The Facts About Anorexia

Anorexia nervosa (AN) is an eating disorder characterized by a significantly low body weight, an intense fear of putting on additional weight and a distorted perception of one's own weight. The condition is more commonly known simply as anorexia.

One of the diagnostic criteria for anorexia nervosa is that an individual's food restriction has led to weight loss or a failure to gain weight that results in a significantly low body weight—a body mass index (BMI) of less than 17. It is also important to note that anorexia can affect individuals of any weight, though this may be classified as atypical anorexia (AAN).

Anorexia can affect virtually every aspect of life, from your ability to maintain meaningful romantic and intimate relationships to fertility and your ability to maintain good heart health.

Anorexia is an eating disorder, but it is often less about food and more about a deep desire for control. It is also an unhealthy and dangerous way to cope with emotional issues. The condition often manifests as food restriction and going to extreme measures to prevent weight gain or to lose weight, according to Mayo Clinic. Additionally, individuals with anorexia often view achieving thinness as a way to gain higher self-worth.

Left untreated, this dangerous condition can lead to serious health problems and life-threatening complications.

People who have anorexia are known to go to extreme measures to lose weight or prevent gaining it. Most notably, they severely restrict the types and amounts of food they eat and/or meticulously count the calories in anything they consume. In some cases, individuals may misuse laxatives, diet pills, enemas and diuretics, or cause themselves to vomit as other ways to control their calorie intake.

People with anorexia may exercise excessively in an effort to lose weight, though no matter how much weight they lose or maintain, the fear of putting on any additional weight remains constant.

The physical symptoms of anorexia include:

• Abdominal pain or digestive issues
• Abnormal blood counts
• Dehydration
• Dizziness
• Extreme weight loss or significantly low body weight
• Fainting
• Fatigue
• Lack of menstruation
• Irregular heart rhythm
• Poor blood circulation
• Swelling of the limbs
• Thinning or brittle hair, loss of hair
• Tooth decay
• Trouble sleeping
• Yellow-tinted skin

Other emotional and behavioral signs and symptoms of anorexia include:

• Avoiding social situations where food may be present
• Weighing and measuring your body excessively
• Checking your body frequently in the mirror or on camera
• Hiding your body in large clothing or multiple layers
• Feeling irritable
• Commenting about poor body image
• Obsessing over food, even when not eating it
• Experiencing a reduction in libido
• Practicing social/emotional withdrawal
• Sticking to only a few "safe" low-calorie foods

Recent surveys have found that more than 20 million women and 10 million men in the United States will have an eating disorder at some time in their life.

Experts are still unsure exactly what triggers anorexia or other eating disorders. They are widely believed to result from a combination of complex psychological, biological or genetic, and cultural causes. Research indicates that individuals with a history of anxiety, obsessive-compulsive disorder (OCD) or perfectionism are at greater risk for developing the disorder.

Anorexia can affect anyone, as eating disorders can occur in people of all races, religions, ages, genders, sexualities, shapes and sizes.

Anorexia is a serious illness that carries with it both short- and long-term risks.

If you think you may be struggling with anorexia, don't hesitate to reach out for professional medical help. Getting treatment as early as possible is critical to avoiding related health complications.

Anorexia can pose the following immediate risks:

• Dehydration
• Fatigue/exhaustion
• Hair loss
• Gastrointestinal problems
• Unsafe weight loss

Anorexia can also pose long-term risks such as:

• Anemia
• Infertility
• Osteoporosis
• Seizures
• Death

Anorexia is diagnosed through a series of tests and medical evaluations and is defined by the current criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as published by the American Psychiatric Association.

If you're evaluated for anorexia, your doctor will likely perform a series of examinations.

A physical exam

Your doctor will measure your height and weight and check your vital signs. During this exam, your doctor will also check for any other potential signs of anorexia, such as problems with your skin, body temperature, teeth and abdomen.

A psychological evaluation

This evaluation will be performed by a mental health professional to assess your mental and emotional state as well as your attitude toward your body, weight, food and eating habits.

Lab work

Blood and urine tests will be performed to check your blood count, electrolyte levels and protein, and to ensure that your liver, kidneys and thyroid are all functioning correctly.

Other exams as necessary

Depending on the severity of the case, a doctor may perform bone studies, lung tests or an electrocardiogram to check heart health.

Treating anorexia typically requires a team of medical professionals that includes doctors, dietitians and mental health professionals. In instances when an individual's life is in immediate danger, hospitalization is necessary to stabilize them before long-term treatment can begin.

Recovery journeys may look different from person to person. Generally, recovery can include a combination of medical help, psychotherapy, nutritional education and emotional support in the form of leaning on loved ones, becoming a member of a support group or joining a 12-step program.

If you're unsure of where to start, the National Eating Disorders Association has a list of resources. However, if you believe your life might be in immediate danger, seek emergency services for help.

The first step toward managing anorexia is to seek treatment. Getting treatment as soon as possible is essential to prevent serious health complications. Treatment will consist of a few important phases, such as medical and psychiatric stabilization, as well as any necessary weight restoration.

It is possible to achieve lasting recovery from anorexia, though it may not always be easy. Be sure to lean on medical and mental health professionals as well as your personal emotional support system throughout your recovery. Some experts recommend positive self-talk and affirmations as powerful tools that can help as you work to overcome your disorder.

Aside from anorexia, bulimia nervosa and binge eating disorder are the most common eating disorders in the U.S.

Similar to those who have anorexia, individuals with bulimia nervosa may force themselves to vomit, misuse laxatives and diuretics, and exercise excessively. The main difference between the disorders is that people with anorexia severely restrict their food intake, whereas those with bulimia nervosa typically eat to excess (binge) and then purge. Those with bulimia may appear to have normal or even higher than normal body weight.

Binge eating disorder is different than both anorexia and bulimia. Sufferers of binge eating disorder overeat rapidly, even when they aren't hungry or are already feeling extremely full. Binge eaters don't purge or overcompensate for binges through exercise or other measures; rather, they often experience feelings of shame, disgust, regret and guilt about binging. According to experts, binge eating disorder is often an unhealthy coping mechanism people develop to deal with anxiety, depression, fear, anger and loneliness.

When people think of anorexia, they probably recall shocking images of underweight young girls they've seen in the media. Actually, all different kinds of people, with different shapes and sizes, struggle with anorexia. And while low weight and severe health concerns often occur in conjunction with anorexia, the disorder can also affect many other areas of a person's life—including their sex life.

Experts have found that prolonged periods of low weight can cause sex hormone levels—testosterone in men and estrogen in women—to plummet, effectively reducing sex drive and overall sexual responsiveness.

The psychological effects of anorexia can be just as debilitating. When anorexia causes someone to have low self-esteem and body dysmorphia, they are less inclined to pursue sexual activity, which isn't surprising. Treating the root cause of the eating disorder can go a long way to repairing eating disorder-related intimacy problems.

Fortunately, organizations such as Uniting Couples in the Treatment of Eating Disorders (UNITE) are available for the very purpose of helping couples in a relationship affected by one or both partners having an eating disorder.

What are the main symptoms of anorexia?

The main symptoms of anorexia are intense fear of weight gain, low body weight and a distorted perception of one's own weight. This often entails extreme food restriction, calorie counting, excessive exercise, forced vomiting, and misuse of laxatives, diet pills, enemas and diuretics. 

Can anorexia cause diabetes?

Although some eating disorders can increase the risk for type 2 diabetes, anorexia is not one of them. Still, experts have found that people with type 1 diabetes are twice as likely to develop an eating disorder than people without it.

Why is anorexia so difficult to treat? 

Anorexia can be difficult to treat because an individual with anorexia may not recognize and/or admit they have anorexia and need treatment for it. Some may mistakenly feel they have the disorder under control without fully understanding that dire health complications can develop suddenly as a result of anorexia.

If you think you may have anorexia or know someone who has, contact your healthcare provider immediately.