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डायबिटीज करें कंट्रोल - मात्र 299 रु में X
एनोरेक्सिया हेल्थ सेंटर
एनोरेक्सिया - Anorexia Nervosa in Hindi
Dr. anurag shahi (aiims) mbbs,md june 28, 2017, august 17, 2023.
एनोरेक्सिया क्या है? एनोरेक्सिया नर्वोसा जिसे अक्सर एरोरेक्सिया भी कहा जाता है, एक खाने का विकार है जिसमें असामान्य रूप से शरीर का कम वज़न, वज़न बढ़ाने का अत्यधिक डर और शरीर के वज़न के प्रति गलत अवधारणाएं होती हैं। एनोरेक्सिया से ग्रस्त लोग अपने वज़न और आकार को नियंत्रित करने के लिए ऐसे प्रयास करते हैं जो उनके जीवन की गतिविधियों के साथ काफी हस्तक्षेप करते हैं। वज़न को बढ़ने से रोकने के लिए या वज़न कम करना जारी रखने के लिए, एनोरेक्सिया से ग्रस्त लोग आमतौर पर अपने खाने की मात्रा को गंभीर रूप से प्रतिबंधित करते हैं। वे खाने के बाद उल्टी करके, मूत्रवर्धक या एनीमा का दुरुपयोग करके अपनी कैलोरी का सेवन नियंत्रित कर सकते हैं। वे ज़्यादा व्यायाम करके अपना वज़न कम करने की कोशिश कर सकते हैं।
एनोरेक्सिया के प्रकार - Types of Anorexia Nervosa in Hindi
एनोरेक्सिया के लक्षण - anorexia nervosa symptoms in hindi, एनोरेक्सिया के कारण - anorexia nervosa causes in hindi, एनोरेक्सिया से बचाव - prevention of anorexia nervosa in hindi, एनोरेक्सिया का परीक्षण - diagnosis of anorexia nervosa in hindi, एनोरेक्सिया का इलाज - anorexia nervosa treatment in hindi.
- एनोरेक्सिया के जोखिम और जटिलताएं - Anorexia Nervosa Risks & Complications in Hindi
एनोरेक्सिया के कितने प्रकार होते हैं ?
एनोरेक्सिया के निम्नलिखित दो प्रकार होते हैं -
1. प्रतिबंधित एनोरेक्सिया इस प्रकार के एनोरेक्सिया से ग्रस्त लोग खाने की मात्रा और उसके प्रकार पर गंभीर प्रतिबंध लगाते हैं।
वह कैलोरी की गिनती करना, भोजन न करना, कुछ खाद्य पदार्थों (जैसे कार्बोहाइड्रेट्स) को सीमित करना और खाने में कुछ नियमों को शामिल जैसे - केवल एक विशेष रंग के भोजन खाना आदि करते हैं। इन व्यवहारों के साथ हो सकता है लोग अत्यधिक व्यायाम करें।
2. अत्यधिक खाने वाला एनोरेक्सिया इस प्रकार के एनोरेक्सिया से ग्रस्त लोग भी खाने पर प्रतिबंध लगाते हैं लेकिन इसमें नियंत्रण से बाहर भोजन की एक बड़ी मात्रा खाना भी शामिल है। इस खाने की क्षतिपूर्ति करने के लिए व्यक्ति उल्टी करता है और मूत्रवर्धक या एनीमा का दुरुपयोग करता है।
ये व्यवहार शारीरिक और मानसिक रूप से अस्वस्थ होते हैं और यहां तक कि जानलेवा भी हो सकते हैं।
एनोरेक्सिया के क्या लक्षण होते हैं ?
एनोरेक्सिया के निम्नलिखित लक्षण होते हैं -
- कई हफ्तों या महीनों तक तेजी से वज़न घटना।
- वज़न बहुत कम होने पर भी सीमित भोजन करना।
- भोजन, कैलोरी, पोषण या खाना पकाने में एक असामान्य रुचि होना।
- वज़न बढ़ाने का अत्यधिक डर।
- भोजन करने की अजीब आदतें, जैसे छुप के खाना।
- वज़न कम होने पर भी मोटा महसूस करना।
- अपने शरीर के वज़न का वास्तविक आकलन करने में असमर्थता।
- लगातार सुधार के लिए प्रयास करना और खुद के प्रति बहुत आलोचनात्मक होना।
- शरीर के वज़न या आकार का आत्मसम्मान पर अनुचित प्रभाव होना।
- डिप्रेशन (अवसाद) , चिंता या चिड़चिड़ापन होना।
- महिलाओं में अनियमित मासिक धर्म होना।
- रेचक, मूत्रवर्धक या आहार की गोलियों का उपयोग करना।
- बार-बार बीमार होना।
- घाटे हुए वज़न को छिपाने के लिए ढीले कपड़े पहनना।
- बलपूर्वक व्यायाम करना। (और पढ़ें - व्यायाम के फायदे )
- बेकार या निराश महसूस करना।
- समाज से दूरी बनाना।
समय के साथ एनोरेक्सिया के निम्नलिखित शारीरिक लक्षण हो सकते हैं -
- ठंड बादश करने में समस्याएं।
- बालों और नाखूनों की कमज़ोरी।
- त्वचा का सूखना या पीलापन।
- जोड़ों की सूजन।
- दाँत खराब होना।
- शरीर पर पतले बालों का एक नया विकास।
एनोरेक्सिया के क्या कारण हैं ?
एनोरेक्सिया का सही कारण अभी तक अज्ञात है। ऐसा माना जाता है कई अन्य रोगों की तरह, यह भी शायद जैविक, मनोवैज्ञानिक और पर्यावरणीय कारकों के संयोजन की वजह से होता है।
जैविक (biological) कारक हालांकि यह अभी तक स्पष्ट नहीं हुआ है कि इसमें कौनसी जीन शामिल होती है लेकिन कुछ आनुवांशिक परिवर्तन हो सकते हैं जिसके कारण कुछ लोगों को एनोरेक्सिया विकसित होने का अधिक खतरा होता है। कुछ लोगों का बेहतर बनने, संवेदनशीलता और दृढ़ता के प्रति एक आनुवंशिक झुकाव हो सकता है जो कि एनोरेक्सिया का कारण हो सकता है।
मनोवैज्ञानिक कारक कुछ भावनात्मक कारक एनोरेक्सिया के कारण बन सकते हैं। युवा महिलाओं को एक प्रकार के आहार खाना और भूख के बावजूद भोजन न करना जैसे कुछ मनोवैज्ञानिक लक्षण हो सकते हैं। उन्हें बेहतर बनने का जूनून हो सकता है जिससे वे ऐसा सोच सकती हैं कि वे पर्याप्त रूप से पतली नहीं हैं। उन्हें बहुत अधिक चिंता हो सकती है जिसे कम करने के लिए वे खाने पे प्रतिबन्ध लगा सकती हैं।
पर्यावरण कारक आधुनिक पश्चिमी संस्कृति पतलेपन पर जोर देती है। सहकर्मी आपके पतले होने की इच्छा को प्रोत्साहित कर सकते हैं।
एनोरेक्सिया के जोखिम कारक क्या हैं ?
एनोरेक्सिया के कुछ जोखिम कारक निम्नलिखित हैं -
- महिलाएं - लड़कियों और महिलाओं में एनोरेक्सिया अधिक आम है। हालांकि, सामाजिक दबाव के कारण लड़कों और पुरुषों में यह विकार विकसित होने के अधिक कारण होते हैं।
- युवा - एनोरेक्सिया किशोरों में अधिक आम है। फिर भी, किसी भी उम्र के लोग इससे ग्रस्त हो सकते हैं हालांकि, 40 साल से अधिक लोगों में यह दुर्लभ होता है।
- जेनेटिक्स - जीन में कुछ परिवर्तन लोगों को एनोरेक्सिया के जोखिम में डाल सकते हैं।
- परिवार का इतिहास - अगर आपके माता-पिता, भाई या बच्चे को एनोरेक्सिया है तो आपको भी यह होने का उच्च जोखिम हो सकता है।
- बदलाव - जब व्यक्ति नए स्कूल, घर या नौकरी में जाता या उसका रिश्ता टूटता है या उसके किसी प्रिय व्यक्ति की मौत या बीमारी होती है तो यह परिवर्तन व्यक्ति में भावनात्मक तनाव ला सकते हैं और एनोरेक्सिया के जोखिम को बढ़ा सकते हैं।
- खेल, काम और कलात्मक गतिविधियां - एथलीट्स, अभिनेता, नर्तक और मॉडल लोगों को एनोरेक्सिया के उच्च जोखिम में होते हैं। कोच और माता-पिता अनजाने में यह सुझाव देकर जोखिम बढ़ा सकते हैं कि युवा खिलाड़ियों के वज़न कम होते हैं।
- मीडिया और समाज - टीवी और फैशन पत्रिकाएं अक्सर पतले मॉडल और कलाकारों को दिखाते हैं। इन छवियों से सफलता और लोकप्रियता के प्रति समानता प्रतीत हो सकती है जिससे लोग एनोरेक्सिया के जोखिम में आ सकते हैं।
एनोरेक्सिया का बचाव कैसे होता है ?
एनोरेक्सिया से बचाव का कोई सिद्ध तरीका नहीं है। प्राथमिक देखभाल करने वाले चिकित्सक एनोरेक्सिया के प्रारंभिक लक्षणों की पहचान कर सकते हैं और इसके पूर्ण विकास को रोकने का प्रयास कर सकते हैं। उदाहरण के लिए, वे नियमित चिकित्सा नियुक्तियों के दौरान आपके खाने की आदतों और संतुष्टि के बारे में सवाल पूछ सकते हैं।
यदि आपको ऐसा अनुभव होता है आपके किसी पारिवारिक सदस्य या मित्र को आत्मसम्मान की समस्याएं, आहार सम्बन्धी गंभीर आदतें और खुद से असंतोष है, तो इन मुद्दों के बारे में आप उससे बात कर सकते हैँ। यद्यपि आप एनोरेक्सिया के विकास को रोक नहीं सकते हैं, आप एक स्वस्थ व्यवहार या उपचार के विकल्पों के बारे में बात कर सकते हैं।
एनोरेक्सिया का निदान कैसे होता है ?
एनोरेक्सिया का निदान निम्नलिखित तरीकों से होता है -
शारीरिक परीक्षण शारीरिक परीक्षण में आपकी लम्बाई और वज़न को मापा जा सकता है, आपके दिल की दर, ब्लड प्रेशर, तापमान, आपकी त्वचा और नाखूनों की जांच भी की जा सकती है। इसमें आपके दिल और फेफड़ों को को सुना जा सकता है और पेट की जांच भी हो सकती है।
प्रयोगशाला परीक्षण प्रयोगशाला परीक्षण में इलेक्ट्रोलाइट्स और प्रोटीन की जाँच के साथ-साथ आपके लीवर, किडनी और थायराइड के कार्य को जांचने के लिए संपूर्ण ब्लड काउंट और अधिक विशिष्ट रक्त परीक्षण किए जा सकते हैं। आपके मूत्र की जाँच भी की जा सकती है।
(और पढ़ें - महिलाओं में थायराइड लक्षण )
मनोवैज्ञानिक मूल्यांकन मनोवैज्ञानिक मूल्यांकन में एक डॉक्टर या मानसिक स्वास्थ्य चिकित्सक आपके विचारों, भावनाओं और खाने की आदतों के बारे में पूछेंगे। आपको मनोवैज्ञानिक प्रश्नों की एक प्रणाली के जवाब भी देने पड़ सकते हैं।
अन्य परीक्षण एक्स-रे से आपकी हड्डी के घनत्व की जांच, तनाव से फ्रैक्चर की जांच, निमोनिया या हृदय संबंधी समस्याओं की जांच की जा सकती है। हृदय की अनियमितता देखने के लिए इलेक्ट्रोकार्डियोग्राम (Electrocardiogram) किया जा सकता है। आपके शरीर का ऊर्जा उपयोग देखने के लिए भी जाँच की जा सकती है, जो पोषण संबंधी आवश्यकताओं को नियोजित करने में सहायता कर सकती है।
एनोरेक्सिया का उपचार कैसे होता है ?
एनोरेक्सिया का उपचार निम्नलिखित तरीकों से होता है -
मनोचिकित्सा परामर्श में संज्ञानात्मक व्यवहार थेरेपी (सीबीटी) शामिल है, जो व्यक्ति के सोचने और व्यवहार करने के तरीके को बदलने पर ध्यान केंद्रित करती है। सीबीटी एक रोगी को भोजन और शरीर के वज़न के बारे में सोचने के तरीके को बदलने और तनावपूर्ण या मुश्किल परिस्थितियों का जवाब देने के प्रभावी तरीके विकसित करने में सहायता कर सकता है। पोषण परामर्श से मरीज को स्वस्थ खाने की आदतों को समझने में मदद मिल सकती है। वे स्वास्थ्य को बनाए रखने में संतुलित आहार की भूमिका के बारे में जान पाते हैं।
दवाएं एनोरेक्सिया की कोई विशेष दवा नहीं है लेकिन आपको पोषण की खुराक की आवश्यकता हो सकती है और चिकित्सक आपको चिंता, मनोग्रसित बाध्यता विकार (obsessive compulsive disorder; ओसीडी) या अवसाद को नियंत्रित करने के लिए दवाएं दे सकते हैं।
अस्पताल यदि वज़न का अत्यधिक कम होना या कुपोषण, खाना ना खाना या मानसिक आपातकालीन स्थिति होती है, तो अस्पताल में भर्ती होने की आवश्यकता हो सकती है। सुरक्षित वज़न बढ़ाने के लिए भोजन का सेवन धीरे-धीरे बढ़ाया जाएगा।
एनोरेक्सिया के जोखिम और जटिलताएं - Anorexia Nervosa Risks & Complications in Hindi
एनोरेक्सिया की क्या जटिलताएं हैं ?
एनोरेक्सिया की जटिलताएं शरीर की सभी व्यवस्थाओं को प्रभावित कर सकती हैं और वे गंभीर भी हो सकती हैं। इसकी शारीरिक जटिलताएं निम्नलिखित हैं -
- हृदय संबंधी समस्याएं - एनोरेक्सिया से निम्न हृदय गति, लो बीपी (लो ब्लड प्रेशर) और हृदय की मांसपेशियों को नुकसान हो सकता है।
- रक्त की समस्याएं - एनोरेक्सिया से ल्यूकोपेनिया और एनीमिया हो सकते हैं।
- जठरांत्र सम्बन्धी समस्याएं - आंतों की गतिविधयां काफी हद तक धीमी हो जाती हैं अगर किसी व्यक्ति का वज़न गंभीर रूप से कम होता है और वह बहुत कम खाना खता है लेकिन आहार में सुधार आने से यह ठीक हो जाता है।
- गुर्दे की समस्याएं - निर्जलीकरण से अत्यधिक मूत्र आना और अधिक मूत्र उत्पादन हो सकता है। वज़न के स्तर में सुधार से अक्सर गुर्दे भी ठीक हो जाते हैं।
- हार्मोन संबंधी समस्याएं - विकास हार्मोन के कम स्तर से किशोरावस्था के दौरान विलंबित वृद्धि हो सकती है। सामान्य विकास एक स्वस्थ भोजन के साथ शुरू होता है।
- हड्डी का फ्रैक्चर - जिन रोगियों की हड्डियां पूरी तरह से विकसित नहीं होती हैं, उन्हें ऑस्टियोपेनिआ या ऑस्टियोपोरोसिस का काफी अधिक जोखिम होता है।
लगभग 10 में से 1 मामले घातक होते हैं। खराब पोषण से शारीरिक प्रभावों के अलावा, आत्महत्या का उच्च जोखिम हो सकता है। एनोरेक्सिया से संबंधित 5 मौतों में से एक मौत आत्महत्या से होती है।
एनोरेक्सिया का जल्दी निदान और उपचार जटिलताओं के जोखिम को कम कर सकते हैं।
- Janet Treasure, June Alexander. Anorexia Nervosa . Routledge, 2013 178 pages
- Evelyn Attia, B. Timothy Walsh. Anorexia Nervosa . Am J Psychiatry 164:12, December 2007.
- Jane Morris et al. Anorexia nervosa . BMJ. 2007 Apr 28; 334(7599): 894–898. PMID: 17463461
- HelpGuide. Anorexia Nervosa . [internet]
- Randy A. Sansone et al. A Primer on Psychotherapy Treatment of Anorexia Nervosa in Adolescents . Psychiatry (Edgmont). 2005 Feb; 2(2): 40–46. PMID: 21179635
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एनोरेक्सिया की ओटीसी दवा - OTC Medicines for Anorexia Nervosa in Hindi
एनोरेक्सिया के लिए बहुत दवाइयां उपलब्ध हैं। नीचे यह सारी दवाइयां दी गयी हैं। लेकिन ध्यान रहे कि डॉक्टर से सलाह किये बिना आप कृपया कोई भी दवाई न लें। बिना डॉक्टर की सलाह से दवाई लेने से आपकी सेहत को गंभीर नुक्सान हो सकता है।
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एनोरेक्सिया क्या है। Anorexia Nervosa in Hindi
Anorexia Nervosa in Hindi
एनोरेक्सिया एक तरह की खाने की बीमारी है। इसे एनोरेक्सिया नर्वोसा भी कहा जाता है। इस बीमारी में शरीर का वजन बढ़ने का अधिक खतरा बना रहता है। व्यक्ति को वजन के प्रति गलत अवधारणाएं होती है। एनोरेक्सिया से पीड़ित लोग अपने वजन और आकर को नियंत्रित करने के लिए विभिन्न प्रयास करते है। जो उनके जीवन की गतिविधिया के साथ शामिल करते है। शरीर का वजन को कम करने या शरीर के वजन एक ही आकर में रखने के लिए एनोरेक्सिया से पीड़ित लोग अपने भोजन को लेकर बहुत सक्रीय रहते है। गंभीर रूप से ध्यान रखते है। चलिए एनोरेक्सिया के बारे में विस्तार से जानकारी प्राप्त करते है।
एनोरेक्सिया क्या है ? (What is Anorexia Nervosa in Hindi)
- एनोरेक्सिया के प्रकार ? (Types of Anorexia Nervosa in Hindi)
एनोरेक्सिया के कारण क्या है ? (What are the Causes of Anorexia Nervosa in Hindi)
एनोरेक्सिया के लक्षण क्या है (what are the symptoms of anorexia nervosa in hindi).
- एनोरेक्सिया का परिक्षण ? (Diagnosis Anorexia Nervosa in Hindi)
एनोरेक्सिया का इलाज क्या है ? (What are the Treatments for Anorexia Nervosa in Hindi)
एनोरेक्सिया एक मानसिक अवस्था है। जिसमे व्यक्ति अपने वजन को लेकर बहुत अधिक संजीदा हो जाते है। ऐसे में लोग अत्यधिक डाइटिंग व व्यायाम का सहारा लेते है। ऐसे में व्यक्तियों को लगता है की अगर वो भोजन का सेवन करेंगे तो मोटे हो जाएंगे। जिसके कारण उनका खान-पान का समय गलत हो जाता है। खानपान में अनियमित एव कम खुराक लेने से उनके स्वास्थ्य पर बुरा प्रभाव पड़ता है।
एनोरेक्सिया के प्रकार ? (Types of Anorexia Nervosa in Hindi)
एनोरेक्सिया के दो प्रकार होते है।
- प्रतिबंधित एनोरेक्सिया : – इस प्रकार में लोग अपने भोजन के प्रतिबंध बहुत लगाते है। ऐसे लोग हमेशा अपनी कैलोरी को गिनते है। भोजन नहीं करना, कार्बोहैा ड्रेड पदार्थ सीमित रखना, केवल रंगो वाले भोजन करना व अत्यधिक व्यायाम करना इत्यादि करने लगते है।
- अत्यधिक खाने वाले एनोरेक्सिया :- इस प्रकार में लोग भी भोजन पर प्रतिबंध लगाते है। किंतु इसमें भोजन में नियंत्रण कर अधिक मात्रा में भोजन शामिल करते है। भोजन की क्षतिपूर्ति करने के लिए व्यक्ति उल्टी करता है व एनीमिया का दुरुपयोग करता है। यह व्यवहार व्यक्ति को मानसिक और शारीरिक रूप से अस्वस्थ कर देता है। यह जानलेवा भी हो सकता है।
एनोरेक्सिया सटीक कारण शोधकर्ताओं को अभी तक ज्ञात नहीं हो पाया है। किंतु ऐसा माना जाता है। यह अन्य रोगो की तरह से व्यक्ति को नुकसान पहुँचाता है।
- जैविक :- किसी व्यक्ति के शरीर में अनुवांशिक परिवर्तन हो सकते है। जो उन्हें एनोरेक्सिया विकसित करने के लिए अधिक ग्रस्त कर सकता है। कुछ लोगो में यह रोग संवेदनशील होते है। यह अनुवांशिक प्रवृत्ति भी हो सकते हैं।
- पर्यावरण :- आजकल बाहरी संस्कृति लोगो पर बहुत तेजी से हावी होती जा रही है। लोग अधिक पतला बराबर होने की कोशिश में एनोरेक्सिया की चपेट में आ जाते है।
- मनोवैज्ञानिक :- कई तरह की भावनात्मक कारक एनोरेक्सिया का कारण बन सकता है। महिलाओं में भूख लगने पर भी भोजन नहीं करना व भोजन बहुत कम करना मनोवैज्ञानिक लक्षण हो सकते है। शरीर का वजन कम करने के लिए अपने भोजन पर प्रतिबंध लगा देते है।
- कुछ अन्य कारक :- लड़कियों और महिलाओं में एनोरेक्सिया बहुत आम बात होती है।
- जीन में परिवर्तन होने के कारण एनोरेक्सिया के जोखिम डाल सकते है।
- परिवारिक इतिहास यानि माता-पिता के ग्रस्त होने से उच्च मात्रा एनोरेक्सिया का जोखिम हो सकता है।
एनोरेक्सिया के निम्लिखित लक्षण है।
- मासिक धर्म की अक्षमता होना।
- चरम वजन घटना।
- बेहोशी आना।
(और पढ़े – चक्कर क्यों आते है और चक्कर आने के कारण क्या है )
- कब्ज की समस्या होना।
- थकान महसूस होना।
- अनिद्रा होना।
(और पढ़े – अनिद्रा के कारण क्या है और अनिद्रा का इलाज क्या है )
एनोरेक्सिया का परिक्षण ? (Diagnosis Anorexia Nervosa in Hindi)
एनोरेक्सिया का परिक्षण डॉक्टर निम्लिखित तरीको से करते है। जिसमे प्रयोगशाला परीक्षण, शारीरिक परीक्षण, मनोवज्ञानिक परिक्षण, अन्य परीक्षण इत्यादि शामिल होते है। यह सब परीक्षण एनोरेक्सिया से निदान दिलाने के लिए किया जाता है।
एनोरेक्सिया का इलाज चिकिस्तक विभिन्न तरीको से करते है।
- मनोचिकिस्तक एनोरेक्सिया से पीड़ित लोगो का ध्यान केंद्रित करते है। उनके व्यवहार में थेरेपी के द्वारा बदलाव करने की कोशिश करते है। जिससे मरीजों को भोजन खाने की ललक लगे और वह पौष्टिक आहार का सेवन करे।
- इसके उपचार में चिकिस्तक कुछ दवाओं की खुराक भी देते है। जिससे मरीज की चिंता व तनाव दूर हो सके।
- अगर वजन में अधिक गिरावट दिखाई देती है तो चिकिस्तक तुरंत स्वास्थ्य केंद्र में भर्ती होने की सलाह देते है। जिससे कुपोषण का सही तरीके से इलाज हो सके।
अगर आपको एनोरेक्सिया के बारे में अधिक जानकारी एव इलाज करवाना हो तो तुरंत चिकिस्तक ( General Physician ) से संपर्क करे।
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- Continuing Education Activity
Anorexia nervosa is defined by the restriction of nutrient intake relative to requirements, which leads to significantly low body weight. Patients with this eating disorder will have a fear of gaining weight along and a distorted body image with the inability to comprehend the seriousness of their condition. This activity reviews the evaluation and management of anorexia nervosa and highlights the role of the interprofessional team in improving care for patients with this condition.
- Outline the epidemiology of anorexia nervosa.
- Explain the pathophysiology of anorexia nervosa.
- Describe the management of anorexia nervosa.
- Summarize the importance of improving care coordination among the interprofessional team members to enhance the delivery of care for those with anorexia nervosa.
Anorexia nervosa is an eating disorder defined by restriction of energy intake relative to requirements, leading to a significantly low body weight. Patients will have an intense fear of gaining weight and distorted body image with the inability to recognize the seriousness of their significantly low body weight.   
The success of many professions depends on a person's weight. Models and actors portray a level of thinness that is difficult to attain, and it is enhanced by make-up and photographic alterations. Athletes in sports such as ballet, long-distance running, and martial arts are pressured to maintain lean body weights to outperform the competition. Media outlets promote diet secrets and weight loss tips in excess. Populations such as maturing females identify thin body types with increased self-esteem and link weight loss with self-control.  
Anorexia nervosa is more common in females than males. Onset is late adolescence and early adulthood. Lifetime prevalence is 0.3% to 1% (European studies have demonstrated a prevalence of 2% to 4%), irrespective of culture, ethnicity, and race. Risk factors for eating disorders include childhood obesity, female sex, mood disorders, personality traits (impulsivity and perfectionism), sexual abuse, or weight-related concerns from family or peer environments.   
Studies demonstrate biological factors play a role in the development of anorexia nervosa in addition to environmental factors. Genetic correlations exist between educational attainment, neuroticism, and schizophrenia. Patients with anorexia nervosa have altered brain function and structure there are deficits in neurotransmitters dopamine (eating behavior and reward) and serotonin (impulse control and neuroticism), differential activation of the corticolimbic system (appetite and fear), and diminished activity among the frontostriatal circuits (habitual behaviors). Patients have co-morbid psychiatric disorders such as major depressive disorder and generalized anxiety disorder.
- History and Physical
Patients will report symptoms such as amenorrhea, cold intolerance, constipation, extremity edema, fatigue, and irritability. They may describe restrictive behaviors related to food like calorie counting or portion control, and purging methods, for example, self-induced vomiting or use of diuretics or laxatives. Many exercise compulsively for extended periods of time. Patients with anorexia nervosa develop multiple complications related to prolonged starvation and purging behaviors.
Workup includes a thorough medical history (comprehensive review of systems, family and social history, medications including nonprescribed, past medical and psychiatric history, prior abuse) and physical exam (looking for complications above). Basic labs include coagulation panel, complete blood count, complete metabolic profile, 25-hydroxyvitamin D, testosterone (males), thyroid-stimulating hormone, and urine testing (beta-hCG [females] and drugs, either illicit or prescription). An electrocardiogram is recommended to assess for life-threatening arrhythmias. Additional studies may be necessary if BMI is less than 14 kg/m, for example, echocardiogram in patients with hemodynamic compromise (dyspnea, murmurs, syncope) or computed tomography of the abdomen to rule out superior mesenteric artery syndrome or amenorrhea more than 9 months (dual-energy x-ray absorptiometry).  
Complications of anorexia nervosa are listed:
- Cardiovascular: bradycardia, dilated cardiomyopathy, electrolyte-induced arrhythmias, hypotension, mitral valve prolapse, pericardial effusion
- Constitutional: arrested growth, hypothermia, low body mass index (BMI), muscle wasting
- Dermatologic: carotenoderma, lanugo, xerosis
- Endocrine: hypothalamic hypogonadism, osteoporosis
- Gastrointestinal: constipation (laxative abuse), gastroparesis
- Hematologic: cytopenias (inc. normocytic anemia), bone marrow hypoplasia/aplasia
- Neurologic: brain atrophy, peripheral neuropathy (mineral and vitamin deficiencies)
- Obstetric: antenatal and postnatal complications
- Psychiatric: depression, impaired concentration, insomnia, irritability
- Renal and electrolytes: hypokalemic metabolic acidosis or alkalosis (laxative or diuretic abuse, resp.), prerenal renal failure, refeeding syndrome.
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) provides the diagnostic criteria for anorexia nervosa (A-C). It classifies the disease by type, status, and severity.
Of note, amenorrhea has been removed from the DSM-5 criteria. Patients who meet the new criteria and continue to menstruate have similar outcomes as those who do not.
Other eating disorders have similar features to anorexia nervosa. Avoidant or restrictive food intake disorder involves food restriction with failure to meet the nutritional need. While patients are often underweight, this disturbance does not meet diagnostic criteria for anorexia nervosa. Individuals with binge eating disorder eat excessive amounts of calories in a short period with a lack of self-control but do not display compensatory behaviors such as purging or restriction. Patients with bulimia nervosa will binge and purge without a corresponding low BMI. Pica refers to chronic ingestion of nonfood substances and may be a manifestation of underlying medical or psychiatric condition. For example, patients with anorexia nervosa may eat toilet paper when they are hungry. Rumination disorder occurs when patients repeatedly regurgitate food for one month when no other medical condition can be identified and does not occur solely during the course of another eating disorder. Other specified feeding or eating disorder refers to conditions with symptoms that impair functioning but do not meet criteria for a specific eating disorder, for example, patients who meet criteria for anorexia nervosa but have BMI more than 18.5 kg/m are classified as “atypical anorexia nervosa.”
Major depressive disorder can cause anorexia and weight loss. However, patients are not obsessed with body habitus. Patients with obsessive-compulsive disorder may have food rituals but maintain a normal weight. Patients who abuse stimulants such as cocaine and methamphetamine experience weight loss through increased metabolism and concentrated efforts to obtain illicit substances rather than consume calories.
Medical conditions can cause weight loss. Examples are celiac disease, hyperthyroidism, inflammatory bowel disease, malignancy, poorly controlled diabetes mellitus, primary adrenal insufficiency, and tuberculosis. The diagnosis will come from the history and physical examination. Order labs as dictated by the clinical picture.
- Treatment / Management
Treatment for anorexia nervosa is centered on nutrition rehabilitation and psychotherapy. Patients who need inpatient treatment have the following characteristics:
- Existing psychiatric disorders requiring hospitalization
- High risk for suicide (intent with highly lethal plan or failed attempt)
- Lack of support system (severe family conflict or homelessness)
- Limited access (lives too far away to participate in a daily treatment program)
- Medically unstable (bradycardia, dehydration, hypoglycemia or poorly controlled diabetes, hypokalemia or other electrolyte imbalances indicative of refeeding syndrome, hypothermia, hypotension, organ compromise requiring acute treatment)
- Poorly motivated to recover (uncooperative, preoccupied with intrusive thoughts)
- Purging behaviors that are persistent, severe, and occur multiple times a day
- Severe anorexia nervosa (less than 70% of ideal body weight or acute weight loss with food refusal)
- Supervised feeding and/or specialized feeding (nasogastric tube) required
- Unable to stop compulsively exercising (not a sole indication for hospitalization).
Outpatient treatment includes intensive therapy (2 to 3 hours per weekday) and partial hospitalization (6 hours per day). Pediatric patients benefit from family-based psychotherapy to explore underlying dynamics and restructure the home environment.
Refeeding syndrome can occur following prolonged starvation. As the body utilizes glucose to produce molecules of adenosine triphosphate (ATP), it depletes the remaining stores of phosphorus. Also, glucose entry into cells is mediated by insulin and occurs rapidly following long periods without food. Both cause electrolyte abnormalities such as hypophosphatemia and hypokalemia, triggering cardiac and respiratory compromise. Patients should be followed carefully for signs of refeeding syndrome and electrolytes closely monitored.
Pharmacotherapy is not used initially. For acutely ill patients who do not respond to initial treatment, olanzapine is a first-line medication. Other antipsychotics have not demonstrated similar effects on weight gain. For patients who are not acutely ill but have co-morbid psychiatric conditions such as generalized anxiety disorder or major depressive disorder, combination therapy with selective serotonin reuptake inhibitors (SSRIs) and therapy is best. Patients who do not respond to SSRIs may need a second-generation antipsychotic. Tricyclic antidepressants (TCAs) are less preferred due to concerns about cardiotoxicity, especially in malnourished patients. Bupropion is contraindicated in patients with eating disorders due to the increased risk of seizures.   
- Differential Diagnosis
- Chronic mesenteric ischemia
- Irritable bowel syndrome
- Celiac disease
Remission in AN varies. Three-fourths of patients treated in out-patient settings remit within 5 years and the same percentage experience intermediate-good outcomes (including weight gain). Relapse is more common in patients who are older with a longer duration of disease or lower body fat/weight at the end of treatment, have co-morbid psychiatric disorders, or receive therapy outside of a specialized clinic. Patients who achieve partial remission often develop another form of eating disorder (ex. bulimia nervosa or unspecified eating disorder).
All-cause mortality is greater in AN compared to the rest of the population. It has one of the highest mortality rates of all eating disorders due to medical complications, substance abuse, and suicide. Patients with AN have increased rates of suicide and this accounts for 25% of deaths associated.
- Delayed puberty
- Failure to thrive
- Renal failure
- Peripheral neuropathy
- Deterrence and Patient Education
Anorexia nervosa is a psychiatric disease in which patients restrict their food intake relative to their energy requirements through eating less, exercising more, and/or purging food through laxatives and vomiting. Despite being severely underweight, they do not recognize it and have distorted body images. They can develop complications from being underweight and purging food. Diagnose by history, physical, and lab work that rules out other conditions that can make people lose weight. Treatment includes gain weight (sometimes in a hospital if severe), therapy to address body image, and management of complications from malnourishment.
- Enhancing Healthcare Team Outcomes
Anorexia nervosa is a serious eating disorder that has very high morbidity. The disorder is usually managed with an interprofessional team that consists of a psychiatrist, dietitian, social worker, internist, endocrinologist, gastroenterologist, and nurses. The disorder cannot be prevented and there is no cure. Hence patient and family education is key to preventing high morbidity. The dietitian should educate the family on the importance of nutrition and limiting exercise. The mental health nurse should educate the patient on changes in behavior, easing stress, and overcoming any emotional issues. The pharmacist should educate the patient and family on the use of drugs like laxatives and weight loss pills. Only through close follow-up and monitoring can patient outcomes be improved.   [Level 5]
Remission in anorexia nervosa varies. Three-fourths of patients treated in out-patient settings remit within five years and the same percentage experience intermediate-good outcomes, including weight gain. Relapse is more common in patients who are older with a longer duration of disease or lower body fat/weight at the end of treatment, have co-morbid psychiatric disorders, or receive therapy outside of a specialized clinic. Often, patients who achieve partial remission develop another form of eating disorders like bulimia nervosa or unspecified eating disorder.
All-cause mortality is greater in anorexia nervosa compared to the rest of the population. It has one of the highest mortality rates of all eating disorders due to medical complications, substance abuse, and suicide. Patients with anorexia nervosa have increased rates of suicide, and this accounts for 25% of deaths associated with the disorder.    [Level 5]
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Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Criteria for Anorexia Nervosa. Contributed by Christine Moore, D.O.
Disclosure: Christine Moore declares no relevant financial relationships with ineligible companies.
Disclosure: Brooke Bokor declares no relevant financial relationships with ineligible companies.
This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.
- Cite this Page Moore CA, Bokor BR. Anorexia Nervosa. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
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Introduction, symptoms of anorexia, causes of anorexia, diagnosing anorexia, treating anorexia, complications of anorexia, getting help for anorexia.
Anorexia nervosa is an eating disorder and a serious, potentially life-threatening, mental health condition.
People who have anorexia are very anxious about their weight and body shape. They try to keep their weight as low as possible by strictly controlling and limiting what they eat. Many people with anorexia will also exercise excessively. They may also use other methods to try to control their weight, including using laxatives , vomiting after eating, and taking stimulant drugs.
Anorexia causes people who have it to be afraid of being ‘fat’. This fear is what causes the other symptoms, leading to weight loss and potential health risks.
Read more about anorexia symptoms
Even when a person with anorexia becomes extremely underweight, they can still feel compelled to lose more weight, and see themselves as being ‘fat’.
Anorexia causes people who have it to focus heavily on food, even when they won’t eat it. For example, they might enjoy cooking for others, but avoid eating any of the meal themselves.
Some people with anorexia binge eat, meaning they eat a lot of food (or what feels to them like a lot of food) in a short space of time. They then try to avoid digesting the food and gaining weight from it by ‘purging’ – either making themselves vomit or using laxatives (medication that causes you to poo).
The symptoms of anorexia usually begin gradually – someone might start a diet to help them lose a little bit of weight, but find that it spirals out of control.
How common is anorexia?
Despite being an uncommon condition, anorexia is the leading cause of mental health-related deaths.
Anorexia can affect anyone – it’s more common in girls and women, with 1 in 100 women affected over the course of their lifetime. For men and boys, anorexia affects approximately 1 in 350 men over the course of their lifetime, and experts advise that it’s becoming more common.
Symptoms of anorexia usually first develop during the teenage years, on average at the age of 15, but it can develop at any time, including in childhood.
The cause of anorexia is unknown, but most experts believe the condition results from a combination of biological, psychological and environmental factors.
Read more about the causes of anorexia
The long-term malnutrition associated with anorexia can cause a range of serious complications, such as:
- osteoporosis (weakening of the bones)
- kidney disease
- heart failure
Read more about the complications of anorexia
It can be difficult for people with anorexia to recognise that they have a mental health condition. Because it’s hard for them to get out of the habits they’ve developed as a result of anorexia, recovery can take some time.
Most people with anorexia respond to treatment, and the earlier it begins, the better the chances of a complete recovery. Treatment for anorexia usually involves talking therapies, such as cognitive behavioural therapy (CBT), which aim to change the person’s thoughts, feelings, and behaviour around food. Nutritional support is also offered to help them gain weight safely.
Read more about treating anorexia
There are 3 main symptoms of anorexia:
- fear of ‘being fat’ or gaining weight
- problems with self-esteem and body image when it comes to food and weight
- restricting food intake and keeping your body weight low, to the point it’s unhealthy
Restricting food intake means your body isn’t getting enough energy or nutrition, which leads to other physical symptoms.
Fear of gaining weight or ‘being fat’
Having anorexia nervosa doesn’t mean you don’t like food, or don’t feel hungry – it means the mental health condition is preventing you from eating in a healthy way. People with anorexia are unable to think about food in the same way as people who don’t have the condition. Instead of thinking about food as something you need to survive, someone with anorexia might be continually focused on how they can eat less, and think of different types of food as ‘bad’ or ‘good’.
Anorexia can make it feel like you have to conceal your eating habits, for example by:
- hiding how much you’ve eaten, or not eaten
- avoiding eating around other people
- coming up with reasons for not eating, like feeling ill, special dietary requirements, or telling people you ate before you saw them
In addition, you may find yourself thinking about food all the time.
Self-esteem and body image
How you feel about food and your body is very personal, so symptoms and thoughts related to anorexia aren’t likely to be the same for everyone. However, there are certain ways of thinking that are common in people who have anorexia.
Anorexia can cause you to think, for example:
- that you’re overweight or ‘fat’
- that you’re unattractive or ugly
- that other people see you in a negative way – maybe that they’ll find you ugly or judge you for the way you look
Also, people with anorexia often believe that they are worth more, and people will like them more, if they are thinner. They might wear baggy clothing to hide their bodies, and withdraw from social situations and hobbies.
Many people will also do something called ‘body-checking’, which involves persistently and repeatedly:
- weighing themselves
- measuring themselves, such as their waist size
- checking their body in the mirror
Men with anorexia, in particular, can spend a lot of time focusing on their muscle mass, and trying to attain a specific body shape.
Anorexia symptoms can make it difficult to concentrate, and cause you to have problems performing at school or work. People with anorexia often seem to lose interest in activities they used to enjoy, but they can seem very busy because of the time they spend thinking about food and weight.
Eating and food
People with anorexia nervosa strictly control what they eat. For example, by:
- strict dieting
- counting the calories in food
- avoiding food they think is fattening
- eating only low-calorie food
- missing meals (fasting)
- hiding food instead of eating it
- cutting food into tiny pieces – to make it less obvious that they’ve eaten very little, and to make the food easier to swallow
- taking appetite suppressants (which make you less hungry), or pills that claim to help your body digest food faster, or remove fat from food
They may also drink a lot of coffee, energy drinks, tea, and other fluids with caffeine to provide a short-term burst of energy without many calories.
Some people with anorexia also use drugs known to cause weight loss, such as cocaine or amphetamines.
The compulsion to burn calories often draws people with anorexia to ‘high-impact’ activities, such as running, dancing or aerobics. Some people with anorexia will use any available opportunity to burn calories, such as pacing or preferring to stand rather than sit.
People with anorexia may think they can avoid absorbing calories, and try to prevent it in various ways. This can involve making themselves vomit.
Signs that someone is purging by vomiting can include:
- leaving the room immediately after eating
- dental problems, such as tooth decay or bad breath, caused by the acid in vomit damaging their teeth and mouth
- hard skin on their knuckles, caused by putting their fingers down their throat
Someone with anorexia might also try to make food pass through their body as quickly as possible. For example, by either taking:
- laxatives (medication that helps to empty the bowels)
- diuretics (medication that helps remove fluid from the body)
In reality, vomiting, laxatives and diuretics all have little effect on the calories absorbed from food.
Other signs of anorexia
Eating too little for a long time can result in physical symptoms, such as:
- fine downy hair (lanugo) growing on the body
- more hair on the face
- pubic hair becoming sparse and thin
- slow or irregular heartbeat
People with anorexia may also:
- have pain in their abdomen (tummy)
- feel bloated or constipated
- have swelling in their feet, hands or face
- feel very tired
- have low blood pressure ( hypotension )
- feel cold or have a low body temperature
- feel light-headed or dizzy
In children with anorexia, puberty and the associated growth spurt may be delayed. They may gain less weight than expected for someone going through puberty, and they might be shorter than other people of the same age.
Women and older girls with anorexia may stop having their periods. Anorexia can also lead to infertility, for both men and women.
The exact causes of anorexia nervosa are unclear, but most specialists believe it’s likely to be the result of a combination of factors.
Many people who develop anorexia share certain patterns of thinking and behaving that may make them more likely to develop the condition. These include:
- a tendency towards depression and anxiety
- finding it difficult to handle stress
- frequently worrying and feeling scared or doubtful about the future
- perfectionism – setting strict, demanding goals or standards
- finding it hard to express feelings
- experiencing unwanted thoughts, images or urges that make them feel they have to behave in certain ways
Environmental factors are parts of the world around a person, and events happening in their life, that can affect their mental wellbeing in a variety of ways.
Puberty can be an important factor contributing to anorexia. This is likely due to the combination of hormonal changes and feelings of stress, anxiety and low self-esteem during puberty.
Western culture and society may also play a part. People of all ages are exposed to a wide range of media messages promoting the idea that only certain body shapes are desirable, and that not having the ‘ideal’ body is something to be ashamed of. Even health advice that’s intended to be helpful can have a focus on the risks of being overweight, which can add to feelings of pressure and low self-esteem.
The media also places significant focus on celebrities’ bodies, pointing out things like cellulite or slight weight gain. This can make people feel insecure about these parts of their own bodies.
Other environmental factors that can contribute towards anorexia include:
- pressure and stress at school, such as exams or bullying – particularly if someone is bullied about body weight or shape
- occupations or hobbies where being thin is seen as the ideal, such as dancing or athletics
- having a family that places high value on being thin and physically active, and praises or rewards weight loss
- a stressful life event, such as losing a job, the breakdown of a relationship, or bereavement
- difficult family relationships
- physical or sexual abuse
Biological and genetic factors
Experts have suggested changes in brain function or hormone levels may also have a role in anorexia, although it’s not clear if these lead to anorexia or if they develop later as a result of malnutrition .
These changes may affect the part of the brain that controls appetite, or may lead to feelings of anxiety and guilt when eating. These feelings are then eased when meals are missed, or after excessive exercise.
The risk of someone developing anorexia is also thought to be greater in people with a family history of eating disorders, depression, or substance misuse, which suggests higher chances of developing these conditions could run in the family.
When making a diagnosis, your GP will probably ask questions about your weight and eating habits. For example, they could ask:
- if you’ve lost a lot of weight recently or quite quickly
- how you feel about your weight, and if you’re concerned about it
- if you think you’re overweight, even though other people think you’re thin
- if you make yourself vomit regularly
- if you have periods, whether your periods have stopped and if so, for how long
It’s important to answer these questions honestly. Your GP isn’t trying to judge you or ‘catch you out’. They just need to accurately assess how serious your symptoms are.
Weight and BMI
Your GP may check your weight. If someone has anorexia nervosa, their weight is generally at least 15% below average for their age, sex and height.
Your GP may also calculate your body mass index (BMI). A healthy BMI for adults in Scotland is 20-25. People with anorexia generally have a BMI below 17.5.
Find out how to calculate your BMI
Blood tests and other tests
Your GP may not need to carry out any tests to diagnose anorexia nervosa, but they’ll probably check your pulse and blood pressure.
If you have anorexia, you have a higher risk of developing some heart conditions, such as irregular heartbeat (arrhythmia). Sometimes an ECG (electrocardiogram) may be needed to check how well your heart is working.
Your GP may do blood tests to check the level of:
- fluids in your body
- chemicals or minerals, such as potassium in your blood
Blood tests look for the complications of anorexia, so even if they come back as ‘normal’, it’s still likely you’ll benefit from a referral to a specialist if you’re experiencing anorexia symptoms.
Referral to a specialist
If your GP thinks you may have anorexia, they’ll refer you to a specialist in eating disorders for a more detailed assessment. Your GP sometimes carries out this assessment.
Before your treatment begins, you will probably have an overall assessment of your health. This may be done by your GP or another healthcare professional, such as one that specialises in eating disorders.
The assessment will help your healthcare professional draw up a plan for your treatment and care. For example, they may assess:
- your overall health and any medical needs
- your social situation, such as how much support you have from family and friends
- your mood and any risks that affect you, such as whether you’re at risk of harming yourself
- whether there are any physical risks as a result of anorexia that mean urgent treatment is needed
Your care plan
If you are diagnosed with anorexia nervosa, your GP will probably be involved in your ongoing treatment and care. Other healthcare professionals may also be involved in your treatment, such as:
- a specialist counsellor
- a psychiatrist (doctor who specialises in treating mental health conditions)
- a psychologist or psychotherapist
- a dietician (specialist in nutrition)
If a child or teenager has anorexia, a paediatrician (doctor who specialises in children) may also be involved in their treatment.
Where you are treated may depend on how mild or severe your condition is. For example, you may be treated:
- as an outpatient (this is most common)
- as a day patient or in a day unit
- as in inpatient in hospital, if your weight loss or symptoms are severe
In some areas, eating disorders such as anorexia are treated by community mental health teams, which are made up of different health and social care professionals.
In other areas, there are units that specialise in treating eating disorders. Some services that treat eating disorders also specialise in treating young people.
What to expect from anorexia treatment
It’s important to start treatment as early as possible, especially if someone has already lost a lot of weight.
Treatment for anorexia usually includes:
- psychological treatment – talking to a therapist or counsellor
- advice on eating and nutrition to help you gain weight safely
These treatments work better when combined, rather than on their own.
Your physical health will be monitored closely during your treatment. For example:
- your weight will be checked regularly
- you may have regular health checks with your GP or another healthcare professional
In children and young people with anorexia, their growth, development and weight will be monitored closely. Their height will also be checked regularly against the average for their age and sex.
Other health problems caused by anorexia will also be treated. For example, if you vomit regularly, you’ll be encouraged to stop. You’ll be given advice on dental hygiene to help prevent stomach acid damaging the enamel on your teeth. You’ll also be advised to visit a dentist regularly. If you take laxatives or diuretics, you’ll be advised to reduce them gradually so your body can adjust. Stopping them suddenly can cause side effects like nausea and constipation.
Gaining weight safely
Your care team will give you advice on how to increase the amount you eat so you can gain weight safely.
They’ll ask about your current eating habits and how much fluid you drink, as well as habits like smoking and drinking alcohol. This will determine what advice they give you, and help them identify any deficiencies in your diet, such as a lack of vitamins.
Your care team will help you to develop healthy eating habits, such as eating more, eating more healthily, and increasing the nutritional benefits you get from food.
Your body will likely need time to adjust to eating more. You may need to start by eating small amounts of food, and then gradually increasing what you eat.
You may need to take supplements, such as multivitamins or multiminerals, to adjust the chemical balance in your body. Some experts think this should be done before you start gaining weight.
You and your care team will work towards establishing a regular pattern of eating, with three meals a day and regular snacks. Your care team might agree a target weight with you, so you have a minimum healthy weight to aim for.
If your weight loss is severe, treatment in hospital may be needed to help you start to gain weight. Your health will be closely monitored to avoid any side effects, particularly in the first few days.
Types of psychological treatment
Various types of psychological treatment can be used to treat anorexia, such as:
- cognitive analytic therapy (CAT)
- cognitive behavioural therapy (CBT)
- interpersonal therapy (IPT)
- focal psychodynamic therapy (FPT)
- family therapy
These different types of psychological treatments are discussed below.
Cognitive analytic therapy (CAT)
CAT is based on the theory that mental health conditions like anorexia are caused by unhealthy patterns of behaviour and thinking, which a person has developed in their past, usually in their childhood.
Cognitive behavioural therapy (CBT)
CBT starts with the idea that thoughts, feelings, and behaviour are linked and affect one another. If anorexia is causing someone to behave in an unhealthy way, CBT helps them to change the harmful behaviour while working on changing how they think about food, eating, and weight.
Interpersonal therapy (IPT)
IPT is based on the idea that relationships with other people and the outside world in general have a range of effects on your mental health, both positive and negative. IPT explores the way you interact with other people and the relationships you have, with the goal of improving them.
Focal psychodynamic therapy (FPT)
Previous experiences, particularly from childhood, can influence the way you think and feel now in ways you’re not aware of. The aim of FPT is to help you become aware of those effects, so you can understand why you think and feel the way you do about food, eating, and weight.
Anorexia doesn’t just affect one person – it can also have a big impact on their family.
Family therapy involves the person with anorexia and close members of their family discussing how anorexia has affected them, and the positive changes the person and their family can make.
Learn more about talking therapies
The types of therapy available can vary depending on where you live. Although different types of therapy take different approaches, the most important part of any talking therapy is the relationship you build with your therapist.
Medication alone isn’t usually effective in reducing anorexia symptoms. For some people it can be helpful to prescribe medication in combination with psychological treatment.
Your treatment team might prescribe nutritional or vitamin supplements for you to help your overall health.
If treatment isn’t improving your symptoms, or you start to get worse, your healthcare professional may consider changing your treatment. This may include treatment in hospital if your health is seriously at risk.
Sometimes the physical health issues caused by anorexia mean a person has to be admitted to hospital. If their life is at risk and they refuse treatment, there are some circumstances when they might be admitted under the Mental Health (Care and Treatment) (Scotland) Act 2015 . This is sometimes called ‘being sectioned’.
Someone can only receive compulsory treatment if their condition is preventing them from making informed decisions about their care.
It’s quite common for anorexia to return after treatment – this is often referred to as relapse. It can happen, for example:
- if someone’s weight starts to fall again
- after having a baby, when a woman tries to lose the weight she gained during pregnancy
- during stressful times in a person’s life
Sometimes, anorexia can lead to another eating disorder called bulimia nervosa , where the person binge eats, then immediately makes themselves sick or uses laxatives to rid their body of the food.
If someone has anorexia for a long time, it can lead to severe complications and health problems that can sometimes be permanent.
People with anorexia have an increased risk of:
- poor circulation and cardiovascular problems
- heart conditions, such as coronary heart disease and irregular heartbeat (arrhythmia)
- health problems caused by malnutrition – a lack of vitamins and minerals
Anorexia can cause an imbalance of minerals in the blood, such as potassium, calcium and sodium. These minerals play an important part in keeping you healthy. When there’s an imbalance, it can cause symptoms like:
- irregular heartbeat (arrhythmia)
- muscle spasms
Other conditions that can be caused by anorexia and malnutrition can include:
- low blood pressure ( hypotension )
- dental problems, such as tooth decay caused by regular vomiting (stomach acid affects the enamel on the teeth)
- low blood sugar levels ( hypoglycaemia )
- acute kidney (renal) failure
- liver damage
- osteoporosis (fragile bones) and loss of muscle strength, particularly in women and girls
- loss of sex drive (libido) and impotency in men
Misuse of laxatives can damage the bowels and cause permanent constipation.
Anorexia and other health conditions
If you have anorexia and another health condition, you’ll need to take extra care of your health.
If you have diabetes , you’ll need regular health checks to help avoid problems with your eyes or other serious complications. This is particularly important if you have type 1 diabetes .
If you have a bone condition, such as osteoporosis , your GP will probably advise you to avoid any physical activities that may lead to falls.
Anorexia and pregnancy
Anorexia can lead to irregular menstrual cycles, or cause your periods to stop altogether. This doesn’t mean anorexia makes you infertile – if you have anorexia, even if your periods are irregular or have stopped, you should continue to use birth control if you aren’t planning a pregnancy.
If you have anorexia and are trying to become pregnant, you should discuss your plans with your GP and care team.
If you are pregnant, your midwife will monitor your health closely during your pregnancy and after your baby is born. You may need extra health checks as part of your antenatal and postnatal care.
Anorexia during pregnancy can increase the risk of complications, such as:
- giving birth early (premature birth)
- having a baby with a low birth weight
Having anorexia during pregnancy can also increase the chances that you’ll need to have a caesarean section (C-section) .
You’re also likely to need extra care and support during pregnancy if you have previously had anorexia and recovered from it.
If someone has anorexia, the most important step towards diagnosis and treatment is for them to:
- recognise they need help
- want to get better
However, to take this first step they may need lots of support and encouragement. Because one of the main symptoms of anorexia is a fear of gaining weight, it’s understandable that people who have the condition can be anxious about seeking treatment that might mean eating more.
If you have eating problems or think you may have anorexia, it’s important to seek help as soon as possible. You could start by:
- talking to someone you trust, such as a friend or member of your family
- going to see your GP – you may find it helpful to bring someone with you for support
Helping someone else
If someone close to you is showing signs of anorexia, you can offer help and support.
You could try talking to them about how they feel, and encourage them to think about getting help. Try not to put pressure on them or be critical of them, as this could make things worse. You could also offer to help by going with the person to see their GP.
If you’d like to get some advice on how to help, a healthcare professional, such as your own GP, can provide information on:
- how to help the person recognise that they have a problem
- the treatments available
- how you can support them during their treatment
You could also get help from a support group for people who have loved ones with eating disorders. Your own GP or Scotland’s Service Directory can help you find services near you.
A leading charity for people with eating disorders is Beat , which has a range of information on the help and support available for people with eating disorders, and their friends and families.
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Anorexia nervosa is characterized by a relentless pursuit of thinness, a morbid fear of obesity, a distorted body image, and restriction of intake relative to requirements, leading to a significantly low body weight. Diagnosis is clinical. Most treatment is with some form of psychologic and behavioral therapy. Involvement of the family is crucial to the care of younger patients. Olanzapine may help with weight gain.
(See also Introduction to Eating Disorders Introduction to Eating Disorders Eating disorders involve a persistent disturbance of eating or of behavior related to eating that Alters consumption or absorption of food Significantly impairs physical health and/or psychosocial... read more .)
Anorexia nervosa occurs predominantly in girls and young women. Onset is usually during adolescence and rarely after age 40.
Two types of anorexia nervosa are recognized:
Restricting type: Patients restrict food intake but do not regularly engage in binge eating or purging behavior; some patients exercise excessively.
Binge eating/purging type: Patients regularly binge eat and/or induce vomiting and/or misuse laxatives, diuretics, or enemas.
Binges are defined as consumption of a much larger amount of food than most people would eat in a similar time period under similar circumstances with loss of control, ie, perceived inability to resist or stop eating.
Etiology of Anorexia Nervosa
The etiology of anorexia nervosa is unknown.
Other than being female, few risk factors have been identified. In some cultures, obesity is considered unattractive and unhealthy, and the desire to be thin is pervasive, even among children. More than 50% of prepubertal girls in the US diet or take other measures to control their weight. Excessive concern about weight or a history of dieting appears to indicate increased risk, and there is a genetic predisposition, and genome-wide studies have begun to identify specific loci that are associated with increased risk.
Family and social factors probably play a role. Many patients belong to middle or upper socioeconomic classes, are meticulous and compulsive, have average intelligence, and have very high standards for achievement and success.
Pathophysiology of Anorexia Nervosa
Endocrine abnormalities are common in anorexia nervosa; they include
Low levels of gonadal hormones
Mildly reduced levels of thyroxine (T4) and triiodothyronine (T3)
Increased cortisol secretion
Menses usually cease, but cessation of menses is no longer a criterion for diagnosis. Bone density declines. In severely undernourished patients, virtually every major organ system may be affected. However, susceptibility to infections is typically not increased.
Dehydration and metabolic alkalosis may occur, and serum potassium and/or sodium may be low; all are aggravated by induced vomiting and laxative or diuretic use.
Cardiac muscle mass, chamber size, and output decrease; mitral valve prolapse is commonly detected. Some patients have prolonged QT intervals (even when corrected for heart rate), which, with the risks imposed by electrolyte disturbances, may predispose to tachyarrhythmias. Sudden death, most likely due to ventricular tachyarrhythmias, may occur.
Symptoms and Signs of Anorexia Nervosa
Anorexia nervosa may be mild and transient or severe and persistent.
Even though underweight, most patients are concerned that they weigh too much or that specific body areas (eg, thighs, buttocks) are too fat. They persist in efforts to lose weight despite reassurances and warnings from friends and family members that they are thin or even significantly underweight, and they view any weight gain as an unacceptable failure of self-control. Preoccupation with and anxiety about weight increase even as emaciation develops.
Anorexia is a misnomer because appetite often remains until patients become significantly cachectic. Patients are preoccupied with food:
They may study diets and calories.
They may hoard, conceal, and waste food.
They may collect recipes.
They may prepare elaborate meals for other people.
Patients often exaggerate their food intake and conceal behavior, such as induced vomiting. Binge eating/purging occurs in 30 to 50% of patients. The others simply restrict their food intake.
Many patients with anorexia nervosa also exercise excessively to control weight. Even patients who are cachectic tend to remain very active (including pursuing vigorous exercise programs).
Reports of bloating, abdominal distress, and constipation are common. Most women with anorexia nervosa stop having menstrual periods. Patients usually lose interest in sex. Depression Depressive Disorders Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. Exact cause is unknown... read more occurs frequently.
Common physical findings include bradycardia, low blood pressure, hypothermia, lanugo hair (soft, fine hair usually found only on neonates) or slight hirsutism, and edema. Body fat is greatly reduced. Patients who vomit frequently may have eroded dental enamel, painless salivary gland enlargement, and/or an inflamed esophagus.
Diagnosis of Anorexia Nervosa
Not recognizing the seriousness of the low body weight and restrictive eating are prominent features of anorexia nervosa. Patients resist evaluation and treatment; they are usually brought to the physician’s attention by family members or by intercurrent illness.
Clinical criteria for diagnosis of anorexia nervosa ( 1 Diagnosis reference Anorexia nervosa is characterized by a relentless pursuit of thinness, a morbid fear of obesity, a distorted body image, and restriction of intake relative to requirements, leading to a significantly... read more ) include the following:
Restriction of food intake resulting in a significantly low body weight
Fear of excessive weight gain or obesity (stated specifically by the patient or manifested as behavior that interferes with weight gain)
Body image disturbance (misperception of body weight and/or appearance) or denial of the seriousness of illness
In adults, low body weight is defined using the body mass index (BMI). BMI of < 17 kg/m 2 is considered significantly low; BMI 17 to < 18.5 kg/m 2 may be significantly low depending on the patient's starting point.
For children and adolescents, the BMI percentile for age is used; the 5th percentile is usually given as the cutoff. However, children above the 5th percentile who have not maintained their projected growth trajectory may also be considered to meet the criterion for low body weight; BMI percentile for age tables and standard growth charts are available from the Centers for Disease Control and Prevention (see CDC Growth Charts ). Separate BMI calculators are available for children and adolescents.
Patients may otherwise appear well and have few, if any, abnormalities in blood tests. The key to diagnosis is identifying persistent active efforts to avoid weight gain and an intense fear of fatness that is not diminished by weight loss.
Another psychiatric disorder, such as schizophrenia Schizophrenia Schizophrenia is characterized by psychosis (loss of contact with reality), hallucinations (false perceptions), delusions (false beliefs), disorganized speech and behavior, flattened affect... read more or primary depression Depressive Disorders Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. Exact cause is unknown... read more , may cause weight loss and reluctance to eat, but patients with these disorders do not have a distorted body image.
Rarely, an unrecognized severe physical disorder may cause substantial weight loss. Disorders to consider include malabsorption syndromes Overview of Malabsorption Malabsorption is inadequate assimilation of dietary substances due to defects in digestion, absorption, or transport. Malabsorption can affect macronutrients (eg, proteins, carbohydrates, fats)... read more (eg, due to inflammatory bowel disease or celiac disease), new-onset type 1 diabetes Diabetes Mellitus (DM) Diabetes mellitus is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia... read more , adrenal insufficiency Clinical syndromes , and cancer. Amphetamine abuse Amphetamines Amphetamines are sympathomimetic drugs with central nervous system stimulant and euphoriant properties whose toxic adverse effects include delirium, hypertension, seizures, and hyperthermia... read more may cause similar symptoms.
1. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision , DSM-5-TR TM , Feeding and eating disorders.
Prognosis for Anorexia Nervosa
Mortality rates are high, approaching 10% per decade among affected people who come to clinical attention; unrecognized mild disease probably rarely leads to death. With treatment, prognosis is as follows:
Half of patients regain most or all of lost weight, and any endocrine and other complications are reversed.
About one fourth have intermediate outcomes and may relapse.
The remaining one fourth have a poor outcome, including relapses and persistent physical and mental complications
Children and adolescents treated for anorexia nervosa have better outcomes than adults.
Treatment of Anorexia Nervosa
Psychotherapy (eg, cognitive behavioral therapy)
For children and adolescents, family-based treatment
Sometimes 2nd-generation antipsychotics
Treatment of anorexia nervosa may require life-saving short-term intervention to restore body weight. When weight loss has been severe or rapid or when weight has fallen below about 75% of recommended weight, prompt restoration of weight becomes critical, and hospitalization should be considered. If any doubt exists, patients should be hospitalized.
Outpatient treatments may include varying degrees of support and supervision and commonly involve a team of practitioners.
Nutritional supplementation is often used with behavioral therapy that has clear weight-restoration goals. Nutritional supplementation begins by providing about 30 to 40 kcal/kg/day; it can produce weight gains of up to 1.5 kg/week during inpatient care and 0.5 kg/week during outpatient care. Oral feedings using solid foods are best; many weight restoration plans also use liquid supplements. Very resistant, undernourished patients occasionally require nasogastric tube feedings.
Elemental calcium 1200 to 1500 mg/day and vitamin D 600 to 800 IU/day are commonly prescribed for bone loss.
Once nutritional, fluid, and electrolyte status has been stabilized, long-term treatment begins. Outpatient psychotherapy is the cornerstone of treatment. Treatments should emphasize behavioral outcomes such as normalized eating and weight. Treatment should continue for a full year after weight is restored. Results are best in adolescents who have had the disorder < 6 months.
Family therapy, particularly using the Maudsley model (also called family-based treatment), is useful for adolescents. This model has 3 phases:
Family members are taught how to refeed the adolescent (eg, through a supervised family meal) and thus restore the adolescent’s weight (in contrast to earlier approaches, this model does not assign blame for the development of the disorder to the family or the adolescent).
Control over eating is gradually returned to the adolescent.
After the adolescent is able to maintain the restored weight, therapy focuses on engendering a healthy adolescent identity.
Treatment of anorexia nervosa is complicated by patients' abhorrence of weight gain and denial of illness. The physician should attempt to provide a calm, concerned, stable relationship while firmly encouraging a reasonable caloric intake.
Treatment also involves regular follow-up monitoring and often a team of health care practitioners, including a nutritionist, who may provide specific meal plans or information about the calories needed to restore weight to a normal level.
Although psychotherapy is primary, drugs are sometimes helpful. Olanzapine up to 10 mg orally once daily may aid weight gain.
Patients with anorexia nervosa have an intense fear of gaining weight or becoming fat that persists despite all evidence to the contrary.
In the restricting type of anorexia nervosa, patients restrict food intake and sometimes exercise excessively but do not regularly engage in binge eating or purging.
In the binge eating/purging type, patients regularly binge eat and/or induce vomiting and/or misuse laxatives, diuretics, or enemas in an attempt to purge themselves of food.
In adults, BMI is significantly low (usually BMI of < 17 kg/m 2 ), and in adolescents, BMI percentile is low (usually < 5th percentile) or does not increase as expected for normal growth.
Endocrine or electrolyte abnormalities or cardiac arrhythmias may develop, and death can occur.
Treat with nutritional supplementation, psychotherapy (eg, cognitive behavioral therapy), and, for adolescents, family-based therapy; olanzapine may be helpful.
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If your doctor suspects that you have anorexia nervosa, he or she will typically do several tests and exams to help pinpoint a diagnosis, rule out medical causes for the weight loss, and check for any related complications.
These exams and tests generally include:
- Physical exam. This may include measuring your height and weight; checking your vital signs, such as heart rate, blood pressure and temperature; checking your skin and nails for problems; listening to your heart and lungs; and examining your abdomen.
- Lab tests. These may include a complete blood count (CBC) and more-specialized blood tests to check electrolytes and protein as well as functioning of your liver, kidney and thyroid. A urinalysis also may be done.
- Psychological evaluation. A doctor or mental health professional will likely ask about your thoughts, feelings and eating habits. You may also be asked to complete psychological self-assessment questionnaires.
- Other studies. X-rays may be taken to check your bone density, check for stress fractures or broken bones, or check for pneumonia or heart problems. Electrocardiograms may be done to look for heart irregularities.
Your mental health professional also may use the diagnostic criteria for anorexia in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
- Bone density test
- Complete blood count (CBC)
- Electrocardiogram (ECG or EKG)
- Liver function tests
Treatment for anorexia is generally done using a team approach, which includes doctors, mental health professionals and dietitians, all with experience in eating disorders. Ongoing therapy and nutrition education are highly important to continued recovery.
Here's a look at what's commonly involved in treating people with anorexia.
Hospitalization and other programs
If your life is in immediate danger, you may need treatment in a hospital emergency room for such issues as a heart rhythm disturbance, dehydration, electrolyte imbalances or a psychiatric emergency. Hospitalization may be required for medical complications, severe psychiatric problems, severe malnutrition or continued refusal to eat.
Some clinics specialize in treating people with eating disorders. They may offer day programs or residential programs rather than full hospitalization. Specialized eating disorder programs may offer more-intensive treatment over longer periods of time.
Because of the host of complications anorexia causes, you may need frequent monitoring of vital signs, hydration level and electrolytes, as well as related physical conditions. In severe cases, people with anorexia may initially require feeding through a tube that's placed in their nose and goes to the stomach (nasogastric tube).
Care is usually coordinated by a primary care doctor or a mental health professional, with other professionals involved.
Restoring a healthy weight
The first goal of treatment is getting back to a healthy weight. You can't recover from anorexia without returning to a healthy weight and learning proper nutrition. Those involved in this process may include:
- Your primary care doctor, who can provide medical care and supervise your calorie needs and weight gain
- A psychologist or other mental health professional, who can work with you to develop behavioral strategies to help you return to a healthy weight
- A dietitian, who can offer guidance getting back to regular patterns of eating, including providing specific meal plans and calorie requirements that help you meet your weight goals
- Your family, who will likely be involved in helping you maintain normal eating habits
These types of therapy may be beneficial for anorexia:
- Family-based therapy. This is the only evidence-based treatment for teenagers with anorexia. Because the teenager with anorexia is unable to make good choices about eating and health while in the grips of this serious condition, this therapy mobilizes parents to help their child with re-feeding and weight restoration until the child can make good choices about health.
- Individual therapy. For adults, cognitive behavioral therapy — specifically enhanced cognitive behavioral therapy — has been shown to help. The main goal is to normalize eating patterns and behaviors to support weight gain. The second goal is to help change distorted beliefs and thoughts that maintain restrictive eating.
No medications are approved to treat anorexia because none has been found to work very well. However, antidepressants or other psychiatric medications can help treat other mental health disorders you may also have, such as depression or anxiety.
Treatment challenges in anorexia
One of the biggest challenges in treating anorexia is that people may not want treatment. Barriers to treatment may include:
- Thinking you don't need treatment
- Fearing weight gain
- Not seeing anorexia as an illness but rather a lifestyle choice
People with anorexia can recover. However, they're at increased risk of relapse during periods of high stress or during triggering situations. Ongoing therapy or periodic appointments during times of stress may help you stay healthy.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and home remedies
When you have anorexia, it can be difficult to take care of yourself properly. In addition to professional treatment, follow these steps:
- Stick to your treatment plan. Don't skip therapy sessions and try not to stray from meal plans, even if they make you uncomfortable.
- Talk to your doctor about appropriate vitamin and mineral supplements. If you're not eating well, chances are your body isn't getting all of the nutrients it needs, such as Vitamin D or iron. However, getting most of your vitamins and minerals from food is typically recommended.
- Don't isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart.
- Resist urges to weigh yourself or check yourself in the mirror frequently. These may do nothing but fuel your drive to maintain unhealthy habits.
Dietary supplements and herbal products designed to suppress the appetite or aid in weight loss may be abused by people with anorexia. Weight-loss supplements or herbs can have serious side effects and dangerously interact with other medications. These products do not go through a rigorous review process and may have ingredients that are not posted on the bottle.
Keep in mind that natural doesn't always mean safe. If you use dietary supplements or herbs, discuss the potential risks with your doctor.
Anxiety-reducing approaches that complement anorexia treatment may increase the sense of well-being and promote relaxation. Examples of these approaches include massage, yoga and meditation.
Coping and support
You may find it difficult to cope with anorexia when you're hit with mixed messages by the media, culture, and perhaps your own family or friends. You may even have heard people joke that they wish they could have anorexia for a while so that they could lose weight.
Whether you have anorexia or your loved one has anorexia, ask your doctor or mental health professional for advice on coping strategies and emotional support. Learning effective coping strategies and getting the support you need from family and friends are vital to successful treatment.
Preparing for your appointment
Here's some information to help you get ready for your appointment and know what to expect from your doctor or mental health professional.
You may want to ask a family member or friend to go with you. Someone who accompanies you may remember something that you missed or forgot. A family member may also be able to give your doctor a fuller picture of your home life.
What you can do
Before your appointment, make a list of:
- Any symptoms you're experiencing, including any that may seem unrelated to the reason for the appointment. Try to recall when your symptoms began.
- Key personal information, including any major stresses or recent life changes.
- All medications, vitamins, herbal products, over-the-counter medications and other supplements that you're taking, and their dosages.
- Questions to ask your doctor so that you'll remember to cover everything you wanted to.
Some questions you might want to ask your doctor or mental health professional include:
- What kinds of tests do I need? Do these tests require any special preparation?
- Is this condition temporary or long lasting?
- What treatments are available, and which do you recommend?
- Is there a generic alternative to the medicine you're prescribing?
- Are there any brochures or other printed material that I can have? What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor or mental health professional is likely to ask you a number of questions, including:
- How long have you been worried about your weight?
- Do you exercise? How often?
- What ways have you used to lose weight?
- Are you having any physical symptoms?
- Have you ever vomited because you were uncomfortably full?
- Have others expressed concern that you're too thin?
- Do you think about food often?
- Do you ever eat in secret?
- Have any of your family members ever had symptoms of an eating disorder or been diagnosed with an eating disorder?
Be ready to answer these questions to reserve time to go over any points you want to focus on.
- Sim LA (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2018.
- Anorexia nervosa. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Nov. 13, 2017.
- Hales RE, et al. Anorexia nervosa. In: The American Psychiatric Publishing Textbook of Psychiatry. 6th ed. Washington, D.C.: American Psychiatric Publishing; 2014. http://psychiatryonline.org. Accessed Nov. 13, 2017.
- Klein D, et al. Anorexia nervosa in adults: Clinical features, course of illness, assessment, and diagnosis. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
- Mehler P. Anorexia nervosa in adults and adolescents: Medical complications and their management. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
- Mehler P. Anorexia nervosa in adults: Evaluation for medical complications and criteria for hospitalization to manage these complications. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
- Pike K. Anorexia nervosa in adults: Cognitive behavioral therapy (CBT). https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
- Walsh BT. Anorexia nervosa in adults: Pharmacotherapy. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
- Anorexia nervosa. Merck Manual Professional Version. http://www.merckmanuals.com/professional/psychiatric-disorders/eating-disorders/anorexia-nervosa. Accessed Nov. 13, 2017.
- Harrington BC, et al. Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa. American Family Physician. 2015;91:46.
- Brockmeyer T, et al. Advances in the treatment of anorexia nervosa: A review of established and emerging interventions. Psychological Medicine. In press. Accessed Nov. 13, 2017.
- Davis H, et al. Pharmacotherapy of eating disorders. Current Opinion in Psychiatry. 2017;30:452.
- Herpertz-Dahlmann B. Treatment of eating disorders in child and adolescent psychiatry. Current Opinion in Psychiatry. 2017;30:438.
- Fogarty S, et al. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review. Eating Behaviors. 2016;21:179.
- Eating disorders. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Eating-Disorders/Overview. Accessed Nov. 13, 2017.
- Lebow J, et al. Is there clinical consensus in defining weight restoration for adolescents with anorexia nervosa? Eating Disorders. In press. Accessed Dec. 4, 2017.
- Lebow J, et al. The effect of atypical antipsychotic medications in individuals with anorexia nervosa: A systematic review and meta-analysis. International Journal of Eating Disorders. 2013;46:332.
- Five things to know about safety of dietary supplements for children and teens. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/tips/child-supplements. Accessed Feb. 9, 2018.
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What is anorexia nervosa?
Anorexia nervosa is an eating disorder and a serious mental illness. A person with anorexia nervosa restricts their energy intake, has a distorted body image and an intense fear of gaining weight. The restriction in energy intake can cause a significant amount of weight loss in a short period of time and may result in a person having a very low weight.
Anorexia nervosa is most common in women and usually starts in adolescence. It is the third most common chronic illness in girls and young women and affects up to 1 in 200 girls. One in 11 people who develop anorexia after puberty are male.
People with anorexia nervosa may see themselves as being heavy or large when they are actually severely underweight. Their perceived body weight or shape can have a significant influence on how they evaluate or feel about themselves. Out of a fear of gaining weight, they follow restrictive diets and may undertake harsh, excessive exercise routines.
Anorexia falls into 3 general types:
People with this type of anorexia nervosa place severe restrictions on the quantity and type of food they consume.
This could include counting calories, skipping meals, restricting certain foods (such as carbohydrates) and following obsessive rules, such as only eating foods of a certain colour.
These behaviours may be accompanied by excessive exercise .
Binge eating/purging type
People with this type of anorexia also place severe restrictions on the food they eat. But this is accompanied by binge eating and then purging.
When binge eating, someone eats a large amount of food and has feelings of being out of control. The person then 'compensates' for this eating by purging the food through vomiting or misusing laxatives, diuretics or enemas.
Atypical anorexia nervosa
Atypical anorexia nervosa is a subtype of other specified feeding or eating disorders (OSFED) in which a person’s body weight is still in the normal weight range despite having significant weight loss from their restricted energy intake. They also have a distorted body image and an intense fear of gaining weight. Apart from the normal weight range, they have all the other characteristics, and similar complications, of anorexia nervosa.
What are the symptoms of anorexia nervosa?
The most obvious sign that someone has anorexia nervosa may be that they are underweight, they have lost weight very quickly, or their weight fluctuates dramatically.
A BMI of less than 18.5 is considered underweight. But being very thin is not the only sign of anorexia. There are also other signs that a person may have anorexia nervosa.
- loss of menstruation in women, decreased libido (sex drive) in men
- fainting or dizziness
- always feeling cold
- bloating, constipation or developing food intolerances
- lethargy and tiredness
- looking pale
- dry, yellow skin
- sunken eyes
- fine hair on the face and body
- being preoccupied with eating, food, body shape and weight
- being extremely dissatisfied with their body, or having a distorted body image
- being anxious and/or irritable at meal times
- depression and anxiety
- difficulty concentrating
- having rigid thoughts about food
- low self-esteem and perfectionism
- intense dieting (counting calories, avoiding foods)
- deliberately misusing laxatives, appetite suppressants, enemas and diuretics
- obsessive behaviour around body weight or shape (weighing themselves obsessively, pinching waist or wrists)
- binge eating
- avoiding eating with other people and secrecy around food
- wanting to be alone
- excessive exercising
- obsessive rituals around food
- preoccupation with cooking, recipes and nutrition
- self-harm, substance abuse or suicide attempts
CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.
What causes anorexia nervosa?
The causes of anorexia nervosa are not fully understood.
There may be genetic risk factors and a combination of environmental, social and cultural factors. It's likely that some people are more vulnerable to anorexia because of particular personality traits.
The causes that may contribute to a person developing anorexia nervosa include:
Psychological factors , such as a high level of perfectionism or obsessive-compulsive personality traits, feeling limited control in life and low self-esteem , a tendency towards depression and anxiety and a poor reaction to stress .
Environmental factors , including the onset of puberty , stressful life events and relationship problems .
Cultural pressures to be thin stemming from media and pop culture such as magazines, TV shows and movies.
Occupations that demand a thin physique may increase the risk of anorexia nervosa, such as certain sports, ballet, or the television and fashion industries.
Brain chemistry , because extreme dieting can affect the balance of hormones in the body, affecting how the brain functions.
Genetic predisposition , which arises from the genes inherited from parents. Anorexia nervosa often runs in families, suggesting there may be a genetic cause.
When should I see my doctor?
Many people with anorexia nervosa think they’re not sick enough or thin enough to need treatment. But seriously restricting calorie intake is dangerous and can have a serious impact on health. If you have anorexia nervosa, the earlier you seek help, the better your chances of recovery.
If you are worried about your eating, it’s important to speak someone. Your doctor is a good place to start, or you could talk to someone you trust like a friend, family member or teacher. They will help you take the first steps towards treatment and recovery.
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How is anorexia nervosa diagnosed?
After ruling out that weight loss is caused by another condition, your doctor or another medical or mental health professional may diagnose anorexia nervosa based on your thoughts, feelings and eating behaviours. They will also check for any other mental or physical complications.
How is anorexia nervosa treated?
The first step to recovery is restoring good nutrition and a healthy weight. This allows treatments to work effectively. If the person has life threatening medical complications or is extremely low weight, they may need to spend time in hospital.
A psychologist can help a person with anorexia nervosa learn behaviours that will help them to return to and maintain a healthy weight. Someone with anorexia nervosa may also see a dietitian, family therapist, psychiatrist or other members of a healthcare team.
Antidepressants and other medicines are sometimes used to treat anorexia nervosa along with psychological therapy.
On average, people have anorexia nervosa for 5 to 7 years. It's common for people with the condition to relapse, so follow-up and treatment for anorexia nervosa is important.
Complications of anorexia nervosa
When people with anorexia nervosa enter a state of starvation, their brain stops functioning properly. They are at risk of self-harm , substance abuse , suicide attempts , depression and anxiety .
Anorexia nervosa can also cause physical complications including:
- an irregular heartbeat or other heart problems
- osteoporosis and bone problems that can increase the risk of broken bones
- kidney failure
Unfortunately, around 1 in 5 people eventually die of the consequences of anorexia nervosa, and one in 5 will attempt suicide.
Resources and support
- Butterfly Foundation — call 1800 33 4673
- National Eating Disorders Collaboration
- Eating Disorders Victoria (for people in Victoria with eating disorders) — call 1300 550 236
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Last reviewed: July 2020
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Anorexia is an eating disorder where you feel a need to keep your weight as low as possible.
- Overview - Anorexia
- Symptoms - Anorexia
- Treatment - Anorexia
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Anorexic मीनिंग : Meaning of Anorexic in Hindi - Definition and Translation
- हिन्दी से अंग्रेजी
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ANOREXIC MEANING IN HINDI - EXACT MATCHES
Definition of anorexic.
- a person suffering from anorexia nervosa
- suffering from anorexia nervosa; pathologically thin
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Anorexic meaning in Hindi : Get meaning and translation of Anorexic in Hindi language with grammar,antonyms,synonyms and sentence usages by ShabdKhoj. Know answer of question : what is meaning of Anorexic in Hindi? Anorexic ka matalab hindi me kya hai (Anorexic का हिंदी में मतलब ). Anorexic meaning in Hindi (हिन्दी मे मीनिंग ) is भूख न लगने की बीमारी.English definition of Anorexic : a person suffering from anorexia nervosa
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Synonym/Similar Words : anorectic