Anorexia nervosa

What is anorexia?

Anorexia nervosa, or anorexia, is a serious eating disorder where you deliberately lose weight by severely limiting how much food you eat or exercising too much, or both. If your weight drops too low, it can starve your body, making you very ill.

What causes anorexia nervosa?

Anorexia is caused by having a distorted image of your body and thinking that you look overweight when you’re actually underweight. People with anorexia often change their eating habits to help them feel more in control when other areas of their lives seem overwhelming.

Anorexia can be linked to:

• A family history of eating disorders or depression

• Criticism of your weight, body shape or eating habits

• Feeling pressure from friends or social media to be a certain weight or because of your job (e.g. models, dancers, athletes or jockeys)

• Feelings of anxiety, inadequacy, low self-esteem or loneliness

• Sexual abuse

Who is at risk of getting anorexia?

Anorexia is most common in women, although cases of male anorexia are on the rise. It can develop at any age, but it usually begins in your teens.

Anorexia symptoms and warning signs

There are often warning signs of anorexia before the eating disorder itself develops. These may include:

• An obsession with dieting, food, calories and weight

• Constantly complaining about being fat

• Cutting out entire food groups

• Pretending not to be hungry or lying about how much you’ve eaten

• Exercising too much

• Losing interest in your friends or hobbies

• Avoiding eating in public

The main symptom of anorexia is deliberately not eating enough food to lose weight. This leads to a low body mass index (BMI) in adults or a lower body weight than average for your age in children and teenagers.
Many of the warning signs above continue when anorexia develops.

Other symptoms may include:

• Weighing at least 15% below the expected weight for your age, gender and height

• Taking medication to try to control your weight, like appetite suppressants to stop you from feeling hungry, laxatives to make you poo or diuretics to make you pee

• Feeling dizzy or lightheaded

• Hair loss

• Dry skin

• Tiredness

• Periods stopping (or not starting at all in younger girls)

• Being sensitive to the cold

• Sleeping problems

Health risks and complications

Being underweight is not good for the body – it can cause many health risks and, in extreme cases, it can lead to death. Health problems that are linked to anorexia include:

• Infertility

• Osteoporosis (‘thinning’ of the bones)

• Bowel problems

• Teeth problems

• Anaemia

• Mental health problems

• Infections

When to get help for anorexia

As anorexia is strongly linked to distorted body image, it can be hard to recognise when you have the eating disorder yourself. Often, it’s difficult to accept how much weight you’ve lost or to admit that you need help.

If you’re worried that you, or someone you know, might have anorexia, it’s important to talk to a doctor as soon as you can for the best chance of recovery.

Having the support of a friend or family member can be helpful. They can help you recognise your symptoms are real, and make sure you get the support you need.

Anorexia diagnosis

It can be a big step to talk to a doctor if you think you have an eating disorder, but remember that they are there to listen and help, and you won’t be judged or blamed. Again, taking a friend or relative along can help you feel more confident.

They will start by asking you about how you’re feeling, your eating habits and any symptoms. They’ll look at your overall health and check your weight, and they may take blood tests to rule out any other possible causes of weight loss.

If the doctor thinks you have anorexia, they’ll refer you to a specialist team who’ll create an individual treatment plan for you.

Anorexia treatment

Your treatment plan will depend on whether you’re an adult or under the age of 18. It usually includes a combination of talking therapy to help you understand why you have a problem with eating, and diet advice to encourage you to gain weight.

If you’re under 18, talking therapy often involves your family, although you may also have one-to-one support. Sessions can help you understand your eating disorder and find ways to manage your feelings. Types of therapy include:

• Family therapy sessions

• Adolescent-focused psychotherapy

Talking therapy for adults involves working with a therapist to understand what’s causing your anorexia and learning techniques to understand nutrition and make healthy food choices. Types of therapy include:

• Cognitive behavioural therapy (CBT)

• Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)

• Specialist supportive clinical management (SSCM)

Other types of support include:

• Diet advice – to get a better understanding of nutrition and a healthy diet

• Medication – drugs aren’t usually used to treat anorexia, but sometimes antidepressants may be offered to help manage conditions like depression or anxiety

Anorexia recovery

Anorexia is a serious condition that some people continue to live with, although a small number will die. But, with the right support and treatment, many people recover well from anorexia. The sooner you seek specialist support, the better your chances of making a full recovery.