Many people participate in weight-limiting or eating-restrictive behaviors in some manner, whether it's through dieting, careful meal prep or exercise. But at what point do these behaviors become disordered and cross over into anorexia nervosa or other eating disorders?
Anorexia nervosa and other eating disorders have less to do with the what—dieting, exercise, controlled eating—and more to do with the why: people with anorexia partake in extreme body-related behaviors because of their distorted and obsessional relationship with body-image.
Here we'll discuss the causes, symptoms and treatment options for anorexia nervosa, and hopefully remind the reader that this disorder is never their fault and that the hope of recovery is always available.
Anorexia nervosa is the deadliest eating disorder and among the most common, along with bulimia nervosa and binge eating disorder. And it's a mental health disorder that severely impacts someone's body image. As such, people with anorexia nervosa will engage in obsessional weight-restrictive behaviors out of an intense fear of gaining weight.
People with anorexia nervosa will experience one or more of the following:
If you've noticed these warning signs in yourself or others, it might be anorexia nervosa.
According to the Diagnostic Statistical Manual-5, the authoritative guide for the diagnosis of mental health disorders, the following criteria must be met to diagnose anorexia nervosa:
Symptoms of anorexia nervosa may mimic other health issues, so receiving an evaluation from a licensed professional is extremely important for an accurate diagnosis. And even if the criteria for anorexia nervosa are unmet, the assessment may indicate other eating disorders or disordered eating habits that will interfere with quality of life and deserve medical attention.
Anorexia nervosa affects people of all ages, races, ethnic backgrounds and socioeconomic levels, but it usually appears in someone's teen or early adult years. This may be a partial result of puberty and its ongoing effects on a young person's body, as well as the social pressures within young peer groups to have a certain body weight and shape.
According to the National Institute of Mental Health (NIMH), the lifetime rate of diagnosis among females was estimated to be three times higher than males, with 0.9 percent of females reporting anorexia compared with 0.3 percent of males.
It's important to note: the statistics may underrepresent anorexia's prevalence because many study respondents downplay the severity of their symptoms or are reluctant to admit to them, especially males. In fact, experts believe that anorexia is increasing among males, and going undiagnosed at greater rates when compared with females.
According to the NIMH, the exact cause of anorexia and other eating disorders is not fully understood, but research suggests a combination of factors, including:
Other behavioral and situational risk factors that heighten the likelihood of anorexia nervosa include being an overachiever or perfectionist, or dealing with a transitional period like divorce, moving, changing jobs or schools, etc.
The emotional, behavioral and physical symptoms of anorexia are listed below.
Emotional symptoms of anorexia include:
Behavioral symptoms of anorexia include:
Physical symptoms of anorexia include:
Unfortunately, many people with anorexia initially dismiss concerns if they don't fit the stereotypical body type associated with very severe anorexia. But many individuals who don't appear to struggle with anorexia—with a BMI that approaches the "normal" range—still meet the diagnostic criteria and would benefit from treatment.
Although there are a few similarities between anorexia and bulimia—the restricting and purging behaviors to manage body weight and shape—there are important differences that affect a person's diagnosis. Whereas people with anorexia engage mostly in food and calorie restriction, people with bulimia will often binge, consuming large amounts of food and calories in a short period of time before engaging in purging and weight-restricting behaviors. Many of the emotional symptoms are the same for both eating disorders, but some additional symptoms of bulimia nervosa include:
Anorexia is a very serious mental illness, and people with anorexia often experience co-occurring mental health diagnoses like:
When compared with their peers, adolescents and young adults diagnosed with anorexia nervosa also have a ten times greater risk of dying, and anorexia has the highest mortality rate of any mental disorder. Additionally, people with anorexia may suffer from or even die from the resulting medical conditions and complications associated with starvation. It's essential that people with anorexia receive proper and timely medical attention for higher chances of recovery and improved health outcomes.
For people diagnosed with anorexia nervosa, their ongoing relationship with food is unavoidable. Even in recovery, people with anorexia are forced to confront their disorder and body image at least several times a day during meal times. This complicating trademark of eating disorders underscores the urgent need for professional help because a person with anorexia needs to fundamentally change the way they approach food and body image.
The first step is to consult a licensed eating disorder specialist to receive an assessment for diagnosis and treatment recommendations. From there, treatment, therapy and nutritional guidance will help a person correct their eating habits, form a healthier relationship with body image and enter into sustained recovery.
Like other mental health disorders, the effectiveness of anorexia treatment is greatly improved by early diagnosis and administration. A few factors will complicate treatment's efficacy, including:
Restoring healthy weight is an important part of treatment, but psychotherapy is necessary to help individuals address their distorted thoughts and beliefs about body size, self-worth, etc. A number of evidence-based treatments like cognitive-behavioral therapy and interpersonal therapy, along with other emerging medicines, show promising results and can help a person find their rightful path back to happiness and health.
If you have noticed unhealthy eating behaviors or suspect a potential eating disorder, please consult a professional to get expert advice and proper treatment. Disorders of all varieties are commonplace. Don't feel shame—whether it's anorexia or another eating disorder—and don't let it affect your livelihood, self-esteem or happiness. Help is always available.