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Anorexia nervosa, commonly called anorexia, is a potentially life-threatening eating disorder. Individuals with anorexia have a distorted body image that causes them to see themselves as overweight even when they're dangerously thin. They often restrict their eating to the point of starvation, exercise compulsively, and may develop unusual habits such as refusing to eat in front of others. If you or someone you know is suffering from anorexia, understanding more about it can help you cope.

This section contains information about what anorexia is, its symptoms, and how it can be diagnosed. Because anorexia is related to self-image and is not just about food, it can be difficult to overcome. With effective treatment, it’s possible for someone with anorexia to rebuild his or her self-image, adopt healthier eating patterns and reverse serious health complications.

For those who suspect a friend or family member has anorexia, it can be tough to know what to do. The Tips for Helping Someone With Anorexia page can give you some guidance to help you support your loved one.

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Below are some warning signs of anorexia:

  • Dramatic weight loss
  • Intense, persistent fear of gaining weight, even though underweight
  • Refusal to eat or highly restrictive eating
  • Preoccupation with weight, food, calories, fat grams, and dieting
  • Continuous dieting
  • Excessive facial and/or body hair due to inadequate protein in the diet
  • Compulsive exercise and need to burn off calories taken in, even in bad weather or when injured or fatigued
  • Sensitivity to  cold
  • Absent or irregular menstruation
  • Dizziness or fainting
  • A bluish discoloration of the fingers
  • Hair that thins, breaks or falls out
  • Dry skin
  • Development of food rituals, for example, eating foods in certain orders, excessive chewing, rearranging food on a plate
  • Consistent excuses to avoid mealtimes or situations that involve food
  • Withdrawal from usual friends and activities
  • Reduced interest in sex
  • Fatigue
  • Insomnia
  • Irregular heart rhythms

If you are experiencing any of the above symptoms, seek professional help. Eating disorders experts have found that prompt intensive treatment significantly improves the chances of recovery.  

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Anorexia nervosa, often called anorexia, is a potentially life-threatening eating disorder. Individuals with anorexia have a distorted body image that causes them to see themselves as overweight even when they're dangerously thin. They often restrict their eating to the point of starvation, exercise compulsively, and may develop unusual habits such as refusing to eat in front of others. This is in order to maintain a weight that’s far below normal for their age and height.

According to Psych Central , there are two types of anorexia nervosa:

  • Restricting type: This is when the person restricts their food intake by following drastic diets, fasting, and exercising to excess
  • Purging type: This is when the person achieves weight loss through self-induced vomiting or by misusing laxatives, diuretics, or enemas

Anorexia, however, is more than just a problem with food. It's a way of using food or starving oneself to feel more in control of life and to ease negative feelings, such as anger and anxiety. When you have anorexia nervosa, you often equate thinness with self-worth.

Because the body is denied essential nutrients, anorexia can lead to a wide range of health complications. This includes acute kidney failure, liver damage, as well as heart failure. It can also cause a reduction of bone density, muscle loss and weakness. Anorexia is often difficult to overcome. But effective treatment can help someone with this eating disorder improve their self-image, adopt healthier eating patterns and reverse some of anorexia’s serious health complications.

What causes anorexia?

There are no simple answers to the causes of anorexia, as it is a complex condition that arises from a combination of many social, emotional, and biological factors. Some contributing factors could include family environment, emotional difficulties, low self-esteem, and traumatic experiences a person may have undergone in the past.

Who is affected by anorexia?

Anorexia typically appears in early to mid adolescence. Women are much more likely to develop anorexia, however, it can also affect boys and men. 

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When making a diagnosis, your doctor will generally ask questions about your weight and eating habits such as whether you have lost a lot of weight recently, how you feel about your weight, whether you think you are overweight, and if your periods have stopped.

If your doctor suspects you have anorexia, he or she will typically run tests and exams to rule out medical causes for the weight loss and to help pinpoint a diagnosis.

These tests can include:

  • Physical exam: This may include measuring your height and weight; checking your vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; checking your skin and nails for dryness or other problems; and examining your abdomen.
  • Laboratory tests: These may include specialised blood tests to check electrolytes and protein levels as well as the functioning of your liver, kidney and thyroid.
  • Other studies: X-rays may be taken to check for broken bones, pneumonia or heart problems. Sometimes an electrocardiogram may be needed to check how well your heart is working.

You may also be referred by your doctor to a specialist or mental health provider for a more detailed assessment.

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Treating anorexia is often a three-step process that involves:

  • Getting you back to a healthy weight
  • Encouraging you to start eating more food
  • Changing the way you think about yourself and food

Since anorexia involves both mind and body, a combined approach to treatment is often best. Treatment for anorexia will usually include medical care, nutritional counselling, and psychotherapy. The most effective treatment plan for you will depend on your particular symptoms, your age and situation.

  • Medical care: The first priority in anorexia treatment is addressing and stabilising any serious health problems. This may require you to be hospitalised if you are dangerously malnourished or so distressed that you no longer want to live. For those who are not in immediate medical danger, outpatient treatment is also available. Once serious health concerns have been addressed, medications are usually only used to treat associated symptoms of anorexia, such as obsessive compulsive disorder or depression.
  • Nutritional counselling: In nutritional counselling, a nutritionist or dietician will teach you about healthy eating and proper nutrition. The nutritionist will also help you develop and follow meal plans that include enough calories to reach or maintain a normal, healthy weight.
  • Psychotherapy: Psychotherapy is a crucial element of anorexia treatment, and its goal is to identify the negative thoughts and feelings that fuel your eating disorder and replace them with healthier, less distorted beliefs. According to Mayo Clinic , individual, family-based and group therapy may all be beneficial.

For the best chance of recovery, it is important to start treatment as early as possible, particularly if you have already lost a lot of weight.

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It can be tough to know what to do if you suspect a friend or family member has anorexia. The best thing you can do is to talk to the person about your concerns, as anorexia has serious physical and emotional consequences and should never be ignored. While your loved one may get defensive and deny that they have an eating disorder, there’s a chance that he or she will welcome the opportunity to open up about the struggle. Here are some suggestions for supporting your loved one:

  • Speak out about your concerns: Be honest and tell your loved one about your worries about his or her eating or exercising habits. Keep in mind that the person may get defensive or angry. But if he or she does open up, let them express their feelings, listen without judgment and make sure the person knows you care.
  • Be supportive: A person with anorexia needs compassion and support, not an authority figure standing over the table with a calorie counter.
  • Suggest they talk to a professional: It can help your loved one to talk to a professional who knows about eating issues. Offer to help them find a counsellor or doctor and make an appointment, and offer to go with him or her to the appointment.
  • Avoid conflicts: Since anorexia is often caused and exacerbated by stress, low self-esteem and shame – negativity will only make it worse. Instead, assure them that you’re always there to listen if they want to talk.
  • Avoid placing blame: Don't make comments like, "If you'd just eat, then things would be fine!" Patronising comments and guilt trips usually exacerbate the situation. Instead, say things like, “I'm worried about you because you won't eat breakfast or lunch”.
  • Set a good example: Set a good example for healthy eating, exercising, and body image by not making negative comments about your own body or anyone else’s.
  • Accept your limits: As a parent or friend, it’s not in your hands to fix your loved one’s anorexia. The person with anorexia must make the decision to take the steps needed for recovery.
  • Take care of yourself: Eating disorders are stressful and affect the whole family, so you need to take care of yourself too. Know when to seek advice for yourself from a counsellor or health professional, as it helps to have your own support system in place.
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