Anorexia nervosa is a serious mental health condition characterised by extreme preoccupation with pursuing as low a body weight as possible.
People with anorexia have an intense fear of gaining weight or becoming fat and engage in a variety of behaviours to keep their weight down. They may:
People with anorexia typically have a distorted body image, seeing themselves as fat even when at a very low weight. Their shape and weight play an excessive role in how they see themselves and they often have difficulty appreciating the severity of their condition.
For diagnostic purposes, anorexia is divided into two sub-types:
It has been theorized that there are marked differences in the causes and ways in which these two subtypes are experienced. The features and underlying causes of the binge-eating/purging type may closely resemble bulimia nervosa and many people shift from one diagnosis to the other.
By contrast, people with restrictive anorexia tend to have a more consistent and confined presentation.
1. Anorexia is more common in women than men, with different studies indicating that females are anywhere from three to ten times more likely to have anorexia than males1.
2. It is thought that 2/3 of people with anorexia will also suffer from an anxiety disorder at some point in their lives, with anxiety difficulties typically predating their eating disorder2.
3. An often-referenced study3 that followed up patients 21 years after initial treatment found that:
Anorexia is the most fatal of all psychiatric disorders. The mortality rate for the disorder has been estimated as 5.6%4 of sufferers per decade.
This is almost twice that of the next most lethal mental illness.
For me the service I received was excellent and I could not have asked for more.”
The symptoms of anorexia will differ between individuals and are likely to change over time – it’s common for people to experience some or all the following syigns of anorexia:
People with anorexia often hide their symptoms from other people, for instance by wearing baggy clothing, picking at food or saying they have already eaten so don’t need any more. They may diminish their weight loss and are often very sensitive to conversations about their weight.
As a parent, relative or friend it can seem almost impossible to know what to do – someone with anorexia will often take huge ‘pride’ in being told they look ill or gaunt and yet as a loved one, all you will want to do is help.
Recovery from anorexia is very challenging. Many people with the condition find it hard to see how ill their eating disorder has made them or feel that they do not need or deserve help. It may be very hard for them to imagine who they are or what their lives might be like without an eating disorder.
The right treatment for helping someone with anorexia depends on a few factors. Most importantly, if someone has a very low body weight (a BMI of 15 or below) it is likely they will need inpatient care. In this case, we always suggest going to your GP as a matter of urgency to initiate the process of referral to an eating disorder clinic.
For those who have a BMI above 15 and who are not losing weight rapidly, it is likely that outpatient care would be relevant. Treatment plans may include regular therapy (with a psychologist or psychotherapist), medication, nutrition guidance and family therapy.