Anorexia: What It Is, Warning Signs, and How to Get Help

Anorexia nervosa is a mental health condition that involves extreme restriction and fear around food which can make it life-threatening, if left untreated. Here's what you should know about what exactly anorexia is, signs and potential causes, as well as how to get support.

What Is Anorexia?

Anorexia nervosa is known as an eating disorder, but it's also important to point out that it is a serious mental health condition as well that involves more than just food or body image. It often causes people to intensely fear gaining weight and go to extreme lengths to restrict food intake.

Anorexia does not just affect young women nor should it be a label attributed to people who are severely underweight. The condition affects all genders, ages, body shapes, and backgrounds. If left untreated, it has one of the highest mortality rates of all mental health conditions, so prompt intervention is vital.

Treatment often involves a team of medical professionals including therapists and registered dietitians. In this article, we'll cover early signs of anorexia nervosa, possible causes, and how it is diagnosed and treated.

Common Warning Signs of Anorexia

Understanding the potential signs of anorexia in yourself or someone you love could lead to early intervention. Knowing what to look for can lead to a faster path to recovery. Be aware, though, just because someone exhibits the behaviors below does not mean they have an eating disorder.

At the end of the day it is up to a medical professional to diagnose anorexia, but a frequent combination of warning signs could indicate the need to open up a conversation about potential disordered eating or harmful eating patterns.

Changes in Eating Habits

If someone you eat with often starts exhibiting changes in eating behavior such as eating very small portions or cutting food into small pieces, they may be dealing with disordered eating. They may also skip meals frequently or too-often say they are not hungry when given opportunities to eat.

Also look for very strict rules around eating or eliminating entire food groups, such as carbohydrates. They may also be very motivated to cook for others, but will not eat the food themselves.

Physical Warning Signs

Adolescence is a particularly dangerous time for anorexia, since proper nutrition is essential during critical growth periods, which cannot be restored once lost. If an adolescent is failing to gain weight during these growth periods or if there is sudden, rapid weight loss seen in an adult, these are possible signs.

If someone feels constantly cold, even in warm environments, or has experienced sudden dizziness, fainting, or extreme fatigue, these are all signs that the body is not getting the calories it needs on a functional level. Women who miss several periods in a row may also be undernourishing.

People with thinning hair, noticeable hair loss, dry skin, or brittle nails may also be undernourishing as these are signs of protein deficiency. Furthermore, people with larger bodies can also suffer from anorexia, so just because someone isn't visibly underweight doesn't mean they couldn't be struggling with the disorder.

Emotional and Behavioral Changes

When searching for signs, sometimes listening can be just as useful as looking. If someone often mentions their weight, an extreme fear of gaining weight, the calories in food, or their body shape, including checking mirrors very often, these are things to take note of. Those with anorexia also see their body sizes as larger than they actually are.

Exercising excessively, even when tired, sore, or injured is another tricky one. Some with anorexia may use something like training for a marathon or other sport as a reason for very frequent exercise. They may also start withdrawing from social interactions, especially those that include food.

The malnutrition that comes along with anorexia can also affect brain chemistry and hormone levels which can lead to mood swings, depression, and irritability. These effects can be worsened if the person is isolating themselves socially.

What Causes Anorexia?

Despite the stigma, anorexia is neither a choice nor a phase and never any one person's "fault" that one develops the condition. Like all mental health disorders, anorexia doesn't have a single thing that can cause it, but often manifests due to a number of factors.

Biological and Genetic Factors

Those who have a family history of mental health conditions or eating disorders increases one's risk of developing anorexia. Some people who display perfectionism or experience anxiety may be genetically predisposed to these qualities, which also happen to be associated with anorexia.

Psychological Factors

People who do engage in perfectionism, have an intense need for control, or a history of trauma, anxiety, or depression do have a higher risk of developing anorexia. This also goes for those who have low self-esteem, a negative image of their bodies, or difficulty expressing and managing emotions, so they restrict food instead.

Social and Environmental Influences

The impact that outside influences can have on the development of an eating disorder cannot be understated. In today's age, exposure to unrealistic body standards on social media and general cultural pressure to achieve a certain body type can be harmful.

Comments or criticism from friends and family members about one's weight can have a negative impact. Parents should be aware of the way they refer to their children's weight or eating habits, even if criticism is coming from good intentions. Adhering to fad diets that require extreme food restriction or elimination of food groups could also lead to an eating disorder.

Also, participating in aesthetic sports or other activities like dancing, modeling, or gymnastics in which weight has an emphasis can also increase risk. Some going through very stressful events or transitions in life may develop the condition as a way to deal with the stress.

Health Risks of Untreated Anorexia

Knowing the potential risks of anorexia can help one understand why getting help early matters. If potential signs of anorexia are dismissed as a phase or cry for attention, the disorder may go untreated, resulting in serious health risks that come along with the malnutrition caused by anorexia.

Physical Health Complications

When the body doesn't get enough nutrients the heart, like any other muscle in the body, starts to weaken. So those with untreated anorexia could develop heart problems like irregular heartbeat and even heart failure.

Slowed metabolism, a weaker immune system, and digestive issues are also common. Bone loss is also a risk, especially during adolescence when milestones of bone growth must be met for optimal development.

Hormonal imbalances can also affect menstrual cycles and even fertility. In severe cases, extreme malnutrition from anorexia can lead to kidney and liver damage.

Mental and Emotional Impact

Without proper nutrition, people may have difficulty concentrating or making decisions due to shifts in brain chemistry. These shifts can also lead to increased risk of depression, anxiety, social isolation, or sudden struggles in romantic relationships.

There is also a higher risk of self-harm and suicidal thoughts in those with anorexia. As scary as this all sounds, these risks are reversible and treatable with the proper care team and nutritional rehabilitation.

How Anorexia Is Diagnosed and Treated

Though noticing signs can help someone get to a professional, it is ultimately up to a professional to diagnose whether or not someone has an eating disorder. This is achieved with medical evaluation, a nutritional review, and psychological assessment.

The Role of Registered Dietitians in Recovery

Dietitians create customized meal plans to help people regain healthy eating habits and rebuild a positive relationship with food without passing judgment. They also educate on nutritional needs, hunger cues, and the importance of food for nourishment of the body and proper growth. Many insurance plans cover the cost of a dietitian for those with eating disorders.

Registered dietitians are tasked to help someone who has experienced rapid weight loss to regain weight to a healthy level, but this happens gradually and in a way that's medically supervised. Since anorexia is a mental health condition, dietitians work collaboratively with physicians and mental health professionals for more comprehensive recovery.

Other Treatment Approaches

Cognitive-behavioral therapy with a mental health expert is considered the gold standard treatment for those with anorexia nervosa, but family-based therapy can also be effective. In some cases, medical monitoring from a physician is also necessary.

Medication to address the underlying obstacle of anxiety or depression may also be a part of the treatment plan. Depending on the severity of the disorder, inpatient or residential treatment with monitoring may be needed, especially for those in danger of heart problems.

Some individuals with eating disorders or even those who have recovered from one find it helpful to join support groups or seek the help of peers to manage their condition or ensure they avoid a relapse.

Supporting Someone With Anorexia

Those who have loved ones who struggle with a condition like anorexia often feel helpless, but their support can make a huge impact. Be compassionate and empathic if you need to talk to a person you think may have anorexia, as these are the things that could have potentially triggered it to begin with.

What to Say (and What Not to Say)

• Do: Be concerned about their health and wellbeing
• Don't: Make comments about their weight or appearance, positive or negative
• Do: Help them locate professional assistance
• Don't: Make them dread meal times by turning them into a power struggle
• Do: Be open-minded and non-judgmental when listening
• Don't: Oversimplify or trivialize recovery ("just eat")

Encouraging Professional Help

When seeking help for anorexia nervosa, your primary care physician or a registered dietitian is a good place to start. If helping a loved one, offering to help them find providers in the area, attend appointments with them, or even see if insurance can cover care would make a huge impact.

It's important to make sure they maintain their autonomy. You can't force someone to seek help, but you can help present them with options for it while staying supportive, not patronizing. It's important to remember that recovery from an eating disorder is far from a quick fix, with some taking months to years to fully recover, but it is possible with the right support.

Taking the First Step Toward Recovery

Asking for help with an eating disorder is a difficult thing to do, that's why it's a sign of strength rather than weakness or failure. No one chooses to develop a mental health condition any more than they do a chronic condition like heart disease, so seeking help is just like getting care for any other ailment.

Full recovery is possible with the right team of experts and other support systems, including friends and family who also play a big role. Registered dietitians who specialize in working with eating disorders are trained to provide evidence-based care with compassion.

You don't have to navigate the challenges of treatment, including finding the right kind, alone and there could be a chance the cost could be covered by insurance. See if your insurance covers a dietitian who specializes in eating disorder support.

Frequently Asked Questions

What are the early warning signs of anorexia that family members should look for?

Signs include lying about how much and when they've eaten, or how much they weigh, avoiding eating with others, cutting their food into small pieces or eating very slowly to disguise how little they're eating, and trying to hide how thin they are by wearing loose or baggy clothes.

What causes anorexia and why do some people develop it?

There's no single cause. Research points to a combination of biological and genetic factors, such as family history of mental health conditions and a genetic predisposition to perfectionism or anxiety, psychological factors like low self-esteem, trauma, or difficulty managing emotions, and social or environmental influences such as cultural pressure around body image, comments about weight from friends or family, and participation in aesthetic sports or activities.

How is anorexia different from other eating disorders?

Anorexia is self-starvation. Bulimia is a disorder in which a person eats large amounts of food ("bingeing") and then rids the body of that food before it can be absorbed ("purging"). A person who is bulimic purges either by vomiting or using laxatives or diuretics (water pills).

Can you fully recover from anorexia and what does recovery look like?

For many people, recovery from an eating disorder signifies an end to eating disorder thoughts, feelings and behaviours and improved physical and psychological wellbeing.

What are the most effective treatment options for anorexia?

Cognitive-behavioral therapy (CBT) remains one of the widely used behavioral therapies in the treatment of eating disorders, including AN.

How can I tell the difference between normal dieting and anorexia?

Healthy dieting is generally an attempt to control weight, while anorexia is an attempt to control one's life and emotions through food. With anorexia, self-worth becomes tied almost entirely to weight and body image, rather than being based on a broader sense of self.

What are the long-term health risks of untreated anorexia?

• Anemia
• Other heart conditions, such as mitral valve prolapse or heart failure
• Bone loss, also known as osteoporosis, which can raise the risk of fractures
• Loss of muscle
• Stomach problems, such as constipation, bloating or nausea
• Kidney problems

How do I find an anorexia specialist or eating disorder therapist near me?

Eating disorders like ARFID, anorexia, binge eating disorder, and bulimia may feel impossible to overcome, but the right kind of help can get you on the road to recovery.