Anorexia Nervosa.

Anorexia nervosa (AN), or anorexia, is a severe eating disorder marked by an overwhelming fear of gaining weight and a distorted body image. Individuals with anorexia may excessively limit their food intake or use other methods, like purging, to prevent weight gain. Despite its seriousness, anorexia remains misunderstood, with many misconceptions surrounding it. Recognizing and addressing this disorder early can be life-saving.

What is Anorexia Nervosa?

Anorexia Nervosa is an eating disorder characterized by severe weight loss, difficulty maintaining or gaining weight, and a distorted sense of self-worth and body image.
It’s essential to note that an individual doesn’t need to appear underweight to have anorexia.

The disorder encompasses physical, emotional, and behavioral symptoms. Thus, solely relying on physical appearance for diagnosis can be misleading and prevent some from receiving the help they need.


Anorexia often presents as rapid weight loss. It might manifest as stunted growth or an inability to gain weight in younger individuals. Common physical symptoms include:

  • Low body temperature
  • Dizziness and fainting
  • Low blood pressure
  • Slow or irregular heartbeat
  • Weakness and loss of muscle mass
  • Dry skin
  • Brittle nails
  • Thinning hair or hair loss
  • Swollen or discolored hands and feet
  • Infrequent or absent menstruation
  • Constipation
  • Difficulty sleeping

Behavioral signs include:

  • Food-related rituals, such as eating in secret or avoiding eating in public spaces
  • Intentionally vomiting after eating
  • A preoccupation with weight and appearance
  • Wearing loose clothing
  • Basing self-worth on weight and appearance
  • Frequently checking appearance in the mirror
  • Working out excessively, past the point of exhaustion
  • Limiting food intake
  • Avoiding entire food groups, like carbohydrates
  • Withdrawing from friends and social events
  • Misuse of diet pills, laxatives, diuretics, and appetite suppressants


The development of anorexia nervosa is complex and multifaceted, often stemming from a combination of various factors.

Biological Factors

  • Genetics: Some research suggests that a predisposition to anorexia might be inherited. Individuals with family members with an eating disorder are at a higher risk.
  • Brain Chemistry: Imbalances in neurotransmitters, which are chemicals in the brain that regulate hunger, appetite, and mood, might contribute to the development of anorexia.
  • Hormonal Changes: Fluctuations in hormones, especially during puberty, can influence mood and appetite, potentially triggering anorexia in vulnerable individuals.

Psychological Factors

  • Perfectionism: A tendency towards perfectionism and a fear of failure can make some individuals more susceptible.
  • Body Dissatisfaction: Chronic dissatisfaction with one’s body can lead to restrictive eating behaviors.
  • Traumatic Events: Experiences like abuse or assault can lead to attempts to regain control through restrictive eating.

Social Factors

  • Cultural Pressure: Societal ideals promoting thinness can contribute to body dissatisfaction and the development of eating disorders.
  • Peer Pressure: Comments or pressures from peers regarding weight can exacerbate feelings of body dissatisfaction.
  • Professional Pressure: Athletes, models, dancers, and actors might face professional pressures to maintain a certain weight or physique.


Healthcare professionals use the DSM-5 criteria to diagnose anorexia. Diagnosis involves assessing physical symptoms, understanding the patient’s relationship with food, and ruling out other potential causes.

The (summarized) criteria for anorexia are as follows:

  • Restriction of Calorie Intake: Consistent limitation of caloric intake leading to significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
  • Fear of Gaining Weight: Intense fear of gaining weight or becoming fat, even underweight.
  • Distorted Body Image: Disturbance in how one’s body weight or shape is experienced, undue influence of body weight or shape on self-worth, or persistent lack of recognition of the seriousness of the current low body weight.
  • Denial of Severity: Denial of the seriousness of the current low body weight.
  • Absence of Medical Reason: Weight loss and thinness that isn’t due to a medical condition.
  • Not Better Explained by Another Disorder: The symptoms aren’t better explained by another mental disorder or the absence of available food.


Effective treatment for anorexia requires a holistic approach tailored to each individual’s needs:

Nutritional Counseling

A nutritionist or dietitian can provide guidance on healthy eating patterns, helping the individual regain weight safely and maintain a balanced diet.


This is the main treatment for anorexia. Cognitive Behavioral Therapy (CBT) can help individuals identify negative thought patterns and develop healthier coping mechanisms. Other therapies, like Dialectical Behavior Therapy (DBT) and Family-Based Therapy, can be beneficial.


While no drug is FDA-approved to treat anorexia, some medications can help address symptoms or coexisting mental health conditions. Antidepressants, antipsychotics, or mood stabilizers might be prescribed.


In severe cases or when there’s a risk of serious health complications, hospitalization might be necessary. Some individuals benefit from inpatient care in a specialized eating disorder facility.

Support Groups

Joining a support group can provide individuals with a platform to share their experiences and coping techniques, offering mutual encouragement.

Prevention of Anorexia Nervosa

While it’s challenging to prevent anorexia nervosa due to its multifaceted origins, some strategies can reduce the risk and promote a healthy self-image and eating behaviors:

  • Promote Positive Self-Esteem: Encourage self-worth based on qualities other than physical appearance. Activities, hobbies, and skills can be avenues to foster self-confidence.
  • Open Communication: Create an environment where feelings, concerns, and pressures about weight and appearance can be discussed openly. This can help in early identification of unhealthy behaviors or thoughts.
  • Educate About Media Influence: Teach individuals, especially young ones, to critically evaluate media and advertisements. Understanding that images are often altered can reduce the pressure to conform to unrealistic standards.
  • School and Community Programs: Support or initiate programs in schools or communities that promote healthy body image and eating habits. Peer-led programs can be particularly effective.
  • Healthy Eating Habits: Encourage a balanced diet and regular meals. Discuss the dangers of dieting and the importance of a varied diet.
  • Professional Counseling: If there are early signs of an eating disorder or if someone is at risk, consider counseling. A mental health professional can provide coping strategies and early interventions.

Frequently Asked Questions (FAQs)

What is the leading cause of anorexia nervosa?
Anorexia nervosa doesn’t have a singular cause. Instead, it’s a culmination of various factors. Peer pressure, societal standards, and personal psychological struggles like low self-esteem play a role. Genetic factors, such as a family history of eating disorders, can also increase the risk of anorexia.
Who is anorexia commonly seen in?
Contrary to common stereotypes suggesting only young women are affected, anorexia nervosa impacts a diverse group. Individuals of all genders, ages, races, and socioeconomic backgrounds can experience this eating disorder.
When do most cases of anorexia nervosa begin?
While the National Institute of Mental Health (NIMH) data suggests a median onset age of 18 for anorexia, the reality is more complex. Many cases emerge during the teenage years, but signs can appear in children as young as five or six.

Related Conditions

  • Eating Disorders
  • Bulimia Nervosa
  • Binge Eating Disorders (BED)

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