Anorexia Nervosa

What is Anorexia Nervosa?

Anorexia nervosa is a serious and potentially life-threatening eating disorder characterized by extreme food restriction, an intense fear of gaining weight, and a distorted body image. People with anorexia often see themselves as overweight, even when they are dangerously underweight, leading them to engage in restrictive eating, excessive exercise, or other behaviors to maintain an unhealthily low body weight. This disorder is not simply about food or weight—it is deeply rooted in emotional and psychological distress, often linked to anxiety, perfectionism, or a need for control. Left untreated, anorexia can cause severe physical complications, including heart problems, bone loss, and organ failure, making early intervention crucial.

If you or a loved one is struggling with anorexia, know that recovery is possible with the right support. Treatment often involves a combination of medical care, nutritional counseling, and therapy to address both the physical and emotional aspects of the disorder. Cognitive-behavioral therapy (CBT) and other evidence-based approaches can help individuals rebuild a healthy relationship with food and their bodies. Seeking help can feel overwhelming, but you don’t have to do it alone—recovery is a journey, and there are compassionate professionals ready to guide you every step of the way.

Types of Anorexia Nervosa

1. Restricting Type

The restricting type of anorexia nervosa is characterized by severe food restriction without regular episodes of binge eating or purging. Individuals with this type of anorexia often limit their calorie intake through extreme dieting, skipping meals, or avoiding entire food groups. They may also engage in excessive exercise to maintain or lose weight. This pattern of restriction is driven by an intense fear of weight gain and a distorted body image, making early intervention essential to prevent serious physical and psychological complications.

2. Binge/Purge Type

The binge/purge type of anorexia nervosa involves periods of food restriction followed by episodes of binge eating and/or purging behaviors, such as self-induced vomiting, excessive exercise, or misuse of laxatives and diuretics. Unlike bulimia, individuals with this type of anorexia remain significantly underweight. The cycle of bingeing and purging is driven by an intense fear of weight gain and a distorted body image, often leading to severe physical and emotional health risks, including electrolyte imbalances, heart issues, and gastrointestinal damage.

Symptoms of Anorexia Nervosa

Physical Symptoms:

Significant weight loss or failure to maintain a healthy weight
Extreme thinness (emaciation)
Fatigue and low energy
Dizziness or fainting
Brittle nails and thinning hair
Dry, yellowish skin
Lanugo (fine hair growth on the body)
Intolerance to cold temperatures
Irregular or missing menstrual periods (amenorrhea)
Slow heart rate and low blood pressure
Muscle weakness and loss of muscle mass
Digestive issues, such as constipation and bloating

Behavioral Symptoms:

Severe food restriction and avoidance of certain food groups
Counting calories obsessively
Skipping meals or eating very small portions
Excessive exercise, even when feeling weak or injured
Hiding or throwing away food
Ritualistic eating habits (cutting food into tiny pieces, eating very slowly, etc.)
Refusal to eat in public or with others
Wearing oversized clothing to hide weight loss
Lying about food intake

Emotional & Psychological Symptoms:

Intense fear of gaining weight, even when underweight
Distorted body image (seeing oneself as overweight despite being thin)
Preoccupation with food, dieting, and body weight
Anxiety or guilt around eating
Depression, irritability, or mood swings
Withdrawal from friends, family, and social activities
Perfectionism and a strong need for control

What Causes Anorexia Nervosa?

Anorexia nervosa is a complex eating disorder with no single cause. Instead, it develops from a combination of biological, psychological, and environmental factors that contribute to restrictive eating behaviors, an intense fear of weight gain, and a distorted body image. While the exact cause varies from person to person, research suggests that genetic predisposition, neurodevelopmental conditions, emotional regulation difficulties, and societal pressures all play a role in its onset and progression.

Genetic and Biological Factors

Studies suggest that genetics play a significant role in the development of anorexia. Individuals with a family history of eating disorders, anxiety, or obsessive-compulsive traits may be at a higher risk. Additionally, research has linked anorexia to neurobiological differences, including:

Dysregulated dopamine and serotonin levels, which influence mood, anxiety, and appetite control.
Alterations in hunger and fullness cues, making individuals less responsive to natural hunger signals.
Heightened reward responses to weight loss and self-control, reinforcing restrictive eating behaviors.

Neurodevelopmental Factors: OCD, Autism, and ADHD

Anorexia nervosa is often linked to neurodevelopmental conditions that affect thinking patterns, routines, and emotional regulation:

Obsessive-Compulsive Disorder (OCD): Many individuals with anorexia display perfectionism, rigid thinking, and compulsive behaviors, which are common traits in OCD. They may develop strict food rules, engage in ritualistic eating behaviors, and feel intense anxiety if those routines are disrupted.
Autism Spectrum Disorder (ASD): Research shows a strong connection between anorexia and autism, particularly in individuals who struggle with sensory sensitivities, rigid routines, and black-and-white thinking. Autistic individuals may avoid foods due to texture, taste, or temperature preferences, and they may fixate on food-related rules or numbers, making recovery more challenging.
Attention-Deficit/Hyperactivity Disorder (ADHD): While ADHD is more commonly linked to binge eating, some individuals with ADHD develop anorexia due to impulsivity, perfectionism, or difficulties recognizing hunger cues. Those with ADHD may hyperfocus on restrictive eating as a form of control or structure in their lives.

Emotional Dysregulation and Trauma

Anorexia is often a way for individuals to cope with overwhelming emotions, stress, or past trauma. Many people with anorexia struggle with emotional dysregulation, anxiety, or depression, making food restriction a form of self-soothing or control. Trauma, including childhood abuse, bullying, or negative body-related comments, can contribute to the development of disordered eating as a way to regain a sense of safety or worth.

Sociocultural and Environmental Influences

Cultural messages about thinness, dieting, and self-worth play a major role in the onset of anorexia. Factors that increase the risk include:

Media and social pressure: Unrealistic beauty standards in magazines, movies, and social media can reinforce the belief that thinness equals success or attractiveness.
Family dynamics: Growing up in an environment that emphasizes weight control, appearance, or perfectionism can contribute to the development of disordered eating.
High-achieving environments: Individuals in competitive fields such as ballet, modeling, athletics, or acting are at a higher risk due to pressure to maintain a certain body size.