All About Anorexia Nervosa: Symptoms, Causes, and Treatment

Anorexia nervosa is an eating disorder that usually involves an intense focus on body size and restricting food intake. It has an effect on a person’s overall well-being through control, shame, and self-esteem.

Anorexia causes behaviors like:

• dieting
• restricting food intake
• compulsive exercising
• purging

Anyone can experience anorexia. While women are more likely to get a diagnosis, some research suggests that eating disorder stigma could play a role in the low rate of anorexia diagnosis for men.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses the body mass index (BMI) as part of the guidelines for anorexia nervosa diagnosis.

While anorexia is often linked to low BMI, some people with anorexia may not fall under the category of low or even average weight according to the BMI calculations.

People with other anorexia symptoms but who aren’t seen as low weight could be living with atypical anorexia.

Research shows that people with atypical anorexia experience many of the same health effects as someone with anorexia at a lower weight.

This means that no matter your current weight, anorexia can impact your health in ways that require intensive care.

Types of anorexia nervosa

The DSM-5 lists two subtypes of anorexia nervosa:

• Restricting type. People with this subtype of anorexia may restrict food and follow a rigid exercise schedule.
• Binge-eating/purging type. People with this type of anorexia engage in cycles of binge eating and purging in addition to restricting foods.

A person living with anorexia may experience malnutrition (and its effects) if their body doesn’t get the nutrients it needs to work properly. This can cause conditions that require medical care.

If you want to learn more about anorexia, here’s our anorexia FAQ page.

Anorexia symptoms can vary a lot, and most people will not have all of the following symptoms.

Physical symptoms and signs of anorexia

• irregular periods or loss of period
• difficulty concentrating
• abdominal pain or constipation
• feeling cold
• fatigue or muscle weakness
• fainting or dizziness
• sleep problems
• dry skin or brittle nails
• thinning or dry and brittle hair
• soft downy hair on limbs
• cold, mottled, or swollen hands or feet

Emotional and behavioral symptoms and signs of anorexia

• constant thoughts about food, weight, or body image
• keeping a rigid exercise schedule
• restricting certain food groups
• feelings of depression, irritability, or anxiety
• feeling “out of control”
• feelings of isolation
• tendency to eat alone rather than with family or loved ones
• rituals or habits associated with mealtime
• worry or avoidance of eating in public
• cooking for others without eating

According to the DSM-5, the diagnostic criteria for anorexia nervosa include:

• restricting food in a way that causes weight loss and negatively affects health
• strong fear of weight gain (even when more weight loss would increase the risk of medical conditions)
• view of one’s body that’s different from how most others see it
• self-esteem or sense of self that’s tied to whether there are good or bad feelings about one’s body
• lack of recognition or denial of weight loss

Many people with an anorexia diagnosis also have one or more co-occurring mental health disorders. Research has found that people with anorexia nervosa may also have symptoms of:

• anxiety disorders
• major depression
• obsessive-compulsive disorder (OCD)
• substance use disorder

People with anorexia may also have higher chances of being on the autism spectrum.

Wondering if you might meet the criteria for an eating disorder diagnosis? You can take this quiz to find out. While it isn’t a replacement for an actual diagnosis or medical help, it could help you decide if reaching out for support is a good next step.

The cause of anorexia nervosa is a combination of biological and environmental factors, like:

• genetics
• brain chemistry
• family behaviors
• beliefs about your appearance

These factors can make a person more likely to develop anorexia. It’s not uncommon for someone with anorexia to have a personal or family history of anxiety, depression, or obsessive-compulsive disorder.

According to the National Eating Disorders Association, other possible contributing factors and causes of anorexia include:

Biological factors

• having a family member with an eating disorder
• having a family member with a mental health condition
• having a history of dieting
• living with type 1 diabetes, as research suggests higher rates of eating disorders among people with Type 1 diabetes

Psychological factors

• unhappiness with one’s body
• perfectionism
• having an anxiety disorder
• preference for order

Social factors

• having a history of being bullied
• holding stigmatizing ideas about weight
• isolation and loneliness
• history of family or generational trauma

Treatment of anorexia nervosa can be challenging. Sometimes a person with this eating disorder doesn’t recognize they have a condition that’s impacting their well-being.

Some of the first steps to anorexia treatment can include talking with an eating disorder specialist. After having a conversation with a healthcare professional, they can then suggest an anorexia treatment program or another approach that fits your needs.

This is usually how anorexia treatment is approached:

Therapy

Therapy is one common treatment for anorexia. It can take place in an inpatient (overnight) or outpatient (having appointments but staying at home) setting.

Cognitive behavioral therapy (CBT) is a popular type of therapy for anorexia. CBT focuses on finding and transforming unhelpful thinking patterns, beliefs, and attitudes that affect behaviors tied to anorexia.

Family therapy is another common therapy for anorexia. It’s a home-based approach that focuses on the person and their family members. It can help family members learn how to support their loved one in recovery.

Medication

There are no specific medications for anorexia. Your doctor may prescribe antidepressants if you also live with symptoms of depression or another medication to treat any medical complications.

Residential treatment

Residential treatment for anorexia could be a good option for people who don’t need intensive medical care but still need higher levels of support.

This treatment involves around-the-clock care and medical monitoring. It can include:

• group therapy
• family therapy
• one-on-one therapy
• nutritional counseling
• psychiatric counseling

Hospitalization

Hospitalization may be an option for people with anorexia who need medical and mental health care. If someone experiences the following, they may be hospitalized until their condition becomes more stable:

• unstable vital signs
• lab results that point to serious medical conditions
• suicidal ideation, an all-encompassing term for thoughts of suicide, suicide planning, and suicide attempts

Reaching out for support can be a form of self-love. Even if you’re working with a health professional, self-care can support the anorexia recovery process.

Some ways to care for yourself as you recover from anorexia nervosa include:

• Talking with people you trust. Connecting with a supportive loved one may help with feeling heard and encouraged.
• Reconsidering boundaries. Some find certain activities or relationships bring back bad memories of anorexia, making it harder to heal. Creating mindful boundaries around these things could help.
• Joining a support group. You can find many online support groups for anorexia. It can be therapeutic to hear others’ stories and share your own.

Many people recovering from anorexia say the support of family and friends played a key role in their getting well.

Here are some ways you can help your loved one with anorexia:

• Learn about anorexia. Read books and articles, watch videos, or listen to podcasts. Learning to tell fact from fiction can help you offer the best support.
• Before you approach them about their condition, prepare what you want to say. Some people find it helpful to write down notes.
• Pick a good time and place to talk. Make sure it’s in a private area and at a convenient time so you won’t feel rushed.
• Be patient and supportive. Fully listen to what they’re saying. Then you can explain why you’re concerned. Try to stick to the facts: “I noticed you haven’t been eating dinner with us lately.”
• Avoid topics that may create negative experiences for your loved one. Don’t make ultimatums, comment on weight and appearance, shame or blame, or offer simple solutions like “just start eating” because anorexia is a complex disorder that requires proper medical care.
• Help your loved one explore treatment options if they’re open to it. You can also offer to help them take the first steps, like setting up an appointment.

But when someone with anorexia does seek support — either on their own or with the help of a loved one — the right treatment can make a big difference.

Anorexia is an eating disorder that involves both the mind and body. For people with anorexia, treatment can have a huge impact on their physical and emotional well-being.

Many anorexia treatment options are available. Seeking out social support and learning more about anorexia can also help.

Living with anorexia can be an isolating experience, but you don’t have to manage it alone.