Eating Disorders | Anorexia Nervosa

What is anorexia nervosa?

Anorexia nervosa is a complicated eating disorder with medical, behavioral, and psychological components. People with anorexia nervosa limit how much and what they eat. Patients with anorexia nervosa are below their body’s ideal weight, typically after significant weight loss. They have a distorted body image, over-preoccupation with food and their body, and an intense fear of gaining weight.

Individuals most commonly develop anorexia nervosa during adolescence. Youth of any gender, race/ethnicity, or socioeconomic background can develop anorexia nervosa. However, many groups, particularly boys, are less likely to be recognized as potentially having any eating disorder.

Anorexia nervosa can be life threatening. Malnutrition experienced as a result of anorexia nervosa places the body in danger. Early diagnosis and treatment are therefore extremely important.

Types of anorexia nervosa

There are two types of anorexia nervosa.

  • Restricting type: An individual severely limits how much and what types of foods they eat.
  • Binge/purge type: An individual restricts their food intake but sometimes will eat an excessive amount and then make themselves throw up or otherwise get rid of the calories.

What are the signs of anorexia nervosa?

If your child is struggling with anorexia nervosa, you may notice them to be more socially withdrawn, irritable, moody, or depressed. Some of the other signs of anorexia nervosa include:

  • intense fear of gaining weight, even while losing weight
  • distorted view of their body, weight, size, or shape; for instance, sees self as overweight despite being severely underweight
  • refusal to maintain a healthy body weight
  • excessive physical activity
  • insistence that they don’t feel hungry
  • preoccupation with food preparation but reluctance or refusal to eat what is prepared

Physical symptoms of anorexia may include:

  • significant weight loss
  • body weight below a healthy range
  • missed or irregular menstrual periods
  • dry skin
  • abdominal pain or bloating after eating
  • constipation
  • fatigue
  • problems maintaining normal body temperature, feeling cold when others are hot
  • development of fine, downy body hair
  • stress fractures

Anorexia nervosa complications

Anorexia is a serious disease. It can affect many systems of your child’s body:

  • Heart: Anorexia nervosa can lead to heart complications such as mitral valve prolapse (a floppy valve in the heart), arrhythmias (a fast, slow or irregular heartbeat), bradycardia (slow heartbeat), hypotension (low blood pressure), and heart failure.
  • Blood: About one-third of teens with anorexia have mild anemia (low red blood cell count). Up to 50 percent of anorexic adolescents develop leukopenia (low white blood cell count).
  • Stomach and intestines: Normal movement in the intestinal tract often slows down with very restricted eating and severe weight loss. Gaining weight, and taking certain medications, can help to restore your child’s normal intestinal function.
  • Kidneys: Individuals with anorexia nervosa may limit their fluid intake leading to dehydration which can result in highly concentrated urine. Polyuria (increased production of urine) may also develop when the kidneys start to lose their ability to concentrate urine. These changes usually return to normal when your child gets back to a normal weight.
  • Hormones: One of the most telling symptoms of anorexia is amenorrhea, or when a girl or woman misses her menstrual cycle for three or more months in a row. Teens with anorexia may also have lower levels of growth hormone, which may explain their failure to grow normally. Normal nutrition usually restores normal growth.
  • Bones: If your child has anorexia, they are at an increased risk for low bone density. If anorexic behavior starts before the bones are fully formed (usually mid to late teens), there is a greater risk of osteopenia (decreased bone tissue) or osteoporosis (bone loss) or fractures.