What’s It Like to Live with Anorexia? What Anorexia Is and Isn’t

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), anorexia is classified as a mental health condition that creates a distorted body image and an intense fear of gaining weight.

The feelings that come with anorexia can be so strong they often lead to weight loss that can impact your health and well-being.

About 0.3% of teens from 13 to 18 years old experience anorexia. Other research states that 0.9–4% of women will experience anorexia at some point.

Meanwhile, about 10% of anorexia cases impact men. But due to stigma, men may be less likely to report an eating disorder such as anorexia.

Some symptoms and signs of anorexia include:

• restricted food intake that leads to weight loss or malnutrition
• intense fear of gaining weight or getting bigger
• a gap between how you experience your body and how others see it
• feeling like your body shape or weight determines whether you feel good or bad about yourself
• a lack of recognition that your eating habits or behaviors are negatively impacting your health and relationships

While the DSM-5 mentions body mass index (BMI) as a way to help diagnose anorexia, many people living with anorexia would not be considered underweight according to the BMI scale. This is called atypical anorexia.

Atypical anorexia usually impacts people with obesity or people considered overweight according to the BMI. If you have atypical anorexia, you may have lost a significant amount of weight in a short time but still be considered to have an average weight.

The myth that anorexia equals a small body can make it harder for people with atypical anorexia to get the care they need. One study found that people with a history of overweight or obesity were less likely to get inpatient care for anorexia than those who had started at a lower weight.

There are also two subtypes of anorexia. While they can appear separately, some people experience both at the same time or at different times:

• Restricting subtype. If you live with this type of anorexia, you may be focused on limiting food intake.
• Binge/purging subtype. If you live with this type of anorexia, you may find yourself in cycles of binge eating and then finding ways to eliminate that food intake.

Your body might be any size if you live with anorexia. The effects of anorexia — such as malnutrition and isolation — can harm your mental and physical well-being over time.

Living with anorexia can feel like being trapped — trapped by food restrictions, trapped by a need to be the “perfect” weight, and trapped by fear of judgment from family and friends.

Many people who live with anorexia have perfectionistic tendencies. They can be very critical of their bodies and may often experience low self-esteem.

One study also suggests that people with anorexia are likely to have low self-directedness, or capacity to adapt. For example, if you live with anorexia, you might have a harder time dealing with change than other people do.

Behavior patterns related to anorexia may also be a part of your daily life. These patterns can impact your emotional health and isolate you from people you care about.

For example, you might:

• Find that food-related habits make it harder for you to participate in celebrations or traditions that involve food.
• Feel a lot of stress or anxiety when someone invites you eat at a restaurant when you’re not familiar with the food options.
• Experience strong feelings of anger when a family member or someone else offers you food. It might feel like they’re trying to “sabotage” you.
• Have a rigid exercise schedule that gets in the way of other aspects of your life. And you might get strong feelings of anxiety or anger if something interrupts that schedule.
• Find that food or your body size is constantly on your mind, to the point that you feel like these things affect every part of your life.
• Avoid plans with friends when you think those plans might mess up your eating or exercise schedule.
• Experience deep shame or even self-hatred if you eat certain foods or feel like you haven’t lived up to your own standards.
• Feel like your whole day is ruined if your food or exercise plans get disrupted.

If you live with anorexia, you might have thoughts like “Eating this or that will make me gain weight” or “Because of the way I am, I can’t eat ‘normal’ foods like everyone else.”

One tricky thing about anorexia is that over time, it can really separate you from the feeling of living life fully. But if these experiences sound familiar, there is hope. Many people have used resources and support to heal from anorexia, and so can you.

Anorexia affects your body, mind, and emotions.

It can also influence many aspects of your life, from keeping you isolated from family and friends to holding you back from pursuing professional opportunities.

In your body, anorexia can cause:

• dizziness or a faint feeling
• a frequent cold feeling
• fatigue or trouble sleeping
• hair thinning or loss
• brittle hair and nails
• dry, blotchy, or yellow skin
• growth of fine hair all over your body
• low blood pressure
• weak muscles
• swollen joints
• irregular or missing periods
• constipation

Many physical effects of anorexia come from not getting enough nutrition and energy to keep your body working as it should. Over time, the malnutrition caused by restricting food often leads to these physical impacts.

Living with anorexia affects your mental health and emotions too.

Anorexia might make you feel:

• sad or depressed
• moody
• confused
• indecisive
• foggy
• irritable or angry
• numb
• anxious
• worthless
• inadequate
• guilty or ashamed
• misunderstood
• stifled
• out of control
• isolated

Emotional regulation (managing emotions) is a challenge for many people with anorexia. A lot of research suggests that anorexia and other eating disorders are maladaptive (unhelpful) ways for some people to deal with difficult emotions.

Anorexia doesn’t tend to go away on its own. And in the long term, it can cause complications like:

• organ failure
• poor brain function
• reduced bone density
• clinical depression
• difficulty getting pregnant
• substance use disorders

In severe cases, anorexia can even lead to death.

These effects are one reason why treatment — meaning, the right treatment for you — is so important. With the right support, you can gain a sense of empowerment and self-esteem that’s not tied to food or your body.

According to older research, more than half, or 55%, of those living with anorexia have a coexisting mental health condition.

Some common co-occurring conditions are:

• anxiety disorders
• depressive disorders
• obsessive-compulsive disorder (OCD)
• personality disorders
• substance use disorders
• schizophrenia

Anorexia could also be more common in people with developmental conditions like autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD).

In most cases, treatment that addresses anorexia and your other mental health needs and symptoms may work better for you.

If you have another condition alongside anorexia, you might experience the following.

Depression

Most research suggests that just over half of people living with anorexia also have a depressive disorder.

In many causes, depression is a result of living with anorexia. Feelings of emptiness and hopelessness that come with depression can make you feel more alone or make you even less likely to reach out for support.

Anxiety

Anxiety can cause chronic feelings of stress and worry. Around 60% of people with anorexia may also live with an anxiety disorder.

Some anxiety disorders linked to anorexia include:

• generalized anxiety disorder
• separation anxiety disorder
• OCD
• panic disorder

Some researchers suggest anorexia could even be a form of OCD, although it’s not currently categorized that way.

Substance use

Approximately 12–18% of adults with anorexia have a substance use disorder.

Substance use doesn’t always develop at the same time as anorexia. Many people live with substance use disorder before, during, or after discovering they have another mental health condition.

In some cases, people with anorexia use substances in an attempt to reduce appetite, lose weight, or purge. And in other cases, substance use may be another maladaptive way to manage overwhelming emotions.

Finding the path forward to positive body image and self-worth can take time and a different approach for each person.

What works for you may not work for other folks, and you might try multiple approaches before you find what feels right.

Finding support often means looking for health professionals such as:

• licensed counselors or psychologists
• registered dietitians
• nurses or doctors

It’s often important for your health professional to have experience working with people who have eating disorders.

Some popular options for anorexia treatment include:

• Medical treatment. If malnutrition due to anorexia has caused physical health issues, medical treatment could help with these effects.
• Medication. If you have symptoms of another mental health condition, medications such as antidepressants could aid in anorexia recovery.
• Nutritional counseling. A registered dietitian can help you learn and practice new patterns of eating that make your body stronger.
• Therapy. You might work with a therapist to process the mental and emotional impacts of anorexia.
• Inpatient care. If you need immediate help for anorexia, inpatient facilities can provide a higher level of care and support.
• Support programs. Residential programs provide round-the-clock support and resources to help you heal from anorexia. Day programs can be a good option if you don’t need as much intensive support.

When looking for the approach to care that’s right for you, it’s important to choose professionals who are knowledgeable and understanding. You can learn more about finding the right treatment for you here.

Let’s be clear: This isn’t a self-help guide to anorexia treatment. The most effective care for anorexia — care that leads to long-term healing — will likely involve some level of professional support.

But during your recovery process, it can help to build up your self-care toolkit too. This will be different for everyone but might look like:

Taking a closer look at your self-talk

If you have anorexia, your inner voice might feel more like an inner bully. Sometimes it can help to challenge your self-talk when it’s putting you down.

You can do this on your own or with the help of a therapist. Try taking a moment to reflect on or write down some things you like about yourself (beyond physical qualities).

Consider rethinking words that break down your self-image. Focus on empowering yourself with supportive, encouraging words.

Trying some new foods

If you work with a nutritionist or dietitian, they’ll likely have some good recommendations for you. One thing that could help smooth the recovery process is finding foods that bring you joy.

While eating provides our bodies with necessary nutrients, it can also bring us pleasure and connect us with others.

Moving, but gently

For many people with anorexia, exercise (especially intense exercise) could be a triggering activity. But there are many gentler ways to move your body if you want to.

Taking walks around your neighborhood or in a peaceful outdoor area, doing yoga, walking your dog, or even working on a hobby that requires some movement might be a way to benefit from movement without overdoing it, especially at first.

Getting back into exercise after an eating disorder can be a process, and consulting with your doctor and trusting yourself can be key parts of it.

Finding what makes you feel good

Some research suggests that sensitivity could factor into anorexia for some people. For people with high sensitivity and anorexia, the high sensitivity will likely remain even after the eating disorder heals.

You may be able to manage this by taking care of yourself in ways that keep you from becoming overstimulated. For instance, the feeling of clothes against the skin might cause distress for some people. It’s OK to find clothes that feel better on your skin.

Options like meditation and breathing techniques could also help you find calm if you’re starting to feel overstimulated.

Building your support network

It’s likely that someone around you wants to be there for you. This could mean a family member, a friend, or a support group that encourages discussion about life with anorexia. It could be helpful to find these people and keep them close.

Healing from anorexia can feel like a journey. At times, it might even be painful, difficult, and emotionally exhausting — but it doesn’t have to stay that way forever.

When you’re ready to move toward recovery, plenty of people and support networks are available to walk with you down that road.

If you’re concerned that you or a loved one may be experiencing anorexia, local healthcare and mental health professionals can explore this possibility with you.

You don’t have to feel like anorexia controls your life. With help, you can find empowerment and self-love.