Symptoms and Warning Signs of Anorexia Nervosa

Symptoms and Warning Signs of Anorexia Nervosa Eating Disorders Symptoms Print Symptoms and Warning Signs of Anorexia Nervosa Physical, Behavioral, and Emotional Symptoms By Susan Cowden, MS facebook linkedin Susan Cowden is a licensed marriage and family therapist and a member of the Academy for Eating Disorders. Learn about our editorial policy Susan Cowden, MS Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 14, 2020 Andrew Brookes/Cultura/Getty Images More in Eating Disorders Symptoms Treatment Diagnosis Awareness and Prevention People who are experiencing anorexia nervosa may exhibit some of the following symptoms (something objectively experienced by the person) and/or signs (observable manifestations) of the disease. Eating disorders may often appear differently than the stereotyped versions of eating disorders commonly portrayed in the media. Sometimes family members and friends will remark after a diagnosis has been made that they didnt realize how many behaviors and changes were related to the eating disorder. However, anorexia nervosa truly affects all areas of a persons life. While it is a disease that disproportionately affects females and most often begins in early to mid-adolescence, it also afflicts men and boys and can be diagnosed in children as well as older adults. It is important to recognize that eating disorders can occur in people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses. Anorexia nervosa is a potentially life-threatening disorder and one of the most lethal psychiatric disorders. Individuals with anorexia nervosa often do not believe they are ill and may try to mask their low weight.   This is not an exhaustive list of signs and symptoms and people who do not have all of the manifestations below may still be struggling with anorexia nervosa. Also, these signs and symptoms are not always specific to anorexia and may reflect other conditions. Physical Symptoms Anorexia nervosa is characterized by not eating enough. The physical symptoms are a result of the body being denied essential nutrients, as the body is forced to conserve its resources in an effort to survive. Many of these physical symptoms are only present in serious cases of anorexia nervosa. They can also be symptoms of other medical conditions so it is important to be assessed by a physician to determine a correct diagnosis and seek treatment. Loss of menstrual period in females post-puberty (or delayed the first period)Sensitivity to coldCold hands and feetPale, dry skinDry and thinning hairHair loss on scalpBrittle nailsLightheadedness or loss of balance (may experience fainting)Downy hair all over the body (called lanugo), which is the bodys effort to conserve heatLow blood pressure and heart rateBruises easilyExtreme weight lossMuscle loss and weaknessExtreme dehydrationAbdominal painConstipationBrittle bones (osteoporosis) Eating Disorders Can Be Deadly Behavioral Symptoms These are signs that are often noticed outwardly by family members and friends of someone who is struggling with anorexia nervosa. They may be noticed somewhat earlier than some of the physical manifestations. Talks or thinks about food, weight, calories, and dieting so much it gets in the way of regular conversationDesperate to exercise even when inappropriate, such as running in inclement weather or missing other commitments in order to exercise (in kids might look like hyperactivity)Talks about fears of gaining weight or being fat even when losing weightRefusal to eat certain foods or entire groups of foods (such as carbohydrates or desserts)Strange eating habits or food rituals, such as an insistence on using specific utensilsEating unusual or odd food combinationsCooks for others, but refuses to eat what is cookedMay seem obsessed with cooking, cookbooks, cooking shows on television or other food-related topicsInsistence on wearing cold-weather clothing, even when it is warm outsideWeighs themselves often, frequently looks in the mirror, or checks the size of certain body partsWithdrawal from friends and familyMay go to great lengths to avoid eating, such as making up excuses for not joining the family for a meal or stating that they have already eatenSudden and extreme changes, such as becoming a vegetarian or refusing to eat non-organic foods, even when that is all that is availableComplaints of stomach achesDenial of hungerFatigueExtreme perfectionismMay hide foods in order to avoid eating them Emotional Symptoms Some of these symptoms might be more difficult for someone on the outside to recognize. However, many family members and close friends would be able to assess that their loved one is experiencing some or all of these warning signs. Determines self-esteem, worth, or attractiveness by appearance and weightDepressionStrong need for approvalAnxietyLittle motivation to engage in relationships or activitiesEasily irritatedExtremely self-critical It is important to note that not all individuals with anorexia nervosa are emaciated. Anorexia nervosa can also be diagnosed in individuals who have recently lost a lot of weight and are what many would consider normal weight. If you or someone you know is showing signs of anorexia nervosa, please seek help from a doctor or healthcare professional. Anorexia Discussion Guide Get our printable guide for your next doctors appointment to help you ask the right questions. Download PDF A Word From Verywell Most of the symptoms and signs of anorexia nervosa are reversible with treatment.  If you or a loved one is suffering from anorexia, it will probably take time to recover. However, speaking with a doctor and seeking support from loved ones are a couple of helpful first steps on the path to achieving recovery. Anorexia in People of Higher Weights