Anorexia: Signs, Symptoms, and Treatment

It’s only human to wish you looked different or could fix something about yourself. But when a preoccupation with being thin takes over your eating habits, thoughts, and life, it’s a sign of an eating disorder. When you have anorexia, the desire to lose weight becomes more important than anything else. You may even lose the ability to see yourself as you truly are.
Anorexia is a serious eating disorder. It can damage your health and even threaten your life. But you’re not alone. There’s help available when you’re ready to make a change. You deserve to be happy. Treatment will help you feel better and learn to value yourself.

Anorexia nervosa is a complex eating disorder with three key features:

• refusal to maintain a healthy body weight
• an intense fear of gaining weight
• a distorted body image

Because of your dread of becoming fat or disgust with how your body looks, eating and mealtimes may be very stressful. And yet, what you can and can’t eat is practically all you can think about.

Thoughts about dieting, food, and your body may take up most of your day—leaving little time for friends, family, and other activities you used to enjoy. Life becomes a relentless pursuit of thinness and going to extremes to lose weight.

But no matter how skinny you become, it’s never enough.

While people with anorexia often deny having a problem, the truth is that anorexia is a serious and potentially deadly eating disorder. Fortunately, recovery is possible. With proper treatment and support, you or someone you care about can break anorexia’s self-destructive pattern and regain health and self-confidence.

Types of anorexia nervosa

There are two types of anorexia. In the restricting type of anorexia, weight loss is achieved by restricting calories (following drastic diets, fasting, and exercising to excess). In the purging type of anorexia, weight loss is achieved by vomiting or using laxatives and diuretics.

What need does anorexia meet in your life?

It’s important to understand that anorexia meets a need in your life. For example, you may feel powerless in many parts of your life, but you can control what you eat. Saying “no” to food, getting the best of hunger, and controlling the number on the scale may make you feel strong and successful—at least for a short while. You may even come to enjoy your hunger pangs as reminders of a “special talent” that most people can’t achieve.
Anorexia may also be a way of distracting yourself from difficult emotions. When you spend most of your time thinking about food, dieting, and weight loss, you don’t have to face other problems in your life or deal with complicated emotions.
Unfortunately, any boost you get from starving yourself or shedding pounds is extremely short-lived. Dieting and weight loss can’t repair the negative self-image at the heart of anorexia. The only way to do that is to identify the emotional need that self-starvation fulfills and find other ways to meet it.

The difference between dieting and anorexia
Healthy Dieting	Anorexia
Healthy dieting is an attempt to control weight.	Anorexia is an attempt to control your life and emotions.
Your self-esteem is based on more than just weight and body image.	Your self-esteem is based entirely on how much you weigh and how thin you are.
You view weight loss as a way to improve your health and appearance.	You view weight loss as a way to achieve happiness.
Your goal is to lose weight in a healthy way.	Becoming thin is all that matters; health is not a concern.

Signs and symptoms of anorexia

Living with anorexia means you’re constantly hiding your habits. This makes it hard at first for friends and family to spot the warning signs. When confronted, you might try to explain away your disordered eating and wave away concerns. But as anorexia progresses, people close to you wont be able to deny their instincts that something is wrong—and neither should you.
As anorexia develops, you become increasingly preoccupied with the number on the scale, how you look in the mirror, and what you can and can’t eat.

Anorexic food behavior signs and symptoms

• Dieting despite being thin – Following a severely restricted diet. Eating only certain low-calorie foods. Banning “bad” foods such as carbohydrates and fats.
• Obsession with calories, fat grams, and nutrition – Reading food labels, measuring and weighing portions, keeping a food diary, reading diet books.
• Pretending to eat or lying about eating – Hiding, playing with, or throwing away food to avoid eating. Making excuses to get out of meals (“I had a huge lunch” or “My stomach isn’t feeling good.”).
• Preoccupation with food – Constantly thinking about food. Cooking for others, collecting recipes, reading food magazines, or making meal plans while eating very little.
• Strange or secretive food rituals – Refusing to eat around others or in public places. Eating in rigid, ritualistic ways (e.g. cutting food “just so”, chewing food and spitting it out, using a specific plate).

Purging signs and symptoms

• Using diet pills, laxatives, or diuretics – Abusing water pills, herbal appetite suppressants, prescription stimulants, ipecac syrup, and other drugs for weight loss.
• Throwing up after eating – Frequently disappearing after meals or going to the bathroom. May run the water to disguise sounds of vomiting or reappear smelling like mouthwash or mints.
• Compulsive exercising – Following a punishing exercise regimen aimed at burning calories. Exercising through injuries, illness, and bad weather. Working out extra hard after bingeing or eating something “bad.”

Anorexia nervosa causes and risk factors

There are no simple answers to the causes of anorexia and other eating disorders. Anorexia is a complex condition that arises from a combination of many social, emotional, and biological factors.  Although our culture’s idealization of thinness plays a powerful role, there are many other contributing factors, including your family environment, emotional difficulties, low self-esteem, and traumatic experiences you may have gone through in the past.

Psychological causes and risk factors for anorexia

People with anorexia are often perfectionists and overachievers. They’re the “good” daughters and sons who do what they’re told, excel in everything they do, and focus on pleasing others. But while they may appear to have it all together, inside they feel helpless, inadequate, and worthless. Through their harshly critical lens, if they’re not perfect, they’re a total failure.

Family and social pressures

In addition to the cultural pressure to be thin, there are other family and social pressures that can contribute to anorexia. This includes participation in an activity that demands slenderness, such as ballet, gymnastics, or modeling. It also includes having parents who are overly controlling, put a lot of emphasis on looks, diet themselves, or criticize their children’s bodies and appearance. Stressful life events—such as the onset of puberty, a breakup, or going away to school—can also trigger anorexia.

Biological causes of anorexia

Research suggests that a genetic predisposition to anorexia may run in families. If a girl has a sibling with anorexia, she is 10 to 20 times more likely than the general population to develop anorexia herself. Brain chemistry also plays a significant role. People with anorexia tend to have high levels of cortisol, the brain hormone most related to stress, and decreased levels of serotonin and norepinephrine, which are associated with feelings of well-being.

Steps to anorexia recovery

• Admit you have a problem. Up until now, you’ve been invested in the idea that life will be better—that you’ll finally feel good—if you lose more weight. The first step in anorexia recovery is admitting that your relentless pursuit of thinness is out of your control and acknowledging the physical and emotional damage that you’ve suffered because of it.
• Talk to someone. It can be hard to talk about what you’re going through, especially if you’ve kept your anorexia a secret for a long time. You may be ashamed, ambivalent, or afraid. But it’s important to understand that you’re not alone. Find a good listener—someone who will support you as you try to get better.
• Stay away from people, places, and activities that trigger your obsession with being thin. You may need to avoid looking at fashion or fitness magazines, spend less time with friends who constantly diet and talk about losing weight, and stay away from weight loss web sites and “pro-ana” sites that promote anorexia.
• Seek professional help. The advice and support of trained eating disorder professionals can help you regain your health, learn to eat normally again, and develop healthier attitudes about food and your body.

Anorexia treatment and therapy

Since anorexia involves both mind and body, a team approach to treatment is often best. Those who may be involved in anorexia treatment include medical doctors, psychologists, counselors, and dieticians. The participation and support of family members also makes a big difference in treatment success. Having a team around you that you can trust and rely on will make recovery easier.

Treating anorexia involves three steps:

• Getting back to a healthy weight
• Starting to eat more food
• Changing how you think about yourself and food

Medical treatment for anorexia

The first priority in anorexia treatment is addressing and stabilizing any serious health issues. Hospitalization may be necessary if you are dangerously malnourished or so distressed that you no longer want to live. You may also need to be hospitalized until you reach a less critical weight. Outpatient treatment is an option when you’re not in immediate medical danger.

Nutritional treatment for anorexia

A second component of anorexia treatment is nutritional counseling. A nutritionist or dietician will teach you about healthy eating and proper nutrition. The nutritionist will also help you develop and follow meal plans that include enough calories to reach or maintain a normal, healthy weight.

Counseling and therapy for anorexia

Counseling is crucial to anorexia treatment. Its goal is to identify the negative thoughts and feelings that fuel your eating disorder and replace them with healthier, less distorted beliefs. Another important goal of counseling is to teach you how to deal with difficult emotions, relationship problems, and stress in a productive, rather than a self-destructive, way.

Overcoming anorexia
It may seem like there’s no escape from your eating disorder, but recovery is within your reach. With treatment, support from others, and smart self-help strategies, you can overcome bulimia and gain true self-confidence.