behave. You may start:

  • Talking a lot about your weight
  • Weighing yourself multiple times a day
  • Not eating around others
  • Cutting food into small pieces
  • Moving food around on your plate instead of eating
  • Going to the bathroom right after eating
  • Exercising all the time
  • Pulling away from friends and family
  • Using diet pills to keep from being hungry
  • Taking laxatives, enemas, water pills, or diuretics

When to See a Doctor

Talk to your doctor if you or a loved one is showing some or all of these signs:

  • Strong focus on their weight
  • Restricting what food they eat
  • Exercising too much
  • Very low weight

Causes

The causes of anorexia are not clear. It may stem from many factors, such as:

  • A drive for perfection. This drive can be fueled by media that show unrealistic thinness. Family and friends who value “fitting in” with a certain body size, shape, or weight might play a role.
  • Some sports. For example, your sport might emphasize how you look (like gymnastics or figure skating) or where a lower weight gives you an advantage (like long distance running or wrestling).
  • Emotional and personality disorders. Depression, anxiety, traumatic life events, and a desire for control may lead to an eating disorder.
  • Feeding problems. Having problems with eating during infancy or early childhood may increase your risk of anorexia.

The cause of anorexia is unique for each person; experiences, genetics, environment, and other personal factors can all cause it.

Diagnosis and Tests

Your doctor will check your symptoms. They will decide if your symptoms fit with those of anorexia. The diagnosis process may include:

  • Talking. The doctor will ask about what you eat and how much. They’ll also want to know if you fast, if you force yourself to vomit, how you see yourself, how much you exercise, and what your family background is.
  • Family conversations. The doctor may also talk to family members to learn more about your behaviors, their behaviors, and your family history.
  • Medical history. The doctor will learn about your past health, diseases, and treatments.
  • Exam. The doctor will do a physical exam to check on your current health.
  • Tests. The doctor may also test your blood and urine. The test results will give them an idea of how well your body is working.

If your weight loss is severe, your doctor may order more tests to find out how much damage your weight loss has caused. These tests might include:

  • Bone density test
  • Electrocardiogram [ih-LEK-trow-KAR-dee-oh-GRAM].
  • Kidney function tests
  • Liver function tests
  • Thyroid function tests

Your doctor might order these tests regularly to keep track of the progress of your treatment.

Treatments

With proper treatment, you can beat anorexia. The keys to recovery are:

  • Committing to getting better
  • Taking the time you need to get healthy 

Your treatment plan will be fit to you and might also focus on other eating problems you have, such as binge-eating. Binge-eating disorder is a separate problem, but it often shows up at the same time as other eating disorders like anorexia and bulimia.

Treatment by a medical care team improves the chances of recovery. Your care team will work to treat your physical, nutritional, and emotional health. You will be part of your care team. Your family might be part of it too. Other members might include your doctor, a therapist, a dietician, and a care manager.

Your doctor will keep track of your overall health. They will treat your medical problems and prescribe needed medicine. No medicine can cure anorexia, but health problems caused by anorexia might be treated with medicine. Emotional issues related to anorexia may also be eased with medicine.

Your therapist or psychologist [sahy-KOL-uh-jist] will counsel you on your emotional issues. They can also talk with you about life events, current stress, and past trauma. All of these factors can affect your eating and feelings about food. They can also treat related problems, such as depression or obsessive compulsive disorder.

Supportive family members can also provide support and join you at appointments when needed.

You will play the most important role in treatment. The more you participate in your treatment, the better your outcome will be. You will need to learn about your problem and the benefits of overcoming it. You will also need to work with your care team to follow your treatment plan. Treatment can be hard. After you return to a healthy weight, you may need long-term help to stay there.

Prevention

Measures to prevent anorexia are not certain. Your doctor may be able to spot early signs of the eating disorder by asking about your eating and your body image. Starting treatment early can prevent many of the health problems that it can cause.

Anorexia is an eating disorder. It involves starving yourself and having very low weight. You may limit calories by following drastic diets, fasting, or exercising too much. It can lead to serious health problems such as heart or kidney failure. Anorexia can affect anyone. With the right treatment, it can be overcome.