Anorexia nervosa 

Introduction 

Anorexia nervosa

Professor Janet Treasure, director of the eating disorder unit at the South London and Maudsley NHS Trust, talks about anorexia nervosa, including how to spot the symptoms and how the eating disorder can affect a person's life

Media last reviewed: 18/03/2013

Next review due: 18/03/2015

Anorexia nervosa is a serious mental health condition. It is an eating disorder in which people keep their body weight as low as possible.

People with anorexia usually do this by restricting the amount of food they eat, making themselves vomit and exercising excessively. 

The condition often develops out of an anxiety about body shape and weight that originates from a fear of being fat or a desire to be thin. Many people with anorexia have a distorted image of themselves, thinking that they're fat when they're not.

Anorexia most commonly affects girls and women, although it has become more common in boys and men in recent years. On average, the condition first develops at around the age of 16 to 17.

Read more about the causes of anorexia.

Signs and symptoms of anorexia

People with anorexia often go to great lengths to hide their behaviour from family and friends by lying about what they have eaten, or by pretending to have eaten earlier.

Signs that someone may have anorexia or another eating disorder include:

  • missing meals, eating very little or avoiding eating any fatty foods
  • obsessively counting calories in food 
  • leaving the table immediately after eating so they can vomit
  • taking appetite suppressants, laxatives or diuretics (medication that helps remove fluid from the body)
  • repeatedly weighing themselves or checking their body in the mirror
  • physical problems, such as feeling lightheaded or dizzy, hair loss or dry skin

Anorexia can also be associated with other psychological problems such as depression, anxiety, low self-esteem, alcohol misuse and self-harm.

Read more about the symptoms of anorexia.

Getting help

People with anorexia often don't seek help, perhaps because they're afraid or don't recognise they have a problem. Many have hidden their condition for a long time – sometimes years.

The most important first step is for someone with anorexia to realise that they need help and want to get better.

If you suspect someone you know has anorexia, you should try to talk to them about your worries and encourage them to seek help.

This can be a very difficult conversation because they may be defensive and refuse to accept they have a problem. But it's important not to criticise or pressure them as this can make things worse.

You may want to seek advice from an eating disorder support group such as Beat on how best to broach the subject.

If you think you may have anorexia, try to seek help as soon as possible. You could start by talking to someone you trust, such as someone in your family or a friend, and perhaps ask them to go with you to see your GP.

Read more about Eating disorders: advice for parents and Supporting someone with an eating disorder.

Treating anorexia

Before anorexia can be treated, a physical, psychological and social needs assessment will need to be carried out by the GP or an eating disorders specialist to help determine the most suitable care plan.

In most cases, treatment will involve a combination of psychological therapy and individually tailored advice on eating and nutrition to help you gain weight safely.

A range of different healthcare professionals will usually be involved in your care, such as GPs, psychiatrists, specialist nurses and dietitians.

Most people are able to be treated on an outpatient basis, which means you can go home between appointments. More serious cases are treated in hospital or specialist eating disorder clinics.

Read more about diagnosing anorexia and treating anorexia.

Outlook

It can take several years of treatment to fully recover from anorexia and relapses are common. For example, a woman may relapse if she tries to lose weight gained during pregnancy.

Around half of people with anorexia will continue to have some level of eating problem despite treatment.

If anorexia remains unsuccessfully treated for a long time, a number of serious further problems can develop. These can include fragile bones (osteoporosis), infertility, an irregular heartbeat and other heart problems.

Despite being an uncommon condition, anorexia is one of the leading causes of mental health-related deaths. This can be because of the effects of malnutrition or as a result of suicide.

Read more about the potential complications of anorexia.

Page last reviewed: 16/04/2014

Next review due: 16/04/2016

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Comments

The 19 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Stupot1968 said on 03 August 2014

Sorry to rant, but anorexia is far from being an uncommon illness! It's just not given the attention needed by the professionals (probably down to cost and available specialist staffing?)
My wife initially displayed signs of the illness at 14yrs, and ended up trying to take her own life, she was told not to be a naughty girl as she came from a 'nice' family!!! Now 30 yrs on she still battles daily, having tried various (NHS) and BEAT counselling sessions. Most of the NHS sessions were almost useless and made her feel like she was attention seeking. She is now 6 1/2 stone and struggles each day to remain with her family. One of the things that most people forget is the endless struggles that the sufferers family had to endure, and I know that we are not the only ones, but it is extremely hard with many sacrifices. I am not sure if anyone reads these boards but my heart goes out to all the other sufferers AND their families.

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Clip said on 05 February 2013

I have a sister and niece with e.d I find it hard to understand. I figure it can be addictive but when u get to a certain healthy weight y can't u stop? I am so worried my sis ill die as she is so thin. My niece seems a little better and I am hopeful for her. :) my sis is 39 and nice 14. It is an evil illness I wish it would go away. Unhappy times

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louisa16 said on 22 November 2012

I think i;m still anorexic when i was thirteen i developed a very unhealthy relationship with food i can't stand thr smell, taste or look of food and because of that i lost two stone, making me 5 ft 5 and five stone 3. i admit looking at pictures it looked awful but theres a voice in my head telling me i was still fat this voice stops me from eating and when i eat makes me feel bad for eating. i used to make myslef sick but it's now physically impossible i was supposed to see a dietician but i didn't want to go because sometimes i wish i was still as bad as i was because then i could be thin

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REN_star said on 25 April 2012

@ clairewilliamsr
I am 21 and have suffered from Anorexia since I was 13. I went into an Eating Disorder unit when I was 16, where I went up to a healthy weight. After I was discharged I had some help with my relationship with food but fell into the void between child and adult services. If it wasn't for my mum, who pushed for more help, I don't think I would be the person I am today. She felt useless and that she had let me down too. Eating disorders are a very selfish force and I reassured her that there was nothing she could do to prevent this from happening to me. In fact, there wasn't really anything that I could do either. The only advise that I have for you is to be there for your son, even if he tries to push you away. Anorexia loves destruction so if you fight it will only make it stronger. Family therapy really helped us. Even though sometimes it was super hard we could express ourselves in a way that we wouldn't at home. Only a mother has that extra strong bond with there child and if you feel the service, that you and your son are getting, isn't the best then you have to push for more, like my mum did. Don't feel intimidated because they are 'the professionals'.
Even though I am at a healthy weight and able to maintain, anorexia is still a massive part of my life. I have control over it now and not the other way around. I really hope this helps and that your son will be able to control anorexia too. He's not alone and it can be done.
All the best.
Ren

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Elyssia said on 18 April 2012

I think that my little sister has Anorexia because she will not eat anything and she is obsessed with her weight and she keeps doing exercise when she has not eaten anythin

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clairewilliamsr said on 03 April 2012

My son was diagnosed yesterday 2 april 12 with anorexia......such a sad day feellike ive let him down as a mother he will be 19yrs in July such a waste .....hopefully we will get the help we were told.

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Briey said on 12 January 2012

I would like to offer some hope regarding this condition. My daughter (now 17) was in treatment for 4 years with seemingly little or no progress until last June. Then she found new friends and started to think about a different future at University and with that came really rapid progress. This week she reached her target weight and is determined to have a future without this terrible condition.
There were times when l thought we would never be rid of Anorexia but it can be done.
Dont give up!

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Emilyyy said on 29 November 2011

I am 17 and i have suffered with an eating disorder for 3 years, it really annoys me that people think that if you have an eating disorder then you chose to be like that but i would give anything to be different, i would love to eat loads, i never feel guilty about what i eat and when i eat loads i feel really proud of myself. I have seen many doctors, dieticians and physciatrists about my disorder but have never found them of much use. I did not choose to suffer with this horrible illness, i never thought i was fat and needed to lose weight, i wish there was more help out there for people like me who would give anything to be able to eat and put on weight.

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Bethhh said on 14 September 2011

Hi guys,
I could really do with some advice. I'm not convinced I have an eating disorder but I feel I have an extremely bad relationship with food. I can't eat a chocolate bar without feeling the worst guilt imaginable. I have absolutely no confidence as it is and hate my body. I am 16 and I have a younger sister who is sports crazy and extremely skinny so I have always felt like the fat one in the family. I love food but hate the way he makes me feel and the thought of me getting into a swimming coustume makes me feel sick. I can't enjoy food as I keep thinking its going to make me fat. I wish I could loose weight and change my body and enjoy food like I use to but at the minute if I eat a portion of chips. I hate myself.
Please help with your adive,
Thank you,
Beth x

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Bethhh said on 14 September 2011

Hi guys,
I could really do with some advice. I'm not convinced I have an eating disorder but I feel I have an extremely bad relationship with food. I can't eat a chocolate bar without feeling the worst guilt imaginable. I have absolutely no confidence as it is and hate my body. I am 16 and I have a younger sister who is sports crazy and extremely skinny so I have always felt like the fat one in the family. I love food but hate the way he makes me feel and the thought of me getting into a swimming coustume makes me feel sick. I can't enjoy food as I keep thinking its going to make me fat. I wish I could loose weight and change my body and enjoy food like I use to but at the minute if I eat a portion of chips. I hate myself.
Please help with your adive,
Thank you,
Beth x

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Bethhh said on 14 September 2011

Hi guys,
I could really do with some advice. I'm not convinced I have an eating disorder but I feel I have an extremely bad relationship with food. I can't eat a chocolate bar without feeling the worst guilt imaginable. I have absolutely no confidence as it is and hate my body. I am 16 and I have a younger sister who is sports crazy and extremely skinny so I have always felt like the fat one in the family. I love food but hate the way he makes me feel and the thought of me getting into a swimming coustume makes me feel sick. I can't enjoy food as I keep thinking its going to make me fat. I wish I could loose weight and change my body and enjoy food like I use to but at the minute if I eat a portion of chips. I hate myself.
Please help with your adive,
Thank you,
Beth x

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Bethhh said on 14 September 2011

Hi guys,
I could really do with some advice. I'm not convinced I have an eating disorder but I feel I have an extremely bad relationship with food. I can't eat a chocolate bar without feeling the worst guilt imaginable. I have absolutely no confidence as it is and hate my body. I am 16 and I have a younger sister who is sports crazy and extremely skinny so I have always felt like the fat one in the family. I love food but hate the way he makes me feel and the thought of me getting into a swimming coustume makes me feel sick. I can't enjoy food as I keep thinking its going to make me fat. I wish I could loose weight and change my body and enjoy food like I use to but at the minute if I eat a portion of chips. I hate myself.
Please help with your adive,
Thank you,
Beth x

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gummy76 said on 20 June 2011

hi i think my neice may have a eating disorder as she has recently lost over a stone in weight and looking skinny she skips meals and when she eats she goes to the toliet after i could be wrong

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chatsubo said on 20 January 2011

Hi lewis101- obviously my advice is no substitute for a medical diagnosis but the combination of an obsession with cooking programmes and cooking book and a constant desire for dieting are pretty much the classic warning signs of AN.

I strongly recommend that you contact your GP as soon as possible, or visit the beat website

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lewis101 said on 17 January 2011

Iv just joined to ask peoples adivce,
im 19, male and was around 10st, i decicded to try and lose a small bit of weight before christmas so i culd over indulge without feeling massive in the new year. I am obsessed with cooking programmes and cooking books, i love the taste of most foods ad really enjoy food, but due to loosing weight before christmas i got heavily seduced by it and carried on until now, i now weight just over 8 stone and try to consume less then 300 cal pr day and try my hardest to to the gym for 30-90 mins per day, i really want to get out of this but at the same time i dont and wish to carry on until i reach my ultimate goal of 7 stone, can anyone help me?

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sammie0012 said on 19 November 2010

i dont feel like i watch what i eat as i eat anything but i find that i stop eating alot and lose my appetite to such a extream limit that i feel sick putting anything into my mouth, i know that i am underweight as iam 23 years old and my bmi is 15.5 iknw this is not good but i dont know what to do, ifeel like im starving constantly but idont want to eat?

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User456369 said on 12 May 2010

I am 5 ft 4 inches and weight around 48 kg. I realised today that I may be suffering from Anorexia after watching some vedios on You Tube. Can Some one tell me what shall I do?

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Caspar said on 12 April 2010

Dear Bexhillgirl,
please have a look at the beat website. They have a services directory which will inform you of local services which may be of interest. Alternatively you may want to see a different GP who may be more aware of services available to you.

http://www.b-eat.co.uk/Home

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bexhillgirl said on 02 March 2010

I was told this morning that there is no help or suppport for eating disorders,no one that I can be referred to,this is after I have been at a critcal state,at 5'7 and weighing 4 1/2stone,I have a history of severe anorexia nervosa,and there is no help for me in my area.

I have no faith in the NHS.

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