Anorexia



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Editors
Madhusmita Misra, MD
Dorothy Shulman, MD
Amy Weiss, MD



Additional Resources
Mayo Clinic
MedlinePlus

What is anorexia?

Anorexia nervosa (often just called anorexia) is a condition in which a person loses an unhealthy amount of weight on purpose through dieting, sometimes along with excessive exercise, bingeing, and/or purging. People with anorexia have a fear of gaining weight and a disturbed body image (such as thinking they are fat even when they are very underweight). Doctors do not know the exact cause of this eating disorder.

What are the risk factors for anorexia?

People most at risk for anorexia include those who are young (teenage or young adult) and female. They may have a history of being depressed, anxious, or having obsessive-compulsive disorder. Those at risk may have family members with eating disorders, mental illness, or substance abuse. About 10–15% of people with anorexia or bulimia are male.

Some personal traits may contribute to anorexia. People at risk may feel that they must try to be perfect. They may have poor self-esteem and rigid ways of thinking about food and other issues in their lives. They may feel pressure to be thin. Taking part in certain sports or activities in which they are expected to be thin, such as gymnastics or ballet, could contribute to this feeling.

Definitions

Binge: To eat a lot of food all at once, with a feeling of lack of control over eating; a person may binge several times a day for weeks or months

Purge: To vomit one’s food on purpose, or use laxatives, diuretics (water pills), or enemas to lose weight

Bulimia nervosa: A condition in which a person both binges and purges but does not limit the number of calories they eat

What are the warning signs of anorexia?

  • Losing a lot of weight
  • Refusing to eat or eating very little
  • Undergoing a change in eating habits and/or being obsessed with food and counting calories
  • Exercising a lot or purging to lose weight

What are the symptoms of excessive calorie restriction?

  • Being tired, weak, and dizzy
  • Feeling cold all the time
  • Being constipated, bloated, or unable to eat a full meal
  • Amenorrhea or missed periods in women and girls
  • Hair loss, dry skin, and growth of very fine body hair

What health problems can anorexia cause?

Serious health problems that occur with anorexia include:

  • Heart problems, such as abnormal heart rhythms or heart failure
  • Dehydration and malnutrition, which can lead to fainting, seizures, or pancreatitis (inflammation of the pancreas)
  • Anemia
  • Tooth decay and/or gum infections

Serious health problems also can occur if a person who has been starving starts taking in too many calories too quickly (called refeeding syndrome). These problems can include heart failure, serious breathing problems, seizures, and even sudden death.

Some people can also have mental health problems, such as thinking about or attempting suicide.

How does anorexia affect hormone health?

Anorexia can lead to low bone density, meaning weak bones. When growing teenagers have weak bones, they may end up with weak bones for life, even if they recover from anorexia. Their risk for fractures (broken bones) may increase.

Other hormone problems include:

  • Delayed puberty and/or growth failure in preteens and teens
  • Amenorrhea (lack of menstrual periods)
  • Too little estrogen in women, causing vaginal dryness and reduced fertility

Where can I get help for my loved one or myself?

You can get help from a primary care doctor, a dietitian, a doctor who specializes in adolescent health, or a mental health professional with experience treating eating disorders. If you suspect a loved one has anorexia, get help for them as soon as possible.

What is the treatment for anorexia?

A team of medical providers is best for treatment. The person is treated as an outpatient, or sometimes if the weight loss is severe and has caused health problems, in residential programs or the hospital. The team should include a doctor to handle medical problems, a mental health professional for individual and/or family therapy, and a dietitian to manage nutritional issues.

The goals of treatment are to get the person back to a healthy weight and a healthy mental status. Sometimes a person also needs to take medicines, such as anti-depressants, or hormones, such as estrogen.

Treatment can help you or your loved one overcome anorexia and the problems that come with it. But some people find they need ongoing therapy to fight the urge to become anorexic later in life.

Questions to ask your doctor

  • Does my loved one have anorexia (or do I)?
  • What are the options for treatment?
  • What are the risks and benefits of each treatment option?
  • How long will my loved one (or I) need treatment?
  • How can I support my loved one during treatment?