Anorexia Nervosa – Symptoms and Causes

Understanding Anorexia Nervosa

Anorexia nervosa is a serious eating disorder. People with anorexia maintain an abnormally low body weight based on their personal history. While many individuals with anorexia appear very thin, not everyone looks underweight.

Some may even appear at a normal weight or overweight despite having lost significant weight or failed to gain needed weight.

People with anorexia typically experience an intense fear of weight gain. They may perceive themselves as overweight even when they’re dangerously thin. To control their weight, they often restrict food intake severely, both in amount and types of food consumed.

They place extreme importance on controlling their body shape and weight, often employing dangerous methods that can severely impact their health and daily functioning.

The disorder causes brain changes due to malnutrition. This creates a cycle where the unhealthy behaviors aren’t simply choices but symptoms of a serious illness.

Health Risks:

• Heart conditions
• Suicide risk
• Organ damage
• Hormonal imbalances
• Bone loss

Without treatment, severe weight loss can lead to life-threatening complications. Anorexia has the second-highest mortality rate among mental illnesses, exceeded only by deaths from opioid overdoses.

Anorexia extends far beyond concerns about food or appearance—it completely takes over a person’s life and thought patterns. The good news is that with proper treatment, individuals can:

• Return to a healthy weight
• Develop balanced eating habits
• Reverse many of the serious medical complications

The disorder requires professional treatment as it involves complex brain changes that make recovery difficult without proper support. With the right help, recovery is possible.

Signs and Symptoms

Body Changes

Anorexia nervosa causes many physical changes due to the body not getting enough nutrients. Some people with anorexia may not appear very thin, and many hide their weight loss and eating habits from others.

Physical signs include heart rhythm problems and low blood pressure. Many people experience dehydration, which means the body lacks enough fluids to work properly. Skin may appear dry, bluish fingers are common, and some notice yellowing of their skin.

Hair problems are frequent signs:

• Hair that falls out easily
• Brittle, breaking hair
• Fine, downy hair growing on the body

Other physical symptoms include:

Common Physical Signs	Additional Symptoms
Extreme weight loss	Dizziness or fainting
Feeling tired and weak	Constipation and stomach pain
Always feeling cold	Swelling in arms or legs
Dental problems from vomiting	Low concentration
Stomach discomfort	Mood problems
Getting full quickly	Bone problems

Women may stop having menstrual periods if they’re not taking birth control pills.

Mental and Behavioral Changes

People with anorexia often become extremely focused on food. They might cook for others but avoid eating themselves. Many skip meals or make excuses to avoid food.

Common eating behaviors include:

• Eating only certain “safe” foods (usually low-calorie options)
• Following strict eating rules
• Refusing to eat with others
• Lying about how much they’ve eaten

Some people with anorexia cycle between restricting food and binge-purge behaviors. During binges, they eat and feel out of control. Then they try to get rid of calories by vomiting or using laxatives, diuretics, or other products.

Despite these episodes, they still maintain very low body weight.

Other behavioral signs include:

• Exercise problems: Working out even when injured, choosing exercise over fun activities, or exercising much more intensely than others.
• Weight fears: Constant worry about gaining weight, checking weight repeatedly.
• Appearance concerns: Frequent mirror-checking for perceived flaws, wearing baggy clothes to hide the body.
• Body image issues: Believing they’re fat despite being underweight.
• Emotional changes: Seeming emotionless, avoiding social activities, showing irritability, losing interest in sex.
• Sleep problems: Difficulty falling or staying asleep.

Some people with anorexia may harm themselves or have thoughts about suicide.

When Medical Help Is Needed

A key challenge with anorexia is that people who have it often don’t recognize how serious their condition is. This happens because malnutrition affects brain function and thinking.

If someone you know has anorexia, it’s better to act quickly rather than wait. Early treatment leads to better outcomes.

For parents worried about their child’s eating habits or body image, talk with your child’s doctor about your concerns.

If you think you have an eating disorder, reach out for help. For those having suicidal thoughts, call or text 988 to reach the Suicide & Crisis Lifeline.

Causes

Anorexia nervosa develops from several interconnected factors rather than a single cause.

Biological Factors

• Genetic predisposition may increase vulnerability
• Certain personality traits (perfectionism, high sensitivity) have genetic links
• Family history of eating disorders raises risk

Psychological Elements

• Obsessive-compulsive traits can enable strict dietary control
• Perfectionism often appears in those with anorexia
• Strong need for control over one’s body and eating habits

Social Influences

• Western culture’s emphasis on thinness creates pressure
• Social media platforms amplify unrealistic body standards
• Peer environments may encourage unhealthy weight goals
• Well-intentioned “healthy eating” messages can become extreme

The complex interaction between these biological, psychological, and social factors helps explain why anorexia affects different people in different ways. When these elements combine in vulnerable individuals, the risk of developing this serious eating disorder increases significantly.

Risk Factors

Anorexia nervosa can affect anyone regardless of gender, race, age, income level, or body type. However, certain factors may increase someone’s chances of developing this eating disorder:

Family Connection

• Having a parent, sibling, or child with anorexia increases your risk
• Genetic factors may play a role in susceptibility

Weight-Related Experiences

• Past experiences of weight bullying or teasing
• Weight shaming from peers, family members, or authority figures like coaches
• Negative comments about body shape, even casual remarks

Age and Development

Teenagers face higher risk due to:

• Physical changes during puberty
• Increased peer pressure
• Greater sensitivity to comments about appearance

Personal History

• Frequent dieting behaviors
• Pattern of weight fluctuations from trying different diets
• Restrictive eating habits

Life Changes

Major transitions can trigger eating disorders, including:

• Starting at a new school
• Moving to a new home
• Beginning a new job
• Ending relationships
• Experiencing the illness or death of someone close

People who face multiple risk factors should be particularly mindful of changes in their eating patterns and body image concerns.

Complications

Anorexia nervosa can lead to serious health problems throughout the body. In severe cases, it can be fatal. Death might occur suddenly—even in people who don’t appear extremely thin.

Dangerous heart rhythm problems (arrhythmias) and mineral imbalances in the body can lead to death.

The physical complications of anorexia affect multiple body systems:

Heart Problems:

• Irregular heartbeats
• Mitral valve prolapse (improper valve closure)
• Heart failure

Bone and Muscle Issues:

• Significant bone loss (osteoporosis)
• Higher fracture risk
• Muscle wasting

Other Physical Complications:

• Anemia
• Digestive problems (constipation, bloating, nausea)
• Kidney damage
• Hormonal changes (missed periods in females, low testosterone in males)

Severe malnutrition can damage every organ system in the body. Some of this damage may be permanent, even after successful treatment.

Anorexia often occurs alongside other mental health conditions:

• Depression
• Anxiety disorders
• Personality disorders
• Obsessive-compulsive disorders
• Substance abuse problems
• Self-harm behaviors
• Suicidal thoughts or actions

The combination of physical and mental health complications makes anorexia particularly dangerous.

Prevention

While there is no guaranteed way to prevent anorexia nervosa, early intervention can make a significant difference. Healthcare providers play a crucial role in identifying warning signs during routine checkups.

They can start conversations about eating habits and body image that may reveal potential problems.

Parents, teachers, and friends should watch for warning signs such as:

• Extreme or rigid dieting behaviors
• Unhealthy fixation on weight or appearance
• Withdrawal from social eating situations
• Excessive exercise habits

If you notice these behaviors in someone you care about, approach the conversation with compassion. Express your concerns calmly and offer to help them find professional support if needed.

Support organizations can provide valuable resources for both individuals at risk and their loved ones. These groups offer educational materials, support networks, and referral services for treatment options.

Being alert to subtle changes in eating patterns or body image concerns may help someone get help before the condition progresses to a more serious stage.