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What is anorexia nervosa?

Anorexia nervosa is an eating disorder where the person restricts food or exercises excessively, or both, with the purpose to lose weight or keep the weight as low as possible. Anorexia is characterised by an intense fear of gaining weight and a distorted perception of the body and weight, which makes the person see himself as fat, even though his weight is under the recommended level. To reduce their weight, people with anorexia do extreme diets, fasting, taking medication to reduce hunger, and sometimes, in the most complicated cases, eating very little or almost nothing.

Sometimes, apart from reducing the calorie intake, people with anorexia can use other methods to reduce weight, such as using diuretics, laxatives, exercising excessively, or purging and vomiting after eating. As Beat Eating Disorders explains, “they may develop rules around what they feel they can and cannot eat, as well as things like when and where they’ll eat”.

People affected can lose between 15 to 50% of their body weight, leading to serious mental and physical issues. This condition can affect anyone of any age, gender, ethnicity, or background, although, as in bulimiabinge eating, and other eating disorders, it is more often in young girls.


The causes of anorexia are unknown, but the National Institute of Mental Health explains that eating disorders are caused by a complex interaction of genetic, biological, behavioural, psychological, and social factors. This institution says that researchers are using the latest technology and science to understand eating disorders better.

Some of the factors that can increase the probability to suffer from anorexia are:

  • If the person suffers from obesity.
  • If the patient’s mother is obese.
  • Having suffered a significant loss.
  • The parent’s divorce.
  • Accidents or traumatic events.
  • Having been sexually abused.
  • Scholar failure or other problems at school.
  • Family with a history of eating disorders.
  • Family with a history of depression or alcohol or drug addiction.
  • Suffering from body dissatisfaction or having been criticised for your weight.
  • Suffering from anxiety or low self-esteem.
  • Having a perfectionist or obsessive personality.


Anorexia’s primary symptoms include:

  • An important weight loss caused by the patient’s diet or restriction methods.
  • A wrong perception of the body and the personal weight.
  • Body dissatisfaction. 

Because of these symptoms, the person will refuse to eat correctly or gain back a healthy weight.

As the person is not eating a healthy diet, and the food intake is limited, the mechanisms that regulate hunger are impacted, and the person stops feeling hungry as an average person.

Anorexia can have other adverse effects on the mental health of the person:

  • Depression, low mood and other emotional issues.
  • Irritability.
  • Superstitions.
  • Dichotomous thinking.
  • Negativism.

Long-term anorexia can lead to serious physical problems:

  • Amenorrhea or loss of menstruation.
  • Chronic constipation.
  • Abdominal pain.
  • Vomiting and, in consequence, dental issues.
  • Arrythmias, that can cause a heart attack.
  • The heartbeat slows down.
  • Low blood pressure.
  • Loss of bone mass and if the anorexia starts early in life, it can slow down or stop the child development.
  • Anaemia.
  • Slower metabolism, that produces a feeling of constant cold.
  • Dehydration and dry skin.
  • Hair loss.
  • Swelling in the feet, hands or face.
  • Loss of sex drive.
  • Fertility problems.
  • Kidney or bowel problems.

The National Eating Disorders Association has extensive information of all the possible health consequences of anorexia.

Ultimately, as the NHS warns, “anorexia can also put your life at risk. It’s one of the leading causes of deaths related to mental health problems. Deaths from anorexia may be due to physical complications or suicide”.

The National Eating Disorders Association has extensive information of all the possible health consequences of anorexia.

Ultimately, as the NHS warns, “anorexia can also put your life at risk. It’s one of the leading causes of deaths related to mental health problems. Deaths from anorexia may be due to physical complications or suicide”.


As with any other mental health condition, anorexia has better prognostic if intervening early. For this reason, it is crucial that the family detect the initial symptoms:

  • Worrying too much about food calories, including counting calories.
  • Feeling cold constantly.
  • Progressively eating less and less food.
  • Too much thought or even obsession with the weight and the body.
  • Hyperactivity.
  • Lying to avoid eating food.
  • Restricting specific food, usually carbohydrates or fat.


If the severity of the condition is high, the patient might need inpatient treatment. In other cases, the patient won’t require hospitalisation, but in any case, the purpose of the treatment for anorexia nervosa is to reverse the patient’s malnutrition and mental health problems. Initially, it is crucial to gain weight by implementing a healthy diet, as starvation and low weight can lead to the risk of death.

Psychotherapy is essential to recover from anorexia, and the type of therapy that has been proven most successful for eating disorders is Cognitive-behavioural therapy (CBT). The purpose of this therapy is to bring to awareness the thoughts that the person is having about their weight and the food, challenge those thoughts, and replace them for other more realistic and accurate, less dramatic and disproportionate.

Other types of therapies useful for anorexia include:

Once the person has started to eat an appropriate diet and has gained healthy weight, the rest of the physical problems, such as the loss of menstruation, should come back to normal with time, although this can take a while to reverse.

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