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Anorexia Nervosa

Anorexia Nervosa

Anorexia nervosa is an eating disorder. People with anorexia struggle to keep their weight at or above the normal range for their age and height.

Anorexia most often develops in the teenage years. It often continues into adulthood.

People with anorexia often:

  • Have an intense fear of weight gain
  • Do many things to prevent weight gain
  • Perceive their body weight or shape in a way that is not true
  • Do not know how severe their low body weight is

To lose weight, people with anorexia often:

  • Restrict food
  • Exercise too much
  • Make themselves vomit
  • Abuse laxatives after meals

Eating disorders are a type of mental illness. It’s vital to seek treatment for anorexia. The effects can be deadly.

There are two types of anorexia: restrictive type and binge-eating / purging type.

Types of Anorexia Nervosa

Restricting Type

The person places extreme limits on the amount of food they eat. They do not binge-eat on a normal basis.

Binge-Eating / Purging Type

The underweight person does one or more of these:

  • Binge eats (uncontrolled overeating) from time to time
  • Purges by making themselves vomit
  • Takes large amounts of laxatives, diet pills or diuretics

How Common Is Anorexia Nervosa?

Millions of Americans are affected by anorexia at some time in their life. This has increased over the years.

Anorexia affects:

  • Mostly teens and young adults, but can also affect older and younger people
  • Mostly females, but is growing in males
  • People of any gender, age, race, ethnic background, body shape, weight, sexual orientation and income level

Signs and Symptoms of Anorexia Nervosa

Signs and symptoms are not always the same for each person. 

People with anorexia often:

  • Feel fat, even when very thin 
  • Are obsessed with food, weight, or body shape 
  • Have strange eating behaviors or routines
  • Exercise more than normal 

Physical symptoms are often due to severe malnutrition. They can include:

  • Missed menstrual cycle (period)
  • Low heart rate or low blood pressure
  • Dry skin or yellow tinted skin
  • Breasts that become smaller
  • Slow or delayed puberty and growth
  • Lanugo (fine soft hair that grows on the arms and legs)
  • Feeling very tired
  • Not able to handle cold temperatures 
  • Feeling dizzy or passing out 
  • Belly pain 
  • Problems passing stool (constipation) 
  • Feeling more irritable

Risk Factors

People with these traits have a higher risk of anorexia: 

  • Thinking their body’s shape or weight is large when it is not
  • Restricted feelings or depression
  • Showing little insight into the problem

Causes of Anorexia Nervosa

Research is still being done on the cause of anorexia. It’s believed that it stems from a blend of biological, psychological and social factors. Studies show that anorexia runs in families. People with anorexia may have a first-degree family member, like a parent or sibling, who also had an eating disorder. 

Social Pressure

Our culture has standards for woman that can’t be met.  Women are often told they need to be thin and flawless. Many images we see in the media have been altered and are not real. 

Sometimes, people try to lose weight for a sport (like ballet, gymnastics or running). This can lead to a pattern of diet and exercise that is not healthy. This can trigger someone with risk factors for anorexia to develop it. 

Psychological Factors

Some psychological traits can put a person at an increased risk for anorexia.

These people tend to:

  • Hold in their feelings
  • Want everything to be perfect
  • Be rigid or not flexible in their thinking 

When people are stressed, most turn to patterns of thoughts and actions that are normal for them. This makes them feel secure. Many people have a change in their exercise or eating habits when under stress. For some, this can lead to the development of an eating disorder. 

Diagnosis of Anorexia Nervosa

Anorexia can’t be diagnosed by a test or lab result. The doctor will do a physical exam and rule out other causes of weight loss. There will also be an in-depth psychological assessment. 

At Cincinnati Children’s, your child may see any of these team members:

  • Medical doctors that are experts in the care of teens
  • Mental health experts such as:
    • Child psychiatrists
    • Child psychologists
    • Mental health therapists
  • Registered dietitians who are experts in nutrition

Recovery and Treatment

The course of anorexia varies from person to person, but it is very possible to recover. Rates of teens who recover come close to 90 percent nationwide. 

Though some people with anorexia deal with this disorder their whole lives, research shows that early treatment leads to the best outcomes. Seek help if you notice signs of anorexia so that treatment can begin as soon as possible. 

 Treatment is based on: 

  • Age, overall health and history 
  • Types of symptoms and how severe they are
  • How the person handles each procedure or therapy 
  • What the person expects for the course of the condition 
  • The family’s ability to take part in the treatment 

Family Involvement

Parents and family play a vital role in the recovery process. 

Anorexia is most often treated with a blend of:

  • Individual therapy
  • Family therapy
  • Behavior modification
  • Nutritional rehabilitation 

Treatment is based on a full evaluation of the child and family. The evidence-based treatment model used at Cincinnati Children’s is called family-based treatment (FBT). This is also known as the Maudsley approach. 

Types of Treatment Programs

At Cincinnati Children’s, we offer these types of treatment programs for eating disorders:

  • Inpatient
  • Outpatient
  • Partial hospitalization 

The treatment and the type of treatment program advised are based on each child’s health status, psychological needs, behaviors and social factors.

Long-Term Outlook

Children and teens who have battled anorexia may face life-threatening problems from health conditions brought on by their eating disorder. 

The severe lack of nutrition in people with anorexia can lead to problems with the:

  • Cardiovascular system / heart
  • Gastrointestinal system / colon and stomach
  • Neurological system / brain
  • Endocrine system / hormones, growth and development 

Depression is also common in those who have an eating disorder. There is an increased risk of suicide. 

It can take a long time for a person to recover, and they can relapse. But people are able to fully recover. Many people with anorexia are able to heal both physically and mentally. They can lead healthy, happy lives free of worry about weight, shape and food.

Last Updated 07/2021

Reviewed By Sara Hughes, RN

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The Eating Disorders Program at Cincinnati Children's treats patients who have significantly unhealthy eating behaviors.