Anorexia Nervosa

What is Anorexia Nervosa?

Anorexia (or anorexia nervosa) is a serious mental illness that often causes individuals to limit how much they eat or drink. Some people develop strict “rules” about what, when, or where they can eat. 

Anorexia can affect anyone regardless of age, gender, ethnicity, or background. While it is typically characterised by low body weight, people can be very unwell at any weight. Some may experience the same symptoms without being underweight - this is known as atypical anorexia, a related diagnosis. It’s important to remember that you can never tell how unwell someone is just by looking at them or considering their weight.

There are two main subtypes of anorexia nervosa:

• Restricting subtype (AN-R): Characterised by severe restriction of the amount and type of food they eat. Behaviours may include skipping meals, counting calories, and following rigid food rules.
• Binge–purge subtype (AN-BP): This also involves restriction, but people may also do lots of exercise, make themselves sick, or misuse laxatives to “get rid” of food eaten. They may also experience cycles of bingeing (eating large amounts of food at once whilst feeling out of control) and then purging.

Sometimes AN-BP can be confused with bulimia nervosa. However, the main difference is that people with AN-BP continue to restrict their intake overall and are typically underweight, whereas people with bulimia nervosa are usually within or above what is considered a healthy weight range. Both are serious and deserving of support.

What symptoms are there?

Weight and shape may be a big factor in someone with anorexia’s sense of self-worth. This can lead to them checking their body regularly and weighing themselves or avoiding scales and mirrors. People with anorexia may have a distorted image of themselves, meaning that they see themselves as bigger than they really are. They may also experience a deep fear of gaining weight.

Sometimes, someone’s symptoms may not exactly match everything a doctor checks for to diagnose anorexia – for example, they may be a weight considered a “normal” weight for their age, sex, and expected development. In this case, they might be diagnosed with atypical anorexia, which is classed as a type of other specified feeding or eating disorder (OSFED). This is just as serious as anorexia nervosa and can develop both into and from it. People with any eating disorder should get treatment as quickly as possible.

Is Anorexia serious?

Yes, very. Anorexia can cause severe physical problems because of the effects of starvation on the body. It can lead to loss of muscle strength and reduced bone strength. People who have periods may find that they stop, which is known as ‘amenorrhoea’. They may also find that their sex drive decreases.

The illness can affect people’s relationship with family and friends, causing them to withdraw; it can also have an impact on their work or education. As with other eating disorders, anorexia can be associated with depression, low self-esteem, anxiety, and other complications and comorbidities. The seriousness of the physical and emotional consequences of the condition may not always be acknowledged or recognised, and those with anorexia may find it difficult to seek help – they may go to great lengths to hide their behaviour from loved ones, or sometimes might not realise that they’re ill.

How can you tell if someone is struggling?

Anorexia in children and young people is similar to that in adults in terms of its psychological characteristics. But children and young people might, in addition to being of low weight, also be smaller in stature than other people their age, and slower to develop physically.

There are a number of signs of anorexia, but someone doesn’t have to have all of them to be suffering. It’s not always obvious that someone has an eating disorder – remember, they are mental illnesses.  If you’re at all worried about yourself or someone else, even if only some of the signs on this page are present, it’s always best to seek help as quickly as possible, as this gives the greatest chance of a full recovery. The first step is usually to make an appointment with the GP.