An estimated 9% of the U.S. population, or 28.8 million Americans, will struggle with an eating disorder at some point in their lifetime.

Among the several types of eating disorders, anorexia nervosa is a severe condition involving an intense fear of weight gain and restrictive eating behaviors used in an attempt to control one’s body weight, shape, or size. Oftentimes, a distorted body image is also present in individuals with anorexia, causing misperceptions of one’s body size or appearance and leading to a destructive cycle of restrictive eating.

Anorexia nervosa can affect any person regardless of age, gender, ethnicity, or socioeconomic background, so it’s crucial to reach out for help if you believe you may be struggling. Let’s talk more about what anorexia nervosa is, its most common warning signs and symptoms, as well as what recovery looks like.

What is Anorexia Nervosa?

Anorexia nervosa is a serious mental health disorder characterized by an intense fear of gaining weight and a distorted body image that leads to self-imposed starvation or restrictive eating and often excessive weight loss. Individuals with anorexia often have a relentless pursuit of thinness and may engage in extreme behaviors to achieve and maintain a lower body weight than what is considered healthy for their age and height.

Key aspects of anorexia nervosa include severe food restriction, an obsessive preoccupation with food, dieting, and body size, as well as a strong desire to control body weight and shape. Physically, individuals with anorexia may also exhibit symptoms such as fatigue, dizziness, emaciation, and changes in skin and hair quality. In addition to the physical consequences, anorexia has profound psychological and emotional effects, including social withdrawal or isolation, irritability, and a distorted perception of one’s body.

Importantly, anorexia nervosa is a complex condition that often coexists with other mental health issues such as, but not limited to, depression, anxiety, and obsessive-compulsive disorder. Treatment for anorexia typically involves a multidisciplinary approach to address all psychological and physical aspects of the disorder.

How Anorexia Nervosa is Diagnosed

According to the DSM-5, an individual must meet the following criteria in order to be diagnosed with anorexia nervosa:

1. Restriction of energy intake relative to requirements: The individual consistently engages in behaviors that result in significantly low caloric intake relative to their energy requirements, often leading to a significantly low body weight for their age, gender, developmental trajectory, and physical health.
2. Intense fear of gaining weight or becoming fat: The individual has a persistent fear of gaining weight or becoming fat, or they exhibit persistent behavior that interferes with weight gain, even if they are underweight. This fear of weight gain is often not alleviated by any type of weight loss.
3. Self-worth is influenced or disturbed by one’s body weight or shape: There is a distorted perception of one’s body weight or shape, and it has a significant impact on self-esteem and self-evaluation. Alternatively, the individual may also deny the seriousness of their low body weight.

Furthermore, there are two subtypes of anorexia nervosa recognized by the DSM-5:

• Restricting Type: The individual primarily engages in dieting, fasting, and other restrictive eating behaviors and has not regularly engaged in binge eating or purging.
• Binge-Eating/Purging Type: Alongside restrictive eating, the individual also engages in recurrent episodes of binge eating or purging behaviors (e.g., self-induced vomiting, abusing diet pills or laxatives).

It’s important to note that the diagnosis of anorexia nervosa requires a comprehensive assessment by a qualified mental health professional, and the criteria should not be applied in isolation. If you believe you or a loved one may be struggling, take our eating disorder screener to gain a better understanding.

Warning Signs and Symptoms of Anorexia Nervosa

Recognizing the warning signs and symptoms of anorexia is crucial for early intervention and support. While the diagnostic criteria provide a formal framework for diagnosis, observing behaviors and physical manifestations can help better identify individuals who may be struggling with anorexia. Although not everyone with anorexia nervosa will necessarily meet or display every single one of these symptoms, the most common warning signs to look out for include:

• Recent changes in eating habits: Drastic changes in eating patterns, such as avoiding meals, eating very small portions, adhering to strict dietary rules, or adopting specific food rituals.
• Physical changes: Noticeable physical signs of malnutrition and undernourishment, such as rapid weight loss, fatigue, dizziness, brittle nails, dry skin, and developing a fine layer of hair on the body (lanugo). 
• Social withdrawal: Avoidance of social events, gatherings, or activities that involve food and/or withdrawal from friends and family.
• Denial of severity: Dismissing concerns about their weight, even when they are underweight or have lost significant weight in a short period of time, and having a distorted perception of their body size.
• Preoccupation with food and body size: Constantly talking about food, calories, dieting, and expressing dissatisfaction with one’s body size and shape.
• Excessive exercise: Engaging in compulsive or excessive exercise routines, often driven by a desire to burn off calories and lose more weight.
• Changes in clothing: Wearing loose or layered clothing in order to conceal body shape and size or recent weight loss.
• Emotional changes: Mood swings, irritability, anxiety, and depression may be present due to the physical and psychological effects of malnutrition.

Note that some of these warning signs may be subtle, making it essential to approach the topic with sensitivity and concern if you’re worried about a loved one. If you suspect that you or a loved one may be struggling with an eating disorder, it’s essential to seek professional help right away to start working toward a successful recovery.

Overcoming Anorexia Nervosa

Treatment for anorexia nervosa varies from person to person depending on their unique needs, specific circumstances, and the severity of the disorder. However, it typically involves a multidisciplinary approach, addressing both the physical and psychological aspects of the eating disorder.

For individuals who are medically underweight, weight restoration is a primary goal which consists of a carefully monitored and controlled refeeding process. Working with a registered dietitian or nutritionist to establish a balanced and individualized meal plan is an essential part of recovery, as this focuses on rebuilding healthy eating habits and addressing any nutritional deficiencies.

Therapy is another essential part of recovery and is often used to address the underlying aspects of the eating disorder and any distorted thought patterns and behaviors related to food, body image, and self-esteem. Other treatment components may include family therapy (particularly beneficial for adolescents), medical stabilization or monitoring, and community support.

Support groups provide individuals with a sense of community and understanding by connecting them with others who are going through similar challenges. Our RecoVERY community is designed to help individuals with all eating disorders reach and maintain lasting recovery. With community and meal support, expert psychoeducation, access to expert care and coaching, and more, our community wraps you in support to help you reimagine your relationship with food and your body.

Wondering if our community is right for you? Start your 30-day free trial to see how it can enhance your recovery journey.

At VERY, our virtual eating recovery treatment helps individuals with all types of eating disorders, including anorexia, receive personalized and focused outpatient care supported by a team of compassionate and specialized professionals. Schedule a free consultation to learn more about how our team can help you reach a full recovery.