Signs of Anorexia

Some of the more common signs of anorexia nervosa are:

Behavioural signs

• Saying they have eaten earlier or will eat later, or that they have eaten more than they have
• Not being truthful about how much weight they have lost
• Strict dieting and avoiding food they think is fattening
• Counting the calories in food excessively
• Eating only low-calorie food
• Missing meals (fasting)
• Avoiding eating with other people
• Hiding food
• Cutting food into tiny pieces to make it less obvious they have eaten little or to make food easier to swallow
• Eating very slowly
• Taking appetite suppressants, such as slimming or diet pills
• Obsessive and/or rigid behaviour, particularly around food
• Irritability
• Excessive exercising – this might involve exercising when not physically well enough to do so, or feeling guilty or anxious about not exercising
• Vomiting or misusing laxatives (purging)
• Social withdrawal and isolation 
• Compromise of education and employment plans

Psychological signs

• Fear of fatness or pursuit of thinness
• Excessive focus on body weight
• Distorted perception of body shape or weight – for example, thinking they are much larger than they are
• Underestimating or denying the seriousness of the problem, or believing there isn’t a problem at all, even after diagnosis
• Spending a lot or most of their time thinking about food
• Anxiety, particularly about eating in front of other people
• Low confidence and self-esteem
• Difficulty concentrating
• Perfectionism and setting very high standards for themselves 
• Other mental illnesses, such as depression, anxiety, or obsessive-compulsive disorder (OCD)

Physical signs

• Weight loss
• Irregular periods, or periods stopping altogether
• Lack of sexual interest
• Difficulty sleeping
• Tiredness
• Feeling dizzy
• Stomach pains
• Constipation
• Bloating 
• Feeling cold or have a low body temperature 
• Growth of soft, fine hair all over your body (called lanugo)
• Hair loss
• Physical weakness
• Loss of muscle strength
• Effects on hormone levels 
• Swelling in their feet, hands or face (known as oedema)
• Low blood pressure

Long term effects of anorexia

Like any eating disorder, anorexia can have long-term physical effects, some of which may be permanent, including:

• Loss of bone density (osteoporosis)
• Erosion of tooth enamel
• Difficulty conceiving, infertility 
• Heart problems
• Damage to other organs, such as the kidneys and liver
• Delayed onset of puberty or stunted growth in children and young teenagers

Issue date: September 2017  Review date: September 2020 Version 2.0 Sources used to create this information are available by contacting Beat. We welcome your feedback on our information resources.