What is anorexia nervosa?

Anorexia nervosa (or simply anorexia) is an eating disorder in which people intentionally starve themselves. It causes extreme weight loss, which the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), defines as at least 15 percent below the individual's normal body weight.

Food and weight become obsessions. Compulsiveness may cause strange eating rituals or the refusal to eat in front of others. It is not uncommon for people with anorexia to collect recipes and prepare gourmet feasts for family and friends, but not partake in the meals themselves. They may also adhere to strict exercise routines to keep off weight.

What causes anorexia nervosa?

The cause of anorexia nervosa is not known. Anorexia usually begins as innocent dieting behavior, but gradually progresses to extreme and unhealthy weight loss. Social attitudes toward body appearance, family influences, genetics, and neurochemical and developmental factors are considered possible contributors to the cause of anorexia. Persons who develop anorexia are more likely to come from families with a history of weight problems, physical illness, and other mental health problems, such as depression or substance abuse. Further, often persons with the disorder come from families that are challenged by appropriate problem solving, being too rigid, overly-critical, intrusive, and overprotective. Persons with anorexia may also be dependent, immature in their emotional development, and are likely to isolate themselves from others. Other mental health problems such as anxiety disorders or affective disorders are commonly found in persons with anorexia.

Who is affected by anorexia nervosa?

The occurrence of anorexia nervosa has increased over the past 20 years. Approximately 90 percent are women between ages 12 and 25. Initially found mostly in upper- and middle-class families, anorexia is now found in all socioeconomic groups and a variety of ethnic and racial groups.

What are some common characteristics of people with anorexia nervosa?

Most people with eating disorders share certain personality traits and use abnormal eating rituals as a means of handling stress and anxiety. These personality traits often include, but are not limited to, the following:

  • low self-esteem

  • feelings of helplessness

  • fear of becoming fat

People with anorexia nervosa:

  • rarely break rules or disobey.

  • often keep their feelings to themselves.

  • tend to be perfectionists, good students, and excellent athletes.

It is believed that they restrict food - particularly carbohydrates - to gain a sense of control in some/one area of their lives. Controlling their weight appears to offer two advantages:

  • taking control of their bodies

  • gaining approval from others

What are the different types of anorexia?

There are two subgroups of anorexic behavior aimed at reducing caloric intake, including the following:

  • restrictor type - severely limits the intake of food, especially carbohydrates and fat containing foods.

  • bulimia (also called binge-eating/purging type) - eats in binges and then induces vomiting and/or takes large amounts of laxatives or other cathartics (medications, through their chemical effects, that serve to increase the clearing of intestinal contents).

What are the symptoms of anorexia nervosa?

The following are the most common symptoms of anorexia. However, each individual may experience symptoms differently. Symptoms may include:

  • low body weight (less than 85 percent of normal weight for height and age)

  • intense fear of becoming obese , even as individual is losing weight

  • distorted view of one's body weight, size, or shape; sees self as too fat, even when very underweight; expresses feeling fat, even when very thin

  • refuses to maintain minimum normal body weight

  • in females, absence of three menstrual cycles without another cause

  • excessive physical activity

  • denies feelings of hunger

  • preoccupation with food preparation

  • bizarre eating behaviors

The following are the most common physical symptoms associated with anorexia - often that result from starvation and malnourishment. However, each individual may experience symptoms differently. Symptoms may include:

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