What Are the Warning Signs of Anorexia Nervosa?

The West Virginia Department of Education estimates around one percent of young adolescent girls develop a potentially life-threatening eating disorder called anorexia nervosa. Although young women are the most susceptible to this problem, it can occur in teen boys and even adults of all ages. Without anorexia nervosa treatment, many of these individuals are at risk for serious complications that range anywhere from malnutrition to bone loss to heart damage.

The symptoms of anorexia nervosa mimic starvation but the social stigmatism that comes with this illness makes it hard for parents, friends, and family to find a way to help. Eating disorder recovery takes time and requires psychologically gentle approaches designed to find that loved one’s healthy self once again. It starts with an understanding of anorexia nervosa disorder and its symptoms.

What Is Anorexia Nervosa?

Anorexia nervosa is an eating disorder characterized by dangerously low body weight. Treatment seeking individuals often describe an intense fear of gaining weight or looking fat. They tend to have distorted internal perceptions of their body size and weight.

People with eating disorders go to abnormal measures to “fix” what they consider broken about themselves. For those with anorexia nervosa symptoms, these abnormal measures often include:

  • Extreme calorie restrictive diets
  • Excessive exercising
  • Binge-eating episodes
  • Long periods of fasting
  • Rigid eating habits like chewing food and then spitting it out before swallowing

Anorexia nervosa isn’t about food or even body weight. It is a coping mechanism for other problems like depression or poor self-esteem. The obsession comes from believing that if you could just look better everything wrong will disappear from your life including stress, feelings of loneliness and the fear of bullying. Studies show that adolescents with asthma, diabetes and other chronic illnesses are four times more likely to develop this particular eating disorder, as well.

What are the Symptoms of Anorexia Nervosa?

The exact physical symptoms vary from person to person. Some signs you or someone you love might need anorexia nervosa treatment include:

  • Extreme weight loss
  • Not meeting developmental growth milestones
  • Abnormal blood counts such as low red blood cells
  • Feeling tired all the time
  • Inability to sleep
  • Feeling faint
  • Discoloration of the fingertips
  • Thinning hair
  • Soft hair growing on the body
  • Absence of menstruation
  • Chronic constipation
  • Abdominal pain
  • Yellowish tint to skin
  • Dry skin
  • Dry, brittle nails
  • Low blood pressure
  • Feeling cold
  • Swelling in the arms or legs
  • Eroded teeth

There are emotional signs of this condition as well such as:

  • Preoccupation with food
  • Skipping meals
  • Lying about eating
  • Claiming not to be hungry
  • Not wanting to eat at restaurants
  • Obsessively looking in the mirror
  • Obsessive weighing or body measuring
  • Wearing layers of clothes even when it’s hot
  • Lack of emotion
  • Social withdrawal
  • Being irritable
  • Lack of interest in sex

Binge-eating episodes and thoughts of purging food often accompany anorexia nervosa. These symptoms are a sign that this person might benefit from enrollment at one of the anorexia nervosa treatment centers around the country. The goal is daily exposure therapy and moving beyond their eating disorder self back into a healthy relationship with food.

What Causes Anorexia Nervosa?

It is unclear why some individuals develop anorexia nervosa disorder, but it is most likely a combination of genetics, biology, developmental concerns and social influences.


Some individuals have a genetic predisposition to tendencies that lead to anorexia nervosa such as:

  • Perfectionism
  • Hypersensitivity
  • Rigidity
  • Obsessive-compulsive personality traits
  • High levels of anxiety

These traits are typically genetically driven. Medical science has not identified specific genes associated with the condition but that is a growing possibility. There is compelling evidence to indicate genetic factors create a heightened risk of an anorexia nervosa diagnosis. Epigenetics, the influence of environment on the way genes behave, is another strong consideration in the therapy for anorexia nervosa.

Coping Skills

Eating disorders like anorexia nervosa disorder can stem from the inability to cope with negative influences. People can turn to restrictive eating as a way to self-soothe or numb their feelings.

Sociocultural Imaging

Environmental and sociocultural factors like poverty and peer pressure come into play with an anorexia nervosa diagnosis as does how society portrays the perfect body type. Ultra-thin models and celebrities create unrealistic concepts of what the human body should look like and that impacts how people see themselves, especially adolescents whose bodies are changing. Marketing campaigns feature Photoshopped figures while magazines airbrush their cover models. These images work together to trigger the disorder in at-risk individuals. It isn’t until symptoms of anorexia nervosa develop that parents or family realize there is a need for treatment.

A Change in Eating Habits

Some who enter anorexia nervosa recovery started out with a healthy sense of themselves. They may have gained a little weight and began fasting or went on a restricted calorie diet and that triggered obsessive behavior regarding food. The weight loss industry is full of fad diets and potentially misleading products that create unsustainable expectations. More than 90 percent of people who lose weight this way will gain it back in five years. That puts a strain on a person’s soul because they may never get the body they consider normal or beautiful.

Teenagers continue to be the biggest at-risk category in eating disorders because their bodies are changing. Puberty can make a person uncomfortable in their own skin, so they become more sensitive to criticism and peer pressure. Even unassuming remarks about how they are changing can lead to a feeling of being different and not fitting in with their friends.

Transitions or Trauma

Change is hard whether you move to a new city, go to a different school or lose someone you love. Adjusting to new things can create emotional stress that manifests itself as anorexia nervosa. If you keep in mind that the need for eating disorder recovery isn’t about food or weight, but about coping and self-image, you can see how change puts a person at risk.

Trauma is another key factor. It can be physical trauma like being hit or a car accident. It might be emotional trauma such as the loss of a parent or grandparent or bullying at school or on social media. It can be a combination of physical and emotional abuse such as rape or sexual molestation. Focusing on body image provides an unhealthy release of anxiety and fear.

What Are the Complications Associated with Anorexia Nervosa?

Anorexia nervosa, like most eating disorders, does damage to the body and can be fatal. Anorexia nervosa treatment involves a combination of medical and psychiatric care done in or outside a hospital setting. During this time, recovered staff look for major complications associated with the illness such as:

  • Anemia
  • Heart damage and disease
  • Bone loss with an increased risk of fracture
  • Loss of muscle mass
  • Absence of menstruation
  • Decreased testosterone in males
  • Gastrointestinal problems
  • Electrolyte imbalances
  • Kidney damage
  • Severe malnutrition with organ damage
  • Substance abuse
  • Self-injury

The goal is to prevent complications and to identify them early if they do happen. Anorexia nervosa treatment centers develop strategies based on each individual’s needs working towards self-healing and tending to the soul.

How Is Anorexia Nervosa Diagnosed?

The first step will be to rule out other medical causes for the weight loss associated with anorexia nervosa. For example, sudden, unexplained weight loss is a symptom of diabetes or even some forms of cancer. A series of tests can better pinpoint the problem and identify existing complications at the same time. Testing might include:

  • Lab work
  • Physical exam
  • Psychological evaluation
  • Imaging studies
  • Electrocardiogram

Once other causes are ruled out, the staff at an anorexia nervosa treatment center or a mental health professional will follow the diagnostic criteria established in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Anorexia nervosa diagnosis is focused around three key behaviors:

  • Restriction of food intake leading to low body weight
  • Intense fear of gaining weight or being fat
  • Disturbance in how weight or shape is perceived

Not every person will have all three symptoms or behaviors at the same intensity, but this combination is a good indicator. Parents and family members can help in the diagnostic process by looking for overt signs of the eating disorder such as:

  • An intense preoccupation with weight and body shape
  • Seemingly abnormal attitude towards food or eating
  • Changes in personality
  • Changes in social behavior

Recovered staff will look for input when developing anorexia nervosa treatment strategies.

What Are Anorexia Nervosa Treatment Options?

Anorexia nervosa recovery is a complex process, but one that can return this person to their healthy self by providing the highest level of medical and psychiatric care in a homelike setting. Therapy for anorexia nervosa involves 24-hour access to medical staff including nurses and psychiatrists. The staff works with the patient to restore medical and nutritional health without the use of supplements. Treatment involves a combination of individual sessions with their primary therapist, group therapy plus medical and nutritional interventions.

Group therapy is a big part of recovery strategies for anorexia nervosa because it introduces individuals to others with similar concerns. Group therapy is a combination of:

  • Cognitive behavioral therapy
  • Acceptance and commitment therapy
  • Dialectical behavioral skills training
  • Interpersonal process
  • Body image training
  • Expressive art
  • Relapse prevention

Therapy for anorexia nervosa includes comprehensive academic and family support, too, especially for adolescent patients. The most important thing about the process is helping treatment-seeking individuals who enroll in a recovery plan to find the truth without judgment and to manage the damaging impact of their eating disorder. The road to your recovered self includes developing coping skills and healthy approaches to food and eating.

At home, recovered staff will urge patients to stick to their treatment plan and attend their regular therapy sessions. They should avoid social isolation and try to stay away from behaviors that can trigger a relapse like changing establish meal plans, skipping meals and weighing themselves.

Is There a Way to Prevent Anorexia Nervosa?

There is no sure-fire way to prevent anorexia nervosa. Parents, friends, and individuals can look to minimize social pressures and recognize negative influences and thought patterns. Find ways to develop or establish a supportive environment that doesn’t focus on body size, appearance or weight. Avoid fad diets that offer unrealistic results. Instead, follow established and extensively validated nutrition and weight loss plans that encourage healthy lifestyle changes instead of drastic calorie reduction. Know when a problem exists and don’t be afraid to consider therapy for anorexia nervosa if you or someone you love needs it.

Anorexia nervosa is just one of a number of eating disorders that can damage the body and soul. For adolescents, the onset is typically between the ages of 14 and 18 and can lead to a lifetime of poor nutrition, skipping meals, binge-eating and unhealthy obsessing about weight. It can trigger other medically serious eating disorders, as well, such as bulimia nervosa.

The National Association of Anorexia Nervosa and Associated Disorders reports that every 60 minutes one person dies from a condition associated with an eating disorder. Therapy for anorexia nervosa is done outside a hospital setting or through residential treatment for those exhibiting symptoms and in need of medical and psychiatric care.