What is Anorexia Nervosa/
Atypical Anorexia?
Anorexia Nervosa
Anorexia nervosa is an eating disorder where individuals engage in limiting the number of calories and often the types of food they eat leading to their bodies not receiving the nutrition that they need to function effectively based on their height, age, gender, physical health. This leads to weight loss and malnutrition that can be dangerous. It can impact individuals of different cultures and ethnicities, shapes and sizes, identities and orientations, cognitive and physical abilities, and socioeconomic levels. Because the diagnosis is based on the DSM-5 (Diagnostic and Statistical manual) criteria, it may not present in the same way for all races or ethnicities nor does it truly cover the intricacies for those that are transgender and/or being prescribed hormonal therapy treatment to support in transitioning.
Individuals experience an intense fear of gaining weight or becoming “fat” even when they are at lower weights. Individuals can experience significant distortions of how they view themselves that then further drives their motivation to lose more weight. Some may describe the distortion as looking at themselves in a fun house mirror and seeing their shape and size very differently than how they appear.
Individuals with anorexia nervosa often experience:
- A drive to be in a smaller body or to be thinner
- Cycles of bingeing and purging
- Frequent trips to the bathroom during or after meals when experiencing the binge/purge subtype
- Restriction and/or fasting generally and between bingeing and purging
- Preoccupation with how one’s body looks and feels
- Patterns of hiding or hoarding food or food wrappers
- Engaging in behaviors alone or in secret
- Withdrawal and disinterest in values driven activities, changes in mood, periods of isolation, impacts on focus and concentration
Anorexia nervosa restricting type
As restriction behaviors increase in frequency and/or intensity, individuals will experience weight loss that can be dangerous and may experience symptoms of the body slowing down related to the weight loss and restriction including dry skin, hair loss, lanugo or fine hair development on the face to help with temperature regulation, brittle nails, low blood pressure (hypotension), low pulse (bradycardia), loss of or delayed onset of menstrual cycle or a lighter than normal cycle, bone changes or loss (osteopenia or osteoporosis).
Anorexia nervosa binge/purge type
As bingeing and purging behaviors increase in frequency and/or intensity, individuals may experience physical symptoms that impact their functioning. Often, the physical symptoms may be dependent upon the type of purging:
- With self induced vomiting individuals may experience acid reflux, nausea, throat irritation, broken blood vessels in eyes, increased nosebleeds, blood in vomit, dental complaints including teeth sensitivity, staining or discoloration of teeth, enamel erosion, increased cavities, swollen cheek or jaw areas, calluses on the back of hands or knuckles, and cracks in corners of the mouth.
- With misuse of diuretics or enemas individuals may have increased urination or diarrhea respectively.
- With any form of purging individuals can develop dangerous and sometimes lethal electrolyte abnormalities, dehydration, and heart rhythm changes.
Atypical Anorexia
1 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)