Anorexia Nervosa
(Anorexia nervosa)
Information for Everyone
Anorexia nervosa is an eating disorder characterized by severe weight loss, an intense fear of gaining weight, and a distorted or obsessive perception of one’s weight or body shape.
It is not simply a “diet” or “ordinary undereating” and can be life-threatening.
1) Common Signs and Symptoms
Not all symptoms may be present in every individual, but the following patterns are common:
Behavioral Symptoms
- Severe restriction of food intake (undereating, eliminating several food groups)
- Avoidance of “high-calorie” foods
- Obsessive monitoring of weight, calorie counting, or wearing concealing clothing
- Excessive exercise or restlessness when not eating
- Episodes of binge eating and purging may sometimes occur (although different forms and patterns exist), such as the misuse of laxatives
Cognitive/Emotional Symptoms
- An intense fear of gaining weight, even when underweight
- A sense of self-worth that is dependent on being thin
- Denial of, or minimizing, the severity of weight loss
- Irritability, anxiety, depression, and obsessive thoughts
Physical Symptoms
(more common in advanced stages)
- Weakness, dizziness, and feeling unusually cold
- Hair loss and dry skin
- Sleep disturbances
- Absent or irregular menstrual periods
- Constipation
- Low blood pressure and a slow heart rate
- Possible anemia and electrolyte abnormalities
2) Why Does It Happen?
Anorexia nervosa usually develops through a combination of the following factors:
Biological
- Genetic predisposition and neurological/hormonal vulnerabilities
Psychological
- Perfectionism, anxiety, fragile self-esteem, and difficulty regulating emotions
Social/Cultural
- Pressure to be thin, discrimination, appearance-based judgment, and the influence of media
Life Experiences
- Major stressors, family or academic changes, and psychological trauma
3) How Is It Different from “Dieting” or “Losing Weight”?
Dieting is usually goal-oriented, generally reversible, and involves flexible control.
In anorexia nervosa, however, there is usually:
- An extremely intense fear of food and weight gain
- Eating control that becomes compulsive
- A persistent feeling of being “not thin enough” even when the person is underweight
- Functional impairment affecting school, work, family life, or health
4) Medical Risks
This disorder can lead to serious complications, including:
- Heart problems, particularly due to electrolyte abnormalities
- Kidney and liver damage, and anemia
- Osteoporosis and decreased bone density
- Infertility and hormonal disturbances
- Risk of organ failure in severe cases
Therefore, medical treatment and monitoring are important.
5) Who Is More at Risk?
Overall, anorexia nervosa can occur at any age, but:
- It is more common during adolescence and young adulthood
- It also occurs in men, although it may be underdiagnosed
- The likelihood may be higher in people with underlying anxiety or depression
6) How Is It Treated?
Treatment is usually comprehensive and is best provided by a specialized multidisciplinary team.
A) Medical Assessment
- Checking vital signs and conducting laboratory tests (electrolytes, thyroid function, CBC, etc.)
- Preventing cardiac complications and complications related to malnutrition
B) Psychotherapy
- Family-based treatment (particularly for adolescents)
- Cognitive behavioral therapy for eating disorders
- Support in developing skills for managing anxiety and emotions
C) Nutrition and Nutritional Rehabilitation
- Planning a gradual and safe increase in calorie intake
- Correcting problematic eating patterns and addressing fear of food
D) Medication
Medication is not routinely a substitute for nutritional rehabilitation and psychotherapy.
However, medication may be prescribed for anxiety, depression, obsessive-compulsive symptoms, or other associated symptoms, under a physician’s supervision.
Important:
Weight restoration in anorexia nervosa should be carried out carefully and under professional supervision because rapid nutritional rehabilitation can lead to a dangerous complication known as refeeding syndrome.
7) If You Are Concerned About Someone, What Can You Do?
Helpful Actions
- Express your concern respectfully:
“I’m worried about your health.”
- Encourage the person to see a physician or psychiatrist
- Provide practical support:
- Accompanying them to appointments
- Helping them find appropriate treatment
- Focus on their mental well-being and overall health, rather than weight alone
Unhelpful Actions
- Arguing about calories or weight
- Humiliating the person or making them feel ashamed
- Giving simplistic advice such as, “Just stop it and use your willpower.”
- Strictly controlling their food intake without professional treatment
8) Warning Signs That Require Immediate Action (Emergency)
If a person has any of the following symptoms, they should seek immediate medical or emergency care:
- Fainting, severe dizziness, or extreme weakness
- A very slow or irregular heartbeat, shortness of breath, or chest pain
- Repeated vomiting or inability to eat or drink
- Confusion or severe drowsiness
- Rapid weight loss or obvious signs of severe malnutrition
- Suicidal thoughts or thoughts of self-harm
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