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Anorexia Nervosa

Anorexia nervosa is an eating disorder. It’s a serious, potentially life-threatening, mental health condition.

People who have anorexia are very anxious about their weight and body shape. They try to keep their weight as low as possible by strictly controlling what they eat. Many people with anorexia will also exercise excessively.

They may also use other methods to try to control their weight, like using laxatives, vomiting after eating, and taking stimulant drugs.

Symptoms of anorexia

Signs and symptoms of anorexia include:

  • fear of ‘being fat’ or gaining weight
  • problems with self-esteem and body image when it comes to food and weight
  • restricting food intake
  • keeping your body weight low, to the point it’s unhealthy

Restricting your food intake means your body isn’t getting enough energy or nutrition. This can lead to other physical symptoms.

Other signs of anorexia

Eating too little for a long time can cause physical symptoms, like:

  • fine downy hair (lanugo) growing on the body
  • more hair on the face
  • pubic hair becoming sparse and thin
  • slow or irregular heartbeat

People with anorexia may also:

  • have pain in their abdomen (tummy)
  • feel bloated or constipated
  • have swelling in their feet, hands or face
  • feel very tired
  • have low blood pressure (hypotension)
  • feel cold or have a low body temperature
  • feel light-headed or dizzy

In children with anorexia, puberty and the associated growth spurt may be delayed. They may gain less weight than expected for someone going through puberty. They might be shorter than other people of the same age.

If you get periods and you have anorexia, your periods may stop. Anorexia can also lead to infertility, for both men and women.

Getting help for anorexia

Speak to your GP if you think you have:

  • an eating problem
  • anorexia

Helping someone else with anorexia

If someone close to you is showing signs of anorexia, you can offer help and support.

You could try talking to them about how they feel, and encourage them to think about getting help. Try not to put pressure on them or be critical of them, as this could make things worse. You could also offer to help by going with the person to see their GP.

If you’d like to get some advice on how to help, a healthcare professional, such as your own GP, can provide information on:

  • how to help the person recognize that they have a problem
  • the treatments available
  • how you can support them during their treatment

You could also get help from a support group for people who have loved ones with eating disorders.

Diagnosing anorexia

When making a diagnosis, your GP will probably ask questions about your weight and eating habits.

For example, they might:

  • ask if you’ve lost a lot of weight recently or quite quickly
  • ask how you feel about your weight, and if you’re concerned about it
  • ask if you make yourself vomit regularly
  • check if you have periods, whether your periods have stopped and if so, for how long
  • check your weight
  • check your pulse and blood pressure
  • do a blood test

It’s important to answer these questions honestly. Your GP isn’t trying to judge you. They just need to accurately assess your symptoms.

Referral to a specialist

If your GP thinks you may have anorexia, they’ll refer you to a specialist in eating disorders for a more detailed assessment. Your GP sometimes carries out this assessment.

Treatment for anorexia

Treatment for anorexia usually involves a combination of:

  • talking therapy, and
  • supervised weight gain

It’s important to start treatment as early as possible to reduce the risk of serious complications.

Treatment for anorexia is slightly different for adults and those under 18 years old.

Complications of anorexia

If someone has anorexia for a long time, it can lead to severe complications and health problems. These can sometimes be permanent.

People with anorexia have an increased risk of:

  • poor circulation and cardiovascular problems
  • heart conditions, like coronary heart disease and irregular heartbeat (arrhythmia)
  • health problems caused by malnutrition – a lack of vitamins and minerals

Anorexia can cause an imbalance of minerals in the blood, like potassium, calcium and sodium. These minerals help keep you healthy. When there’s an imbalance, it can cause symptoms like:

  • tiredness
  • weakness
  • dehydration
  • fits
  • irregular heartbeat (arrhythmia)
  • muscle spasms
  • confusion

Health conditions

Other conditions that can be caused by anorexia and malnutrition can include:

  • low blood pressure (hypotension)
  • anemia
  • dental problems, like tooth decay caused by regular vomiting
  • low blood sugar levels (hypoglycemia)
  • acute kidney (renal) failure
  • liver damage
  • heart failure
  • osteoporosis (fragile bones) and loss of muscle strength, particularly in women and girls
  • loss of sex drive (libido) and impotency in men

Misuse of laxatives can damage the bowels and cause permanent constipation.

Anorexia and pregnancy

Anorexia can lead to irregular menstrual cycles (periods), or cause your periods to stop altogether. This doesn’t mean anorexia makes you infertile.

If you have anorexia, even if your periods are irregular or have stopped, you should continue to use birth control if you aren’t planning a pregnancy.

If you have anorexia and are trying to become pregnant, you should discuss this with your GP and care team.

Anorexia during pregnancy can increase the risk of complications, like:

  • miscarriage
  • giving birth early (premature birth)
  • having a baby with a low birth weight

You’re also likely to need extra care and support during pregnancy if you have previously had anorexia and recovered from it.