Anorexia Definition And Treatment Options

Anorexia is characterized by an intense fear of gaining weight and a distorted body image, often leading to severe weight loss and life-threatening health issues. People with anorexia often have restrictive eating habits that result in a low body weight compared to what is considered healthy for their height and age. Symptoms of anorexia can overlap with those of bulimia nervosa, and understanding the risk factors can be important for early intervention and treatment.

Despite the complications it can produce, anorexia nervosa can be managed with the right approach. Familiarizing yourself with the signs and symptoms of this eating disorder can help you seek support if you recognize them in yourself or someone you love. Below, we’re going to cover anorexia—its symptoms, warning signs, effects, and treatment options. 

Anorexia: A definition

Anorexia nervosa is an eating disorder in which an individual restricts their caloric intake, exercises frequently, or purges to control their weight and appearance. There are two subtypes of anorexia: restricting type and binge-eating/purging type. Though both subtypes involve a focus on weight loss, the restrictive sub-type of anorexia is marked by fasting, skipping meals, or other methods of reducing caloric intake; while the binge-eating/purging subtype involves eating large amounts of food but then purging through laxatives, vomiting, or other means. 

Anorexia can significantly impact the life of an individual living with it, causing serious mental and physical health concerns, disruptions in everyday functioning, and relationship complications. Anorexia isn’t always something you can see on the surface, and there are common misconceptions about how an individual with the disorder may appear. Though being underweight is a common symptom, people of varying body types can live with anorexia. 

If you or someone you know is living with an eating disorder, consider reaching out to the ANAD Eating Disorders Helpline at 1 (888)-375-7767.

Diagnostic criteria for anorexia nervosa

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) provides guidance on how eating disorders may be diagnosed. The diagnosis of anorexia nervosa is summarized as follows:

• Limiting caloric intake beyond nutritional guidance, causing an individual to be underweight

• Fear of putting on weight or being overweight or taking consistent action to avoid weight gain 

• Being troubled by one’s weight or appearance, connecting self-worth to weight or appearance, or failing to recognize the seriousness of being underweight

Symptoms and characteristics of anorexia

Anorexia can have a wide range of physical, behavioral, cognitive, and emotional effects. The following are the symptoms of anorexia:

• Substantial weight loss over a period of weeks or months

• Fear of putting on weight

• Skewed body image 

• Self-criticism

• Obsession with caloric intake and dieting

• Irritability

• Aversion to specific types of food

• Need for control

• Suicidal ideation

If you or someone you love is experiencing suicidal thoughts, reach out for help immediately. The 988 Suicide & Crisis Lifeline is available 24/7 and can be reached by calling or texting 988 or chatting with a representative. 

For most people, food restriction is due to a fear of gaining weight. Often, people with anorexia have developed a distorted body image. This skewed self-perception can contribute to their desire to maintain a specific weight, shape, or size. And it is often related to mental health concerns related to self-esteem, which may go beyond feelings about their body. They may lack confidence in their abilities and display self-critical tendencies (there is a well-established link between perfectionism and anorexia). 

There are several misconceptions about anorexia, one of which is the commonly held belief that people with the disorder have a specific body type. Anorexia can affect people of all body types, including individuals with a body weight that is at or above average. Women and girls experience anorexia nervosa more frequently than men. Still, approximately 25% of individuals living with the disorder are male.  

Warning signs of anorexia

Knowing how anorexia can manifest may help you determine whether to seek care for yourself or someone you know. The following are common signs to look out for:

• Refusal to eat or making excuses not to eat

• Denying hunger and skipping meals

• Excusing oneself to go to the bathroom during or immediately after meals

• Limiting diet to only certain foods

• Practicing food or eating rituals

• Being overly concerned with body shape

• Dressing in layers to hide body shape and size

• Exercising frequently or excessively

Effects of anorexia

Because anorexia can impact an individual’s mental, emotional, and physical health, it may produce a wide range of complications. Some of the most notable of these challenges are the significant physical health concerns that can arise, which include the following:

• Loss of energy and fatigue (due to low calorie intake)

• Dizziness or fainting (due to dehydration and low blood sugar)

• Constipation (due to dehydration and irregular eating)

• Thin hair that breaks and falls out; brittle nails; dry skin

• Frequently cold and difficulty warming up

• Development of fine hair on the body, called lanugo

• Low blood pressure and irregular heart rhythms

• Abnormal blood counts and elevated liver enzymes

• Gastrointestinal distress (e.g., nausea, constipation, diarrhea)

• Loss of menstruation/period called amenorrhea 

• Bones that break easily (due to loss of bone calcium)

• Anemia (due to iron deficiency)

• Seizure (due to electrolyte imbalance and malnutrition)

Several different mental health concerns can arise alongside eating disorders like anorexia. Many people with anorexia live with comorbid conditions, including depression, anxiety, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, and autism spectrum disorder. Anorexia can also produce serious cognitive difficulties. Many people with anorexia report difficulty concentrating, which can affect their performance at work or school.

In addition to the physical and mental impacts of the disorder, anorexia can affect an individual’s relationships and social life. A person with anorexia may attempt to hide their behaviors from their partner, friends, or family members. They may also have trouble connecting with their loved ones due to an increasing obsession with their weight and diet. Sometimes, people with anorexia do not realize they’re living with disordered eating. Other people who restrict their caloric intake may become accustomed to this way of life, making it increasingly difficult to change their behaviors and arrive at a healthy weight. 

Treatment options

Treatment for anorexia typically consists of therapy, medication, or a combination of both. Therapists can help individuals with anorexia develop coping skills, find the sources of a distorted self-image, and address trauma that may contribute to their mental health challenges. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Cognitive behavioral therapy (CBT) is a modality that is considered particularly effective for eating disorders like anorexia. With CBT, the therapist helps to identify unhelpful thought patterns that may be underlying disordered eating and a distorted body image. For example, a therapist might help an individual recognize that they have irrational beliefs regarding a connection between their value to others and their weight. Addressing these cognitive distortions may help them develop healthy eating patterns and a positive sense of self-worth

When someone with anorexia still lives at home, the process may involve family therapy to ensure that everyone in the house knows how to support the client best. In the Maudsley method of family therapy, the parents take responsibility for ensuring their teen improves their eating habits.

Another common treatment option is medication. Research suggests that people with anorexia may have in the brain, which medication can address. Medication can also help alleviate symptoms of comorbid conditions like anxiety and depression. 

Nutritionists may also be employed to help the individual implement a nutritional plan that works for them. Then, the therapist and nutritionist may collaborate as part of an eating disorder care team to provide the best possible care. If you believe you’re living with an eating disorder or a similar mental health concern, consider consulting a medical or mental health professional.

How online therapy can help

Research shows that online therapy is an effective form of care for individuals living with an eating disorder. For example, in a study examining the effects of online cognitive behavioral therapy on anorexia, participants reported significant improvements in symptoms. Cognitive behavioral therapy is a widely utilized modality focused on helping individuals reframe negative thought patterns, such as those related to negative self-esteem or one’s appearance. 

If you're looking for useful mental health resources and valuable support as you address an eating disorder or similar concern, consider utilizing an online therapy platform like BetterHelp. With online therapy, you can talk with a licensed therapist remotely, which can be helpful if you’re not comfortable discussing topics like anorexia in person. BetterHelp works with a team of mental health professionals with diverse specialties and areas of expertise, so you’ll have a good chance of matching with someone who can help you develop a healthy relationship with food and a positive self-image.