Anorexia nervosa

People with anorexia try to keep their weight as low as possible by not eating enough, exercising too much, or both.

*Last updated 25 May 2021

Anorexia nervosa (commonly referred to as anorexia) is an eating disorder and serious mental health problem. Someone with anorexia often has an intense fear of gaining weight and may have a distorted view of their body, thinking they’re fat even when they’re underweight.

People often think anorexia is about dieting, but it’s more complicated than that. It’s linked to low self-esteem, negative body image and many other factors.

Anyone can be affected by anorexia. While it’s more commonly reported by young women, anorexia is increasingly being reported by men and boys, women over the age of 40, and in children as young as seven.

What are the symptoms of anorexia?

If you have anorexia, you may feel:

  • afraid of putting on weight or being fat
  • preoccupied with your weight
  • unable to think about anything other than food
  • as though your body is bigger or a different shape than it really is
  • anxious, especially around mealtimes
  • lacking in confidence and self-esteem
  • irritable and moody
  • that you have very high standards for yourself or you are a perfectionist.

You may also underestimate or deny that you have a problem, even after you’ve been diagnosed.

The physical signs of anorexia include:

  • weight loss
  • lack of sexual interest
  • difficulty sleeping
  • dizziness
  • hair loss
  • constipation, bloating and stomach pains
  • feeling cold and weak
  • soft downy hair (called lanugo) growing all over your body
  • difficulty concentrating
  • low blood pressure
  • periods stopping or becoming irregular.

Anorexia can affect your behaviour. You might:

  • reduce your food intake or stop eating altogether
  • spend a lot of time counting calories
  • avoid food you think is fattening
  • skip meals
  • hide food or throw it away
  • cut food into tiny pieces to make it less obvious you haven’t eaten much or to make it easier to swallow
  • develop rules and rituals around eating, such as listing ‘good’ and ‘bad’ foods
  • eat very slowly
  • exercise a lot
  • take pills that claim to reduce your appetite or speed up your metabolism
  • make yourself sick or use laxatives
  • withdraw from other people and shut yourself off from the world.

With other people you may lie about what you’ve eaten, make excuses about why you’re not eating or pretend you’ve eaten earlier. You might also lie about how much weight you’ve lost.

What causes anorexia?

There is no single cause of anorexia. Everyone’s reasons for developing anorexia can be very different. It usually develops because of a combination of factors.

Common traits

People with anorexia often have common traits, including:

  • low self-esteem, feeling worthless or like you’re not good enough. Losing weight can start to feel like a sense of achievement or a way to feel a sense of worth
  • perfectionism
  • having another mental health conditions, particularly depressionself-harm and anxiety

Social and cultural pressure

Society places a lot of importance on body image, meaning we’re constantly told that how we look reflects our worth. This can leave us feeling ashamed if we don’t fit the model of a ‘good body’.

While these pressures don’t cause eating disorders, they can make us feel we’re not good enough or negatively affect our self-esteem. This can trigger an eating disorder in people already vulnerable to developing one.

Biological and genetic factors

Research shows there may be genetic links to anorexia. Our brain chemicals that control our hunger, appetite and digestion can also make us more likely to develop anorexia. If we have too much or too little of these brain chemicals, or we’re particularly sensitive to them, our appetite and mood can be affected.

What help is available?

Anorexia can happen to anyone. If you’re worried you may have anorexia, contact your GP. They may not be an expert in treating eating disorders, but they will be able to assess any physical symptoms and then refer you to specialist eating disorder services.

Talking therapies

Talking therapies can help you identify the feelings and fears that triggered your anorexia and help you develop a healthier attitude towards food and your body. You may be offered:

  • Cognitive analytical therapy (CAT). This looks at past experiences and events to help you understand why you think, feel and behave the way you do now. Your therapist will then help you develop new tools to cope in a healthier way
  • Cognitive behavioural therapy (CBT). This focuses on identifying and changing the thoughts and beliefs that may trigger your anorexia. Your therapist will help you understand and change disordered thoughts such as ‘everyone thinks I am fat.’ You may be set homework and goals around challenging any unhealthy rules you have around food.

Support for children and young people

The ‘Maudsley Approach’ is a type of therapy to help children and young people with anorexia. It involves parents taking an active role in helping to get their child’s weight to a normal level, gives control of eating choices back to the child, and then encourages them to develop a healthy independence.

Medication

Antidepressants shouldn’t be the only treatment you’re offered. However, you may be offered them alongside self-help or therapy to manage other conditions such as depression, anxiety or obsessive compulsive disorder (OCD).

Inpatient treatment

Most people with anorexia won’t need to go to hospital. However, if your weight is very low, you may be admitted. Your treatment could involve counselling, group and family therapy, and working with a dietician and mental health team.

Ways you can look after yourself

It’s difficult to recover from an eating disorder on your own, but there are things you can try alongside treatment and support. Beat has lots of tips for recovery, and Mind has ideas for self-care including managing relapses, changing unhealthy routines and being careful online.

You may find that support groups are useful. It can be comforting to talk to others who have had the same feelings and experiences. You could join Beat’s online support group for people with anorexia.