What is Anorexia?

Anorexia nervosa is an eating disorder characterized by a distorted body image, excessive dieting that leads to severe weight loss, together with a pathological fear of becoming fat.

Anorexics see themselves as overweight when in reality they are extremely underweight. Despite this, they never believe they are thin enough, and have an intense fear of becoming fat or gaining weight.

In order to reduce their weight, individuals with anorexia restrict the amount of food they take in by skipping meals and cutting down on the types and amounts of food they eat, essentially starving themselves, which leads to severe weight loss. This usually starts by cutting out ‘bad’ foods, mainly fats and sugar, but as time goes on, they cut out more and more types of food, eventually limiting food intake to the point where their health can be compromised.

People with anorexia genuinely see themselves as fat/disgusting/obese, and the pathological fear of becoming fat means that they will deny there is a problem and often go to great lengths to hide their behaviours from family and friends. They will always have an excuse for why they do not want to eat, such as not being hungry/feeling unwell/have already eaten/not liking the food/too busy to eat.

They often become very deceitful, lying to family and friends about what and when they have eaten, sometimes going to great lengths to cover up their lies. Sufferers may also become very down, withdrawn and quiet, and begin to isolate themselves.

Individuals with anorexia are often obsessed with thoughts of food, calories, exercise, and diets and sometimes appear to take real pleasure in recipes, menus and cooking for others, yet don’t eat themselves. They may also start to become overly interested in reading food labels, and know the fat/calorific content of variety of foods. Thoughts of food, fat, shape and weight dominate their minds, and may dominate their conversations, and you may often hear them complaining of being fat.

As well as restricting their food intake, anorexics may also exercise excessively, and use laxatives or diuretics in an attempt to lose more weight. Individuals are often irrational and unrelenting in their quest to lose weight, and may weigh themselves excessively, and spend a lot of time scrutinizing their bodies in the mirror.

What are the signs of Anorexia?

Individuals with anorexia go to great lengths to hide their illness from those around them. Therefore signs and symptoms can be hard to spot.

Some of the most common features of Anorexia are –

  • Strict dieting
  • Dramatic weight loss
  • Wearing baggy clothes to hide their body
  • Constant thoughts and talk of weight/food/calories/fat
  • Counting calories excessively
  • Avoiding food they believe is fattening
  • Skipping meals
  • Lying about what/when they have eaten
  • Intense fear of weight gain
  • Self-induced vomiting
  • Use of laxatives
  • Body image disturbance – thinking they are fat when they are not
  • Compulsive weighing
  • Excessive exercising
  • Becoming vegetarian/vegan
  • Social isolation
  • Developing rituals around food
  • Mood swings/depressed/irritable
  • Insomnia
  • Avoiding eating with other people
  • Hiding food
  • Cutting food into tiny pieces – to hide from others how little they have eaten
  • Taking appetite suppressants, such as slimming or diet pills
  • Difficulty sleeping and tiredness
  • Stomach pains
  • Constipation
  • Setting high standards and being a perfectionist
  • Shutting yourself off from the world
  • Black and white thinking – e.g. things are either right or wrong, good or bad, there is no in between
  • Strange oral habits e.g. drinking lots of low calorie fizzy drinks, always chewing gum
  • Always reading cookery books and recipes

What are the dangers of Anorexia?

Eating disorders are extremely serious, potentially fatal conditions, that impact a person’s physical and emotional health. They often result in medical complications that can have long-term consequences.

Starvation is the main feature of Anorexia, and this can have serious effects on all major body systems and organs. When Anorexia becomes extreme, the person is deprived of all the essential nutrients they need to function, so the body will start to use its own tissue, including muscle and organs, for energy, since there is no food to use. This often causes permanent damage to the organs in the process.
Due to the lack of essential nutrients received, the body begins to shut down some of its processes in an attempt to conserve energy. This can result in potentially serious medical complications.

Some of the major health implications of Anorexia include –

  • Loss of concentration
  • Lowered immunity – due to malnutrition and vitamin/mineral deficiencies
  • Weakness, dizziness or fainting – due to dehydration, low levels of potassium and a drop in blood pressure
  • Anaemia – iron deficiency due to lack of nutrition which can lead to fatigue, shortness of breath and palpitations
  • Severe dehydration – due to lack of fluids
  • Sensitivity to cold – due to losing the insulating layer of fat
  • Lanugo – a body grows a layer of soft, downy hair all over, including the face. This is an in-built protective mechanism the body uses in an attempt to keep itself warm during periods of starvation
  • Dry skin/hair – caused by malnutrition, dehydration and vitamin and mineral deficiencies
  • Muscle loss and weakness – muscle wastage and muscle loss occurs due to the body feeding off itself
  • Reduction of bone density – Thinning of the bones is caused by a deficiency in the essential vitamins and minerals, and can lead to osteoporosis or osteopenia, which is the precursor to osteoporosis
  • Gastrointestinal problems – body will become unable to digest food effectively due to a reduction in digestive enzymes. This can lead to bloating, constipation, malnutrition and electrolyte imbalances
  • Periods stop (amenorrhoea) – periods stop due to the body no longer producing the hormones required such as oestrogen
  • Loss of hair – due to vitamin and mineral deficiencies
  • Heart problems – the heart beats at a much slower rate, a condition known as brachycardia, cardiac arrhythmias and ECG abnormalities are common due to electrolyte imbalances, severe dehydration and malnutrition
  • Hormone abnormalities – changes involving the reproductive, stress, thyroid and growth hormones. This can lead to a loss of sex drive or erectile dysfunction
  • Infertility – due to loss of menstrual cycle and hormone imbalance
  • Intense depression – caused by malnutrition, dehydration, hormone deficiencies, and vitamin/mineral deficiencies
  • Kidney stones or kidney failure – due to severe dehydration
  • Reduced brain volume
  • Liver damage – cirrhosis can occur due to malnutrition
  • Death – most deaths occur due to organ failure or suicide

Although there are very serious medical complications which can result from all types of eating disorders, the good news is that almost all are completely reversible upon the person becoming weight restored and nutritionally healthy.

Other eating disorders

Other Specified Feeding or Eating Disorders (OSFED)

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Unspecified Feeding or Eating Disorder (UFED)

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