Anorexia

Also known as anorexia nervosa

Anorexia is an eating disorder that most commonly affects young women, but also affects some men.

Key points about anorexia

  1. Anorexia is defined as being 15% or more below your ideal weight for your height.
  2. Anorexia is more common in girls and young women (about 0.5% to 3.7% of this age group), but boys and men can also be affected.
  3. People with anorexia have a fear of putting on weight or of getting fat, even if they are already slim or underweight.
  4. They will avoid eating or eat only small amounts of certain foods, even if this leads to becoming dangerously thin.
  5. Anorexia can lead to dangerously low body weight, which puts your body’s vital organs at risk.
  6. Ask for help as soon as you notice signs you or someone you care for may have anorexia. Early treatment leads to better outcomes.

How does anorexia develop?

Anorexia most commonly occurs during adolescence. People with anorexia often start with dieting, which develops into an obsession to control food intake. You develop obsessive eating habits such as avoiding eating, eating only small amounts of certain foods, or weighing and measuring your food extremely carefully, despite suffering hunger pangs.

Other habits to maintain low body weight may also include frequent, intense exercise, purging mechanisms such as forced vomiting, and abuse of laxatives, enemas and diuretics. 

What are the symptoms of anorexia?

Anorexia includes physical and emotional symptoms such as:

  • an intense fear of becoming fat or putting on weight, even if already underweight
  • distorted views of weight or shape image
  • denying the seriousness of extremely low body weight
  • resistance to maintaining a normal body weight
  • severe sensitivity to cold
  • growth of down-like body hair
  • delayed onset, infrequent or no menstrual periods in females who have reached puberty
  • irritability, inability to concentrate/think clearly
  • obstinate behaviour, unhappiness, depression.

What are the causes of anorexia?

Factors involved can include:

  • low self-esteem
  • poor body image
  • a reluctance to mature – physically, sexually and emotionally
  • a feeling of not being in control of your life
  • life crises, eg, changed relationships, death, childbirth.

What is the treatment for anorexia?

If you have anorexia, it's important to realise this is a serious problem. Because of the complexities of eating disorders, treatment should be started as early as possible for the best outcome and should involve comprehensive specialist care. 

Treatment for anorexia is usually tailored to your individual needs. This usually includes medical oversight (either by a GP or psychiatrist), who carry out regular medical assessments and psychological treatment. The medical professional and the psychologist keep in regular contact to ensure your welfare is being looked after as much as possible.

Psychological treatment can include looking at factors that contribute to the eating disorder (thoughts and behaviours) and learning ways to reduce or change these. If the person with anorexia is a child or young person, the best treatment seems to be family systems therapy.

If you have a dangerously low weight, you might need to restore your weight to a healthy level. Weight restoration could be required when it is clear that your health is in danger, eg, your potassium is so low that your heart is of risk of developing problems, or your psychological health is at risk, eg, if you get too low in weight your brain will literally eat itself to survive and your thinking will become very distorted.

You and your team work together to decide what "weight restoration" means in your case.

Selective serotonin re-uptake inhibitors (SSRIs) – a class of antidepressants – have been used to maintain weight gain, treat mood and anxiety symptoms associated with anorexia and prevent relapse. SSRIs are generally used only after you have recovered your weight loss.

Family, whānau and friends should try to encourage you to take personal responsibility in seeking help, and to learn to accept your strengths and limitations and your successes and failures as being a normal part of life.

It is important to remember the following:

  • Early recognition can help prevent more serious eating disorders developing.
  • While dietary monitoring and advice are important, effective treatment must address any underlying psychological issues.
  • The same approach will not work for all people with an eating disorder.
  • Don't give up if the first treatment approach does not work – most people with an eating disorder make a good recovery, even it takes a while.

Self-care with anorexia

Learning how to take good care of yourself and manage your emotions is key to recovering from an eating disorder. The following steps can help you on your road to recovery. 

  • Learn about eating disorders to help you make sense of how you feel.
  • Seek help early. The longer you leave it, the harder it is to get well.
  • Make a decision to recover – see your doctor and get the treatment you need.
  • Don’t be so hard on yourself – seek support and learn strategies to help you deal with difficult emotions and thoughts.
  • Learn about nutrition and develop a healthy relationship with food.
  • Learn ways to improve your body image – self-acceptance and kindness to yourself are important to help you recover.
  • Feeling good about yourself is key – make time for pleasurable activities and spend time with people who can boost your mood.

What is the outcome with anorexia?

The outcome for people with anorexia varies from recovery after a single episode, fluctuating weight gain and loss, or chronic illness that causes health deterioration over many years.

Sometimes the condition can cause death. The most common fatal complications of anorexia are imbalances in electrolytes (your body's essential fluids and salts), which can lead to cardiac arrest and suicide. Kidney, bladder, bowel and brain function can also deteriorate.

For these reasons, getting help early is really important. If you do, you have a good chance of getting better. 

Learn more

Seeking help Central Region Eating Disorder Services, NZ
Disordered eating Centre for Clinical Interventions, Australia
Just a Thought NZ
Treatments & drugs Mayo Clinic, US
Eating disorders explained Eating Disorders Association of NZ (EDANZ) 

Reviewed by 

Dr Courtney Cline is a registered clinical psychologist who specialises in eating disorders. She has worked for many years in the profession, beginning at Invercargill then Nelson adult mental health divisions in the hospitals. She now works part time in my private practice based in Nelson.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Courtney Cline, registered clinical psychologist, Nelson Last reviewed: 30 Apr 2020