Anorexia wreaks havoc on physical and mental well-being, resulting in damaging and potentially life-threatening issues. Education is crucial for early intervention, enabling you to recognise symptoms and encouraging a supportive atmosphere for seeking help. We delve into anorexia, exploring signs and symptoms and dispelling common myths, offering valuable insights on how you can seek assistance.

What is anorexia nervosa?

Anorexia nervosa is an eating disorder characterised by an intense fear of gaining weight and a distorted body image that leads to self-imposed starvation and excessive weight loss. People with anorexia often have an obsessive preoccupation with food, dieting and body size. The condition goes beyond normal concerns about dieting and body image, resulting in severe physical and psychological consequences. It is a serious mental health condition that can have profound effects on a person’s overall well-being.

DSM-V criteria for anorexia:

According to the DSM-V, the diagnostic criteria for anorexia include:

  • Restriction of energy intake relative to requirements
  • Intense fear of gaining weight or becoming fat
  • Disturbance in the way one’s body weight or shape is experienced (i.e: persistent lack of recognition of the seriousness of the situation)

It’s important to note that the severity of anorexia is classified into three subtypes based on body mass index (BMI) and the presence or absence of specific behaviours:

  • Mild: BMI greater than or equal to 17 kg/m²
  • Moderate: BMI 16–16.99 kg/m²
  • Severe: BMI 15–15.99 kg/m²
  • Extreme: BMI less than 15 kg/m²


The BMI criteria helps in categorising the severity of a person’s anorexia, providing a guideline for assessing the impact of the disorder on their physical health. It’s essential to keep in mind that the diagnosis and treatment of anorexia should involve a comprehensive evaluation by a qualified healthcare professional.

Are there different types of anorexia?

Anorexia is a complex condition that manifests differently in people. Several distinct types of anorexia include:

  • Restrictive: This is the most widely recognised form of anorexia, characterised by extreme dieting, fasting and excessive exercise.
  • Binge eating and purging: people with anorexia may involve themselves in binge eating and purging behaviours, such as vomiting or using laxatives, in addition to restricting their food intake.
  • Atypical: Those with atypical anorexia exhibit symptoms of an eating disorder that may not fully meet the criteria for anorexia.
  • Sports and exercise: Although not officially categorised, anorexia is prevalent among athletes and involves engaging in excessive exercise without adequate calorie intake.

What are the signs of anorexia?

Anorexia extends beyond undereating. Emotional factors play a crucial role, highlighting the complex nature of this eating disorder that requires comprehensive understanding and compassionate support for those affected. Below, we take a look at some of the main signs of anorexia in three different categories: physical, psychological and behavioural.

Physical signs of anorexia:

  • Significant weight loss: Anorexia often leads to severe weight loss, which can result in malnutrition and various physical complications, such as muscle wasting and weakness.
  • Brittle nails: Malnutrition can affect the health of nails, leading to brittleness and increased susceptibility to breakage.
  • Dry skin: Inadequate nutrition and dehydration can contribute to dry and flaky skin.
  • Development of fine body hair (Lanugo): The body may grow fine hair, known as lanugo, due to insufficient insulation caused by extreme weight loss.
  • Fatigue: Lack of essential nutrients can result in fatigue and overall weakness, impacting the person’s ability to engage in daily activities.
  • Weakness: Muscular weakness is common in people with anorexia due to the body’s inability to maintain muscle mass without proper nutrition.
  • Dizziness: Low-calorie intake and dehydration can lead to dizziness and lightheadedness.
  • Irregular menstruation (Amenorrhea): Women with anorexia may experience disruptions in their menstrual cycle, including irregular periods or the absence of menstruation altogether.

Psychological signs of anorexia

  • Intense fear of weight gain: The fear of gaining weight is often irrational and disproportionate, driving the restrictive eating behaviours seen in anorexia.
  • Distorted body image: people with anorexia may perceive their bodies inaccurately, seeing themselves as overweight even when severely underweight.
  • Preoccupation with food, dieting and body size: Constant thoughts and concerns about food, calories, dieting and body size dominate a person’s mental space.
  • Changes in eating habits: Restrictive eating habits may involve avoiding specific foods or entire food groups, extreme calorie counting and rigid adherence to self-imposed dietary rules.
  • Denial of the severity of weight loss: Many people with anorexia may downplay or deny the seriousness of their low body weight, making it challenging to recognise the need for intervention.

Behavioural signs of anorexia

  • Restrictive eating habits: Anorexia is characterised by severe restrictions in food intake, often leading to inadequate nutrition and weight loss.
  • Excessive exercise: Some people with anorexia engage in compulsive and intense exercise as a way to burn calories and control weight.
  • Social withdrawal: people with anorexia may withdraw from social activities, particularly those involving food, to hide their eating habits and body size.

What causes anorexia?

Anorexia is a complex psychiatric disorder with multiple contributing factors, and its exact cause is not fully understood. It will likely result from genetic, biological, psychological and environmental factors. Here are some key factors that may contribute to the development of anorexia:


There is evidence to suggest a genetic predisposition to anorexia. People with a family history of eating disorders may be at a higher risk. A recent 2022 study stated that ‘genetic factors predispose for approximately 33-84% to anorexia nervosa’.


With state-of-the-art technology and emerging research, scientists are now able to study the brains of people with eating disorders, such as anorexia. Researchers have identified differences in the brains of those with eating disorders compared to those without.

They include differences in:

  • Neurochemistry
  • Grey matter volume
  • Cortical thickness
  • White matter volume
  • Integrity and structural connectivity
  • Functional and effective connectivity

This new research is valuable as it enables researchers to develop models for understanding brain function and food avoidance in people with eating disorders. By identifying specific neural patterns, scientists can enhance treatment strategies, leading to more effective interventions and support for those struggling with conditions like anorexia.

Psychological factors

Psychological factors, such as low self-esteem, perfectionism and obsessive-compulsive personality disorder (OCD), can contribute to the development of anorexia. Some people may use restrictive eating as a way to cope with stress, anxiety, or traumatic experiences.

Environmental factors

Societal pressures and cultural influences, including the media’s portrayal of an idealised body image, can contribute to the development of body dissatisfaction and drive people to pursue extreme weight loss. Peer pressure and societal expectations regarding beauty standards may also play a role.

Life events

Traumatic events, major life changes, or stressful situations could be the cause of anorexia in some people. Studies have shown that 23.1% of those with anorexia also met the criteria for PTSD.

Can anorexia be dangerous?

Those diagnosed with anorexia are at risk of experiencing a wide range of damaging and dangerous issues. These impacts on health can be found through:

  • Psychological impacts
  • Hormonal imbalances
  • Social issues (such as withdrawal)
  • Reproductive health issues (in females)

However, one of the most dangerous complications of anorexia is its impact on the body.

Anorexia often results in severe malnutrition and weight loss. Prolonged insufficient intake of essential nutrients can lead to a range of physical complications, including electrolyte imbalances, cardiac issues and disruptions in organ function.

When the body is deprived of necessary nutrients, it starts to break down its tissues, including muscles and organs, to meet energy demands. This can lead to a weakened immune system and a heightened risk of other medical complications.

When we combine all of the complications anorexia can bring, we see just how devastating it can be on a person’s mental and physical health. Research indicates a concerning mortality rate of 5% within the first four years of diagnosis. Additionally, there is a high incidence of suicide attempts among those with anorexia, affecting up to 20% of those diagnosed with the eating disorder.

Debunking common anorexia myths

Myth 1: “Anorexia is solely about wanting to be thin.”
Reality: While body image concerns are a factor, anorexia often involves deeper emotional issues, control struggles and self-esteem problems. It may serve as a coping mechanism for underlying psychological issues.
Myth 2: “Only females experience anorexia.”
Reality: Anorexia can affect people of any age, gender, race, or socioeconomic background. It is not limited to a specific demographic group.
Myth 3 “Anorexia is always easy to spot because people with the disorder are extremely underweight.”
Reality: Not everyone with anorexia appears severely underweight. Some may engage in restrictive behaviours or excessive exercise without displaying significant weight loss. Body weight alone is not the only indicator of the disorder.
Myth 4 “Anorexia is just a phase that people will grow out of.”
Reality: Anorexia is a serious and potentially life-threatening condition that requires professional intervention. It is not a phase that people can simply outgrow without appropriate treatment.
Myth 5 “Recovery from anorexia means gaining weight and nothing more.”
Reality: Recovery involves addressing the physical, emotional and psychological aspects of the disorder. Gaining weight is just one component; therapy, nutritional counselling and support are also crucial for long-term recovery.
Myth 6 “Parents or family members are to blame for causing anorexia.”
Reality: Anorexia is a multifaceted disorder with various contributing factors, including genetic, biological, environmental and psychological influences. Blaming family members (for being too lenient, for example) oversimplifies the complexity of the condition.

How is anorexia treated?

When seeking help for anorexia, it is crucial to seek guidance from professionals who comprehend the intricacies of the condition. Healthcare providers or therapists should address any concurrent mental health issues rather than solely concentrating on eating behaviours.

At a reputable treatment centre, you may participate in various individual and group therapies, such as:

These programmes equip you with essential skills and resources applicable during the rehabilitation period and as you continue your recovery at home. Collaborating with experienced therapists, you enhance your comprehension of anorexia, explore potential causes or triggers and develop coping mechanisms and stress management techniques to avoid reverting to past behaviours.

What are the next steps?

Begin your journey to recovery by acknowledging the issue and confiding in trusted friends and family for emotional strength. Sharing your struggle alleviates the burden and encourages a network of understanding. Seek expert guidance from healthcare professionals, including therapists and addiction specialists, who can offer insights and tailored support.

Prioritise your recovery by thoroughly assessing the most effective treatment options for your unique journey. This assessment serves as a crucial foundation, guiding you towards evidence-based solutions. By understanding your struggle’s root causes and intricacies, you empower yourself to make informed decisions about your path forward.

With the combined strength of personal connections and professional expertise, you can navigate through the challenges of anorexia, reclaiming control and building a foundation for lasting recovery.

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Is anorexia a mental illness?
Yes, anorexia nervosa is a mental illness. It is a serious and potentially life-threatening eating disorder characterised by an intense fear of gaining weight, a distorted body image, and extreme efforts to restrict food intake, leading to self-induced starvation and often excessive weight loss.
What causes anorexia?
Anorexia nervosa is believed to result from a combination of genetic, biological, psychological, and environmental factors, including genetic predisposition, body image concerns, and societal pressures.
Can you die from anorexia?
Yes, anorexia nervosa can be a life-threatening condition. Severe malnutrition and complications related to self-imposed starvation, such as electrolyte imbalances, cardiac issues, and organ failure, can lead to serious health consequences and, in some cases, death.
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