What are the Signs and Symptoms of Anorexia?
Early signs and symptoms of anorexia (anorexia nervosa) can be very difficult to distinguish from the spectrum of normal eating behavior. These indicators may also be concealed by the woman, attributed to other health conditions or dismissed as side effects of prescription drugs.
However, eating disorder treatment professionals can distinguish symptoms of anorexia from other medical conditions by identifying physical signs such as:
- extreme weight loss
- thin appearance
- abnormal blood counts
- elevated liver enzymes
- fatigue
- dizziness or fainting
- seizure
- brittle nails
- hair that thins, breaks or falls out
- absence of menstruation (amenorrhea)
- constipation
- dry skin
- intolerance of cold
- irregular heart rhythms
- low blood pressure
- dehydration
- osteoporosis, the loss of bone calcium, which may result in broken bones
What Are the Warning Signs of Anorexia Nervosa?
Most early signs of anorexia are related to preoccupation with food. An affected person's behavior patterns may appear obsessive or compulsive to loved ones, and begin to consume more of her time. Eventually, they will become more noticeable to others and potentially disrupt her schooling, career, and relationships with family and friends.
If you're concerned that you or someone you love may have an eating disorder, watch for these early indicators of anorexia, which may be present with or without a co-occurring disorder:
- refusal to eat
- denial of hunger
- difficulty concentrating
- obsession with body size and shape
- skipping meals
- making excuses for not eating
- eating only a few certain foods considered safe, usually those low in fat and calories
- adopting meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing
- weighing food
- cooking elaborate meals for others but refusing to eat
In girls or women with a preoccupation with food, several other behaviors should also be recognized as clear warning signs of anorexia nervosa:
- excessive exercise
- flat mood, or lack of emotion
- repeated weighing of themselves
- frequent checking in the mirror for perceived flaws
- wearing baggy or layered clothing
- complaining about being fat
What is Anorexia?
Anorexia nervosa is an eating disorder in which a woman or girl is obsessed with her weight, body shape and food intake. Anorexia frequently develops over a period of years in women with certain genetic, emotional or life-experience predispositions.
Anorexia nervosa symptoms appear in two inter-related patterns:
- Conscious refusal to maintain a body weight that's healthy for a woman's age and height
- Obsession with the perception that she is overweight, even when severely underweight
To prevent weight gain or to continue losing weight, a woman or girl with anorexia nervosa will severely restrict her food intake or exercise excessively, and resist efforts to change her behavior. Some women with anorexia also engage in purging after eating regular meals or in binge eating followed by purging. Without proper treatment, anorexia can reduce a woman to a point where she is skeletally thin but still perceives that she's overweight.
Anorexia nervosa causes are much more than serious an unhealthy view of food or an obsession with body image. Although anorexia is most distinguished by disordered eating behaviors and rituals, the disease process involves much more than food. Anorexia symptoms are ultimately attempts to cope with seemingly unmanageable emotions by achieving perfectionism and control. A woman with anorexia nervosa often equates her self-worth with her ability to reach a goal of thinness or maintain control over her body and appetites.
What Causes Anorexia?
Much work remains to be done to understand the causes of anorexia nervosa. As with other addictions and eating disorders, anorexia involves complicated interaction among biological, psychological and social factors.
Anorexia treatment professionals have more recently acknowledged that genetics play a part in the development of anorexia. A young woman with a biological sibling or parent with an eating disorder is at higher risk, suggesting a possible genetic link. However, it's not clear specifically how genetics may interact with other contributing factors. It may be that some people have a genetic tendency toward perfectionism, sensitivity and rigidity, all traits associated with anorexia nervosa.
Psychological and emotional characteristics may also leave some people more susceptible to seeking emotional relief through control of food intake. Common examples are:
- Low self-esteem, which may stem from unresolved experiences of neglect or abuse during childhood
- Obsessive or compulsive personality traits, which make it easier to adhere to strict diets and resist hunger
- Perfectionism, when focused on the body leads to thought distortions such as "I'm never thin enough."
- Low levels of serotonin, one of the brain chemicals involved in depression
Cultural influences can also contribute to the development of anorexia nervosa. Our society sends a constant stream of messages reinforcing thinness as an ideal, especially for women. Television, magazines, and billboards are filled with images of unrealistically thin models and actors. Success and worth are often equated with being thin. Peer pressure may fuel the desire to be thin, particularly among young girls, who over time view anorexic symptoms as normal, even positive.
What Other Signs or Symptoms Should I Look For?
Anorexia nervosa is a complicated disease that affects each woman differently. There are several patterns of signs and symptoms that commonly go along with anorexia:
- Co-occurring alcoholism: adolescent women with anorexia show a dramatically greater incidence of alcoholism than the rest of their peer group. This can occur when efforts to numb feelings of inadequacy by restricting food intake fail to bring the control and emotional relief a woman with anorexia seeks. College-aged women in particular are much more likely to show symptoms of co-occurring addiction to alcohol along with anorexia nervosa.
- Stimulants: loved ones should be alert to the possibility a woman may be using or abusing stimulants, such as medication for ADHD, which often have appetite suppressing side effects. Because of the ready availability of these drugs in schools and on college campuses, adolescents are particularly susceptible to the temptation to use them to suppress appetite.
- Co-occurring disorders: anorexia nervosa often co-exists with other psychiatric conditions, like depression, anxiety disorders, or obsessive compulsive disorder. These are called co-occurring disorders, that are difficult for many treatment providers to diagnose accurately and treat effectively. Obsessive compulsive personality disorder is another condition that commonly co-exists with anorexia nervosa. Women with unaddressed co-occurring disorders will face a vastly more difficult treatment path and complex challenges in recovery.
Anorexia nervosa is a very serious eating disorder, particularly if it is accompanied by co-occurring psychiatric and addictive disorders. Like other eating disorders, anorexia is a medical disease that can result in irreversible health complications, including death. Learn more about anorexia treatment for women and girls (ages 12 and up) at Timberline Knolls Residential Treatment Center.
