Anorexia Nervosa

Anorexia nervosa is an eating disorder characterized by physical, emotional, and psychological symptoms. This complex mental disorder can involve a range of symptoms regarding eating habits, weight loss, body weight, and more. 

The signs and symptoms can vary among individuals, but some commonalities can be categorized as follows. 

Food and weight symptoms

Below are some symptoms of anorexia related to food and weight: 

• Intense fear of gaining weight, which does not diminish as weight loss occurs
• Distorted body image, such as seeing oneself as overweight despite being underweight
• Severe restriction of food intake, leading to lower body weight
• Obsession with dieting, food, calories, and weight
• Making excuses to avoid meals or situations involving food
• Binge eating after extended peoples of avoiding or restricting food intake

Physical symptoms

Despite appearing at a seemingly normal weight, the complications of anorexia often lead to life-threatening health implications. Due to the restrictive eating and other behaviors associated with anorexia, the following physical symptoms may occur: 

• Significant or rapid weight loss
• Sudden change in body weight and shape
• For women, loss of menstrual periods (amenorrhea)
• Fatigue and weakness
• Insomnia or disturbed sleep patterns
• Dizziness or fainting
• Intolerance to cold
• Dry skin, brittle hair, or hair loss
• Dental problems like enamel erosion or cavities due to induced vomiting (specifically for those with the purging subtype)
• Blood pressure fluctuations and abnormalities in blood counts

Emotional and psychological symptoms

Below are some of the psychological symptoms of anorexia: 

• Preoccupation with body shape and weight
• Negative or distorted self-image
• Fear of weight gain
• Denial of low body weight
• Mood swings, irritability, or depression
• Withdrawal from social activities, especially those involving food
• Feeling a lack of control overeating habits

These symptoms can indicate a serious health issue, and anyone exhibiting these signs may benefit from seeking support from a healthcare professional. While some symptoms are related to food and weight, physical and psychological symptoms can profoundly affect an individual’s overall health and well-being. This list is not exhaustive, and each person with anorexia may experience a unique combination of symptoms.

Anorexia nervosa is influenced by various risk factors that can affect individuals of any age or gender. It can develop from a complex mixture of factors, including genetic, biological, behavioral, psychological, and social. Here’s an outline of the causes that often play a role in developing this condition. 

Genetic factors

Some evidence suggests that anorexia can run in families. If a person has a sibling or parent with anorexia, they may be at a higher risk of developing the disorder themselves. 

Biological factors

Certain biochemical imbalances in the brain, especially alterations in neurotransmitters like serotonin and dopamine, could potentially contribute to the development of anorexia.

Behavioral factors

Patterns of perfectionism, rigid thinking, or obsessive-compulsive thoughts or behaviors might increase an individual’s risk of developing anorexia. These tendencies can contribute to the dietary control and harsh self-criticism often seen in individuals with this disorder.

Psychological factors

Low self-esteem and a strong desire for control can also predispose a person to developing anorexia. Negative body image and dissatisfaction with one’s appearance often precede the development of eating disorders.

Social factors

Cultural pressures emphasizing thinness or idealizing specific body types can contribute to the development of this disorder. Pressure from peers or media can impact a person’s self-image and potentially lead to disordered eating behaviors. 

Additionally, certain sports and activities that focus on body shape and size (such as ballet, gymnastics, modeling, or weightlifting) can also increase the risk of developing anorexia. These environments often emphasize weight and appearance; the pressure to maintain a particular body type can contribute to the onset of the disorder. 

These factors do not cause anorexia by themselves but can contribute to its development when combined. Note that not everyone exposed to these risk factors will develop anorexia, as individual factors also play a significant role in mental health and overall well-being.

Common treatments for anorexia involve a combination of nutritional, medical, and psychological therapies to restore the individual to a healthy weight, correct nutritional deficiencies, and address psychological issues that may be contributing to the disorder. Often, the goal of treatment is to assist the individual with anorexia in developing a healthier relationship with food and cultivating a better self-image, leading to long-term recovery and improved health overall.

Medication

There are currently no medications specifically approved to treat anorexia. However, medication may be part of an individual’s treatment plan to address co-existing conditions that are often associated with disorders like anxiety or depression. Additionally, olanzapine is an atypical antipsychotic medication that is suggested to help restore a healthy weight in some patients with anorexia nervosa, when used in combination with psychotherapy and nutritional rehabilitation. 

Medication may be beneficial in a treatment plan when combined with other approaches, like therapy or nutritional counseling. Note that the decision to use medication as a treatment can be made with a healthcare provider who is familiar with the individual’s specific symptoms, health, and medical history. Do not start, change, or stop a medication without consulting your doctor.

Other treatment options

Treatment for anorexia can require a comprehensive and multi-faceted approach beyond therapy, medication, and self-care. Nutritional counseling can help individuals better understand their dietary needs and develop healthier food habits. 

In some cases, hospitalization may be necessary to address immediate malnutrition-related health risks. Residential or inpatient treatment can also provide structured, intensive support. Finally, support groups can offer a sense of community and understanding, enabling individuals to learn from the experiences of others. As with all treatments, these options may be best pursued under the guidance of a healthcare professional.

Self-care

Self-care can be an essential and sometimes overlooked aspect of treatment and recovery from anorexia nervosa. Utilizing practices encouraging physical, emotional, and mental well-being can contribute majorly to the healing process. For example, establishing regular sleep patterns, low-impact physical activity (as approved by a healthcare professional), or adopting mindfulness practices to help manage stress can be valuable. 

Self-care strategies are often personalized and emphasize activities that the individual finds enjoyable and empowering. However, while self-care is valuable, it may be most effective as part of a comprehensive treatment plan overseen by healthcare professionals.

Therapy can play a significant role in treating anorexia and may address the psychological and behavioral aspects of the disorder. Therapists can help individuals understand the root causes of their fears around weight and food while also developing helpful coping strategies and challenging unhealthy thought patterns. Cognitive-behavioral therapy (CBT) can be particularly effective because it focuses on identifying and changing problematic thoughts and behaviors.

Traditional face-to-face therapy is standard in anorexia treatment, but online therapy services like BetterHelp can be a helpful and convenient option, allowing individuals to connect with licensed therapists who specialize in eating disorders.

Other resources may include the following: 

• National Eating Disorders Association: NEDA is the largest non-profit organization dedicated to supporting individuals and families affected by eating disorders, including anorexia nervosa.
• The Eating Disorders Hope Recovery Helpline: This hotline offers support, referrals, and information for individuals with anorexia and their loved ones. 
• National Institute of Mental Health (NIMH): NIMH provides comprehensive information about eating disorders, including clinical trials and resources for getting help.

For those with thoughts of suicide, contact 988 Suicide & Crisis Lifeline at 988. Please also see our Get Help Now page for more immediate resources.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

Research indicates that systemic family therapy and family-based therapy (FBT), also known as the Maudsley Model, are effective treatment methods for anorexia. These approaches use family dynamics and strengths to address eating and weight-related issues. FBT is typically divided into three stages: weight restoration led by parents, transitioning control over food to the individual, and managing other development issues. Though FBT and similar family-centered treatments have been widely implemented and effective in the past, an optimal approach integrates family involvement with their cost and commitment in mind.

A study published in the MDPI’s Nutrients journal shows ketamine might hold promise as a potential treatment for anorexia nervosa due to its impact on neurotransmitters, particularly serotonin and dopamine. Research indicates that ketamine can positively influence these neurotransmitter systems. 

Ketamine’s antidepressant effects, shown to be partly due to its impact on serotonin, could potentially improve mood and coexisting depression in individuals with anorexia. Its ability to modulate brain circuits related to reward and motivation might impact the often-altered dopamine system in anorexia. The initial research on ketamine as a treatment for anorexia has shown reductions in depression scores, suicidality, and eating disorder psychopathology. However, more extensive controlled trials are needed to further establish its efficacy and safety. Talk to a doctor before considering ketamine treatments, as these are not yet regulated or approved by the FDA.

50% of people with eating disorders seek treatment

Yale School of Medicine found that 50% of those with eating disorders like anorexia nervosa and bulimia nervosa sought treatment for their condition. Individuals with anorexia amount to 34.5% of those who sought therapeutic support.¹

¹Yale School of Medicine

Below are some more of the key statistics on anorexia:

• The National Institute of Mental Health says, “The lifetime prevalence of anorexia nervosa in adults is 0.6%. Lifetime prevalence of anorexia nervosa was three times higher among women (0.9%) than men (0.3%).”
• The Bulimia Project cites, “Young females are at the highest risk, and anorexia often begins in adolescence. The vast majority (95%) of people with an eating disorder are between the ages of 12 and 25.”
• According to the UK’s Beat Eating Disorders Association, “Research suggests that around 46% of anorexia patients fully recover.”