Anorexia Nervosa
An eating disorder characterized by an intense fear of gaining weight, distorted body image, and severe restriction of food intake leading to significantly low body weight.
Prevalence: 0.3-1% of young women. Lifetime prevalence 0.9% females, 0.3% males (NIMH). 90-95% of cases are female.
Common Symptoms
- Extreme restriction of food intake
- Significantly low body weight (BMI < 18.5 or below expected)
- Intense fear of gaining weight or becoming fat
- Distorted body image (seeing self as overweight despite being underweight)
- Denial of seriousness of low body weight
- Self-worth heavily influenced by body shape/weight
- Excessive exercise despite fatigue or injury
- Preoccupation with food, calories, nutrition
- Ritualistic eating behaviors (cutting food into tiny pieces, eating very slowly)
- Social withdrawal, especially from meals
- Amenorrhea (loss of menstrual periods) in females
- Fatigue and weakness
- Dizziness or fainting
- Cold intolerance, feeling cold all the time
- Dry skin, brittle hair and nails
- Lanugo (fine body hair)
- Constipation and abdominal pain
- Low blood pressure and slow heart rate
- Difficulty concentrating
Risk Factors
- Female gender
- Adolescence
- Family history of eating disorders
- Perfectionism and high achievement orientation
- Anxiety disorders
- History of dieting
- Type 1 diabetes
- Childhood trauma or abuse
- Participation in appearance-focused activities
Treatment Approaches
- Family-Based Treatment (FBT) - gold standard for adolescents
- Enhanced Cognitive Behavioral Therapy (CBT-E)
- Dialectical Behavior Therapy (DBT)
- Acceptance and Commitment Therapy (ACT)
- Psychodynamic therapy
- Inpatient hospitalization if medically unstable
- Residential treatment programs
- Intensive outpatient programs (IOP)
- Medication: SSRIs (after weight restoration), olanzapine
- Treat comorbid conditions
- Group therapy
- Art or music therapy
Self-Help & Natural Approaches
- Family-Based Treatment (FBT) - most effective for adolescents
- Nutritional rehabilitation with dietitian
- Structured meal planning and support
- Gradual weight restoration
- Regular medical monitoring
- Challenge distorted thoughts about food and body
- Develop healthy coping mechanisms
- Address underlying emotional issues
- Build support network
- Mindful eating practices
- Reduce body checking behaviors
- Limit social media use
- Engage in non-appearance-focused activities
- Art or expressive therapy
- Yoga (non-weight-focused)
- Journaling
- Support groups
- Gradual resumption of social eating
- Learn hunger and fullness cues
- Challenge all-or-nothing thinking
When to Seek Professional Help
- Rapid weight loss (>10% body weight)
- BMI below 18.5 or significantly below expected
- Obsessive thoughts about food, weight, calories
- Avoiding meals or social eating
- Excessive exercise despite fatigue
- Physical symptoms (dizziness, fainting, irregular heartbeat)
- Purging behaviors
- Preoccupation with body image
- Social withdrawal
- Depression or suicidal thoughts
- Loss of menstrual periods
- Unable to stop restrictive behaviors
Crisis Resources
- National Eating Disorders Association (NEDA) Hotline: 1-800-931-2237
- NEDA Crisis Text Line: Text 'NEDA' to 741741
- 988 Suicide & Crisis Lifeline
- Emergency room if medically unstable (heart rate <40, blood pressure low, severe dehydration)
- NEDA website: nationaleatingdisorders.org
- Eating Disorder Hope: eatingdisorderhope.com
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.