Anorexia nervosa

What is anorexia nervosa?

Anorexia nervosa, usually shortened to anorexia, is a serious and complex illness that can present in different forms. Perhaps the most well-known of all eating disorders, that does not necessarily mean it is always thoroughly understood. If left untreated, anorexia can lead to loss of life either through health complications such as organ failure, or suicide. If you are concerned that you, or someone you care for, may have anorexia it is important that you make an appointment with a GP as soon as possible.

People with anorexia are often underweight but still see themselves as overweight. They may engage in behaviours to control or eliminate calories; become obsessive about the foods they eat and give themselves very rigid rules regarding foods, calories, and mealtimes.

Although generally more common in younger females, anorexia can affect anyone of any age, gender, race, or background.

Signs and symptoms of anorexia nervosa

Signs of anorexia include:

  • An intense and overwhelming fear of gaining weight
  • A belief that you are fat or overweight when you are underweight
  • A reluctance or refusal to eat foods perceived as fattening
  • Adopting rituals and strict rules around food consumption and mealtimes
  • Using laxatives or other methods of eliminating food and calories after eating
  • Excessive exercising
  • Obsessively weighing yourself
  • Leaving a meal table early (possibly to hide or secretly dispose of food) or not wanting to eat in front of others

Symptoms of bulimia include:

  • Weight and height being under what would be expected for age (children under 18 years)
  • A lower than expected BMI (body mass index) in adults
  • In people who menstruate, periods may not start or stop once started
  • Poor circulation often accompanied by unusually cold hands and feet
  • Persistent bloating and digestive issues such as constipation
  • Frequent headaches, dizziness and feeling very tired
  • Problems sleeping
  • Mental distress or illness including depression and anxiety

There are a range of treatment options available for anorexia depending on your age and how unwell you are.

Treatment for anorexia nervosa in adults
  • For adults (18+), a combination of talking therapies, diet guidance and support to restore weight to an agreed level is usual.
  • Talking therapies available via NHS treatment include cognitive behavioural therapy (CBT), Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), or specialist supportive clinical management (SSCM). Depending on your needs, therapy should be offered for a minimum of 20 weekly sessions but may be up to 40 weeks. Talking therapies will support you or your loved one to look at what the causes of the eating disorder are, help identify coping strategies and ways to change negative thoughts and feelings.
  • You should also be offered expert support to learn about the importance of nutrition and the effects of starvation on the body and be given helpful guidance on a healthy diet. This may be through the guidance of a dietitian.
  • If needed, you may be prescribed antidepressants to help cope with difficult thoughts and feelings or any other connected issues such as anxiety or depression. Medication should not be the only treatment offered for recovery from anorexia. They should only be used in combination with talking therapies and specialist eating disorder recovery guidance.
  • Usually, treatment is offered on an outpatient basis. However, if you or your loved one is very unwell, or outpatient treatment is not proving helpful, day patient treatment or an inpatient admission may be required. This may be in a hospital or in a specialist eating disorder treatment unit depending on the area you live, the severity of your illness and any other factors specific to you.
Treatment for anorexia nervosa in children and young people
  • For those under 18 years of age, talking therapies such as CBT and/or family therapy are offered. Family therapy involves talking to a therapist either alone or with family members, usually those the sufferer lives with, to discuss how family and loved ones can offer support to get better. Sessions will take place over 18-20 weeks.
  • Vitamins and minerals may be prescribed by a doctor if there are concerns about nutrient absorption that can affect normal growth and development, especially during puberty. Parents and carers should also receive information and guidance around healthy diet to enable them to support their loved one at home.
  • A bone scan may be suggested by your doctor if there is concern about osteoporosis and medicine prescribed if needed. Antidepressants are not usually prescribed to those under 18 years of age.
  • Find more information on NHS treatment for anorexia

If you are concerned that you, or someone you care for, may have anorexia, we are here to help. Please book a 1:1 support call or take a look at our peer support groups . Our team of staff and volunteers have lived experience of eating disorders. They can listen to your worries and provide practical guidance to help you take positive steps towards getting help and recovery.

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