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Anorexia Nervosa

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What Are the Symptoms of Anorexia?

The symptoms of anorexia often include the following:

  • Rapid weight loss over several weeks or months
  • Continuing to diet/limited eating even when thin or when weight is very low
  • Having an unusual interest in food, calories, nutrition, or cooking
  • Intense fear of gaining weight
  • Strange eating habits or routines, such as eating in secret
  • Feeling fat, even if underweight
  • Inability to realistically assess one's own body weight
  • Striving for perfection and being very self-critical
  • Undue influence of body weight or shape on self-esteem
  • Depression, anxiety, or irritability
  • Infrequent or irregular, or even missed menstrual periods in females
  • Laxative, diuretic, or diet pill use
  • Frequent illness
  • Wearing loose clothing to hide weight loss
  • Compulsive exercising
  • Feeling worthless or hopeless
  • Social withdrawal
  • Physical symptoms that develop over time, including: low tolerance of cold weather, brittle hair and nails, dry or yellowing skin, anemia, constipation, swollen joints, tooth decay, and a new growth of thin hair over the body

Untreated, anorexia nervosa can lead to:

  • Damaged organs, especially the heart, brain, and kidneys
  • Drop in blood pressure, pulse, and breathing rates
  • Loss of hair
  • Irregular heart beat
  • Thinning of bones (osteoporosis)
  • Fluid-electrolyte imbalance
  • Death from starvation or suicide

 

How Is Anorexia Diagnosed?

Identifying anorexia can be challenging. Secrecy, shame, and denial are characteristics of the disorder. As a result, the illness can go undetected for long periods of time.

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no laboratory tests to specifically diagnose anorexia, the doctor might use various diagnostic tests, such as blood tests, to rule out physical illness as the cause of the weight loss, as well as to evaluate the effects of the weight loss on the body's organs.

If no physical illness is found, the person might be referred to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists may use specially designed interview and assessment tools to evaluate a person for an eating disorder.

What Is the Treatment for Anorexia?

Emergency care for anorexia may be needed in some extreme cases where dehydration, malnutrition, kidney failure, or an irregular heartbeat may pose imminent risk to life.

Emergency or not, treatment of anorexia is challenging because most people with the disorder deny they have a problem. Like all eating disorders, anorexia requires a comprehensive treatment plan that is adjusted to meet the needs of each patient.

Goals of treatment include restoring the person to a healthy weight, treating emotional issues such as low self-esteem, correcting distorted thinking patterns, and developing long-term behavioral changes. Treatment most often involves a combination of the following treatment methods:

  • Psychotherapy: This is a type of individual counseling that focuses on changing the thinking (cognitive therapy) and behavior (behavioral therapy) of a person with an eating disorder. Treatment includes practical techniques for developing healthy attitudes toward food and weight, as well as approaches for changing the way the person responds to difficult situations.
  • Medication: Certain antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) might be used to help control anxiety and depression associated with an eating disorder. Some antidepressants may also help with sleep and stimulate appetite. Other types of medications also might be offered to help control anxiety and/or distorted attitudes toward eating and body image.
  • Nutrition counseling: This strategy is designed to teach a healthy approach to food and weight, to help restore normal eating patterns, and to teach the importance of nutrition and following a balanced diet.
  • Group and/or family therapy: Family support is very important to treatment success. It is important that family members understand the eating disorder and recognize its signs and symptoms. People with eating disorders might benefit from group therapy, where they can find support, and openly discuss their feelings and concerns with others who share common experiences and problems.
  • Hospitalization: As mentioned above, hospitalization might be needed to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications, such as heart disorders, serious depression, and risk of suicide. In some cases, the patient may need to be fed through a feeding tube or through an IV.

 

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