Anorexia Nervosa

What is anorexia nervosa?

Anorexia nervosa is an eating problem that occurs when you are so afraid of becoming overweight that you eat as little as possible. If you have this disorder, you see yourself as being overweight when you are not.

This condition is both a physical illness and a mental illness. Hormone changes result from the low weight and low levels of body fat. In women menstruation usually stops.

This illness occurs most often in young women. The illness can also occur in athletes, dancers, models, and actors who want to maintain low weight for better performance.

Anorexia nervosa can be a very severe illness. Death may occur from starvation or suicide. If you are pregnant, eating disorders can affect your health and your baby's development.

How does it occur?

The cause of anorexia nervosa is not clear. Part of the cause in many cultures is thinking that being thin means being beautiful.

You may be at risk of developing anorexia nervosa if you:

• have a family history of anorexia nervosa or other eating disorders
• have a family or personal history of mood disorders, such as major depression and bipolar disorder (manic depression), anxiety disorders, or obsessive-compulsive personality disorder.

What are the symptoms?

Signs and symptoms may include:

• severe weight loss (to below healthy body weight) from strict dieting
• binge eating (eating large amounts of food in a short period of time) and purging (using laxatives, diuretics, or making yourself throw up)
• weakness and feeling dizzy
• brittle nails
• increased body hair
• feeling cold all the time
• feeling depressed or anxious
• trouble sleeping
• if you are a woman, not having monthly periods when your weight drops below a certain level
• fasting or eating very little
• too much exercise
• fearing weight gain even when you are underweight
• thinking about food all the time.

How is it diagnosed?

Your healthcare provider will do a physical exam, order lab tests, and ask about your medical history. He or she will ask about your eating and other behaviors, such as:

• always choosing food that is low in calories
• binge eating
• purging, taking laxatives
• ritualistic eating
• over exercising
• withdrawing from friends and usual activities
• denying hunger or denying you have any problem at all.

How is it treated?

Anorexia can be very difficult to treat. It does not go away or get better on its own. Your healthcare provider or dietitian will help you to start eating normally again. Also, you will probably need individual psychotherapy and possibly family therapy. Your healthcare provider may prescribe medicine (especially medicine used for mood disorders) to:

• help reduce your fear of becoming fat
• help reduce depression and anxiety
• help reduce constant thoughts about food and thinness
• help you gain weight.

You may need to be hospitalized if your condition is severe and life threatening.

How long will the problem last?

If you have anorexia, you may stay preoccupied with weight and food for many years. Even after you reach a healthy weight, you may need to continue taking medicine or having therapy for many months. Being under a lot of stress can cause a relapse. The earlier you seek treatment, the more successful it is likely to be.

How can I take care of myself?

Besides following your provider's treatment plan and developing a support network, you can:

• Eat a healthy diet.
• Limit your exercise program as advised by your treatment team.
• Get plenty of rest and sleep.
• Maintain a realistic weight for your height and body frame.
• Take mineral and vitamin supplements, if recommended by your healthcare provider.
• See your healthcare provider regularly to have your weight, blood pressure, heart rate, and temperature checked.
• Keep an optimistic outlook.
• With your therapist, work out areas of conflict in your life. Learn healthy ways to cope with what bothers you.
• Balance your work with recreation and social activities.
• Learn to communicate your feelings.

What can be done to help prevent anorexia nervosa and maintain good physical health?

Accepting yourself and your body can help prevent this problem. In addition you can:

• Keep appointments with your healthcare provider or therapist.
• Do not skip meals.
• Do not use laxatives.
• Do not use diet pills
• Do not drink a lot of caffeine.
• Do not exercise too much.
• Do not drink alcohol.
• Do not smoke cigarettes.

You may want to contact:

Mental Health America (formerly the National Mental Health Association or NMHA). The toll-free number is 800-969-6642. The Web site is http://www.NMHA.org.

National Eating Disorders Association. Their toll-free number is: 800-931-2237. The Web site is http://www.nationaleatingdisorders.org.