Patient education: Anorexia nervosa (The Basics)

What is anorexia nervosa? — Anorexia nervosa, often just called "anorexia," is an eating disorder that makes people want to weigh less than is healthy.

What are the symptoms of anorexia? — People with anorexia:

●Weigh much less than they should for their age and height – To lose weight, people eat too little, exercise too much, or do other things, such as make themselves vomit.

●Are very worried about gaining weight – To avoid gaining weight, they will not eat, even when they are hungry.

●See their body and shape in an abnormal way – For example, they:

•Think that they are fat, even when they are underweight

•Don't understand that their low body weight can cause serious medical problems

•Feel good about themselves when they lose weight and feel bad when they gain weight

It is also common for people with anorexia to:

●Spend a lot of time thinking about food, meals, and calories

●Create rules around food and eating

●Skip meals and avoid eating in public

Anorexia is more common in females than males. It usually begins in the teen or early adult years.

People with anorexia often hide how thin they are or deny that they have a problem. They often don't want treatment, because they don't want to gain weight. But it's important for people to get treatment, because people can get seriously ill and die from anorexia.

Is there a test for anorexia? — No. There is no test. But your doctor or nurse should be able to tell if you have it by talking with you, measuring your height and weight, and doing an exam.

Your doctor or nurse will do tests to check your health, because anorexia can lead to many health problems. You will probably have:

●Blood tests

●Urine tests

●An electrocardiogram ("ECG") – An ECG measures the electrical activity in your heart and records your heart rate and rhythm (figure 1).

What problems can anorexia cause? — Anorexia can cause many problems. That's because the body and brain don't get the nutrition that they need. Anorexia can cause:

●Problems with the brain, heart, lungs, liver, kidney, and glands

●Bone loss and muscle weakness

●Bloating and trouble having bowel movements

●Thinning hair and nails that break easily

●Feeling cold all of the time or often feeling tired

People with anorexia can also have:

●Depression – This is when people feel very sad, empty, or hopeless most of the time, or do not enjoy the things that usually make them happy. In addition, people can have trouble with their sleep, appetite, energy, memory, or concentration. Some people with depression think about hurting themselves. If you are thinking of hurting yourself, call your doctor or nurse right away or go to the hospital. In the US, you can also call or text 988 to reach the Suicide & Crisis Lifeline.

●Anxiety – This is when people worry a lot or think about certain things over and over.

●Problems with alcohol or drug use

●Problems with memory, thinking, or paying attention

●Trouble sleeping

How is anorexia treated? — Treatment for anorexia involves:

●Gaining weight – You will work with your doctor and a dietitian (food expert) to gain weight. The dietitian will make meal plans that can help you gain weight safely and slowly. The doctor will follow your weight and health closely.

●Psychotherapy – Psychotherapy involves meeting with a therapist to talk about your feelings, thoughts, and life. Different kinds of psychotherapy can be helpful, including:

•Working one-on-one with a therapist

•Group therapy – You can join a group for people with eating disorders.

•Family therapy – Your family can work with a therapist.

Medicines are not usually used to treat anorexia, except in certain cases when the above treatments alone don't help.

Some people can be treated at home, but others need to be treated in the hospital. It depends on the person's weight, symptoms, and health problems. Treatment for anorexia can be hard work, and it can take a long time. A complete recovery can take years.

What happens after treatment? — Many people get better with treatment. But people with anorexia often "relapse." This is when their symptoms return and they lose weight again.

To help prevent a relapse, follow your treatment plan and keep seeing your therapist. If you start to have symptoms again, let your family, therapist, or doctor know as soon as possible so that you can get help.

More on this topic

Patient education: Bulimia nervosa (The Basics)
Patient education: Depression in adults (The Basics)
Patient education: Generalized anxiety disorder (The Basics)
Patient education: Medicines for depression (The Basics)
Patient education: Malnutrition (The Basics)
Patient education: Malnutrition – Discharge instructions (The Basics)

Patient education: Depression in children and adolescents (Beyond the Basics)
Patient education: Depression in adults (Beyond the Basics)