If you have noticed that a loved one has new behaviors associated with food and body image, you might wonder about the signs of anorexia. Alternately, you may have noticed changes in yourself, such as an impulse to skip meals, anxiety around mealtime, and a preoccupation with your body. You might wonder if you meet the diagnostic criteria for anorexia.

Anorexia nervosa is an eating disorder characterized by low body weight, a persistent restriction of food, and a belief that one is overweight, despite evidence to the contrary (NIMA, Eating Disorders, 2023). And anorexia is treatable. The first step on the path to recovery is to recognize the signs of anorexia nervosa.

Signs and Symptoms of Anorexia

If you have noticed that a loved one has new behaviors associated with food and body image, you might wonder about the signs of anorexia. Alternately, you may have noticed changes in yourself, such as an impulse to skip meals, anxiety around mealtime, and a preoccupation with your body. You might wonder if you meet the diagnostic criteria for anorexia.

Anorexia nervosa is an eating disorder characterized by low body weight, a persistent restriction of food, and a belief that one is overweight, despite evidence to the contrary (NIMA, Eating Disorders, 2023). And anorexia is treatable. The first step on the path to recovery is to recognize the signs of anorexia nervosa.

Comorbidity and High Mortality

Anorexia nervosa is both painful and dangerous to experience. It can feel bewildering to family, friends, and to the person struggling with the disorder. Over 56% of people who struggle with anorexia nervosa have a comorbid diagnosis, meaning they also struggle with anxiety, depression, trauma, or other impulse control disorder (NIMA, Statistics, 2023). In fact, anorexia nervosa may have developed as a means to cope with another disorder (Sander, Moessner, & Bauer, 2021).

Anorexia nervosa has the highest mortality rate among all mental health diagnoses (van Hoeken & Hoek, 2020). The medical complications that arise as a result of anorexia nervosa can lead to a multitude of problems with the heart, the reproductive system, the skeletal-muscular system, and the nervous system. Due to the medical complications related to this disorder, intervention is crucial.

Denial and Recognition

A person with anorexia nervosa may deny the disorder (Starzomska & Tadeusiewicz, 2016). This denial is usually not conscious or intentional. Eating disorders can feel baffling for the person with the disorder because, at one level, the behaviors of anorexia nervosa meet an important need for control and stability, as well as a sense of discipline and mastery. A person struggling with anorexia nervosa may believe that as they lose weight, they will feel more confident, decrease their social anxiety, and increase their self-worth. However, these needs are met at the expense of other vital needs for health and well-being.

If you are struggling with anorexia nervosa, it might be hard to recognize that your behaviors have become harmful because you may believe you are succeeding at the goals you set for yourself. You may believe that you have control and that you can stop restricting at any time.

However, you may also hear feedback from your family and friends that they are worried about you. You might notice a discrepancy between how you see your body in the mirror and the feedback people tell you about your body. You might notice that your scale reports a particular number, and although you may be aware that this number indicates a healthy-to-low body weight, you may feel this number is not low enough. As a result, you feel compelled to lose more weight.

The list below aims to help friends and family identify signs of anorexia nervosa in a loved one. However, this list is also helpful if you believe you may have anorexia nervosa and wish to learn more about the disorder.

Do I Have an Eating Disorder?

If you suspect you might have an eating disorder or are struggling with your body image or eating habits, we’ve created a quiz to help you learn more.

Signs of Anorexia Nervosa

If you have noticed that your friend or loved one is engaging in specific behaviors related to food, mealtimes, and body image, you can use the list below to identify signs of anorexia. You might notice behavioral indicators, emotional indicators, and medical changes in your loved one.

Behavioral Signs and Symptoms

You might notice that your friend or loved one:

Regularly talks about dieting, “clean eating,” or “healthy eating,” and is regularly “on a diet”

  • Will not have meals with you
  • Wears baggy clothing that hides their body, masking evidence of their weight loss
  • Skips meals, does not eat much at meals, and cuts their food into tiny pieces; additionally, you may notice partially chewed food in napkins or bits of food in pockets of clothing
  • Has increased their exercise regimen and appears to be angry or anxious if they cannot work out
  • Makes a separate meal from what others are eating
  • Denies hunger even though you rarely see them eat
  • Examines themselves in the mirror more than usual
  • Talks about “being fat” or mentions that they “need to lose weight,” even if they appear to be underweight
  • Isolates themselves more than usual
  • Seems preoccupied with food and participates in cooking but does not consume the food they’ve made

Emotional Signs of Anorexia Nervosa

You might notice that your loved one or friend:

  • Appears to have heightened distress related to food and meals. For example, your friend might appear angry or anxious if a restaurant does not have a specific meal they have requested
  • Appears to struggle with unpleasant moods such as depression, anxiety, or irritability
  • Appears to have obsessive-compulsive tendencies and perfectionism
  • Appears to cry more than before

Physical Signs of Anorexia Nervosa

Anorexia nervosa can impact the cardiovascular system, the integumentary system, the skeletal system, the muscular system, the endocrine system, and the nervous system. The severity of the impact of anorexia nervosa on the body may be difficult to identify until there is a medical crisis. However, you may notice the following physical signs of anorexia nervosa in your loved one:

Cardiovascular Signs of Anorexia Nervosa

The symptoms below are significant as they indicate potential problems with the heart. Anorexia nervosa can lead to arrhythmias, bradycardia, and hypotension (Mehler, Watters, Joiner, & Krantz, 2022). If you notice these symptoms in your loved one, it is important to get them immediate medical care as heart issues such as these can be life-threatening:

  • Low energy
  • Dizziness
  • Fainting

Integumentary System Signs of Anorexia Nervosa

The effects of anorexia nervosa slow blood circulation and result in a lower body temperature. As a result, you may notice the following:

  • Fingers, toes, and ears may have a blue tint to them
  • Excessive amounts of fine hair on the upper lip, chin, spine, and arms (known as lanugo)
  • Thinning of hair on the scalp

Skeletal, Muscle, and Nervous System Signs of Anorexia Nervosa

Some of the signs of anorexia listed below might be hard to identify as they are often private, as is the case with digestion and menstruation. However, you may still notice the following:

  • Seizures
  • Constipation
  • Hypoglycemia
  • Loss of menstrual cycle
  • Osteoporosis: You may notice this symptom if your loved one has had a bone fracture or break in a manner that was not expected for their age.
  • Reduction of grey matter in the brain: You might notice that your loved one appears to have brain fog, altered cognition, reduced attention span, or seems more irritable than usual.

Restoring Mental Health

Behavioral interventions are effective for treating ARFID in adults. Examples of therapies that work include family-based treatment, cognitive-behavioral therapies, exposure therapy, dialectical-behavioral therapy, and psychoeducation. Creating an aftercare and relapse prevention plan to follow once you complete the program ensures you have support in your home environment.8

There Is Hope

It can be frightening to recognize that you or a loved one shows signs of anorexia nervosa. It is a serious disorder. However, it is treatable, and recovery is possible. Treatment involves a combination of medical care, psychotherapy, and peer support. In treatment, both the symptoms and root causes of the disorder are addressed. At Virtue Recovery Center, we have a team of compassionate professionals dedicated to high-quality, personalized care for you and your family.

Contact us to speak with a recovery specialist today.

Resources:

  1. National Institute of Mental Health (2023). Eating Disorders. DOI: https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Eating-Disorders
  2. National Institute of Mental Health (2023). Statistic of Eating Disorders. DOI: https://www.nimh.nih.gov/health/statistics/eating-disorders
  3. Mehler, P., Watters, A., Joiner, T., & Krantz, M. (2022). What accounts for the high mortality of anorexia nervosa? Internation Journal of Eating Disorders, V55, I5, pg 633-636. DOI: https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.23664
  4. Sander, J., Moessner, M., & Bauer, S. (2021) Depression, Anxiety and Eating Disorder-Related Impairment: Moderators in Female Adolescents and Young Adults. Int. J. Environ. Res. Public Health 18, 2779. https://doi.org/10.3390/ijerph18052779
  5. Starzomska, M., & Tadeusiewicz, R. (2016). Pitfalls in anorexia nervosa research: The risk of artifacts linked to denial of illness and methods of preventing them. Psychiatria Danubina, 28(3), 202–210. DOI: https://pubmed.ncbi.nlm.nih.gov/27658828/
  6. van Hoeken, D. & Hoek, H. W. (2020). Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden. Current opinion in psychiatry, 33(6), 521–527. https://doi.org/10.1097/YCO.0000000000000641

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