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Anorexia Nervosa Fast Facts

Anorexia Nervosa is an eating disorder that causes people to restrict their food intake in order to lose weight. Suicide is the cause of death for half of anorexia nervosa sufferers, more than the number who die from starvation. In fact, one in five people attempt suicide while they struggle to overcome the disorder.

It is impossible to recover from Anorexia Nervosa unless you reach a minimal normal weight. – Angela Guarda, MD

Research suggests that genetics influences who is vulnerable to the disorder. Although experts think 50-80% of cases result from genetics, no specific gene has yet been linked to the disorder.

An estimated 20 million women in America will have an eating disorder at some point in their lives.

What Is Anorexia Nervosa?

  • Eating disorders overwhelmingly affect women. Men account for only about 10% of anorexia nervosa cases.
  • Anorexia has the highest mortality rate of any psychiatric disorder.
  • One in every 200 American women suffers from anorexia nervosa at some point during her life.

Anorexia nervosa is an eating disorder that makes people restrict their food intake in order to lose weight. Many people with anorexia starve themselves, while others binge eat and then purge [see bulimia nervosa]. People with anorexia nervosa can experience life-threatening weight loss caused by risky dieting, fasting, and over-exercise.

Many people with anorexia nervosa have a distorted view of their body weight. To lose weight, people with anorexia nervosa severely limit meals and worry constantly about gaining weight.  Most don’t realize the significance of their weight loss or the medical seriousness of their drastic dieting. Their self-worth is tied to false perceptions about body image.

People with anorexia nervosa feel good about themselves when they lose weight, and then become angry with themselves when they gain weight. They think they look fat, even when they are seriously underweight.

Suicide is the cause of death for half of anorexia nervosa sufferers, more than the number of those with anorexia nervosa who die from starvation. In fact, one in five people attempt suicide while they struggle to overcome the disorder.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

What Causes Anorexia Nervosa?

Over the years, anorexia nervosa has been viewed primarily as a psychiatric diagnosis. Childhood trauma can linger into adulthood, often with devastating emotional consequences. Victims of childhood sexual abuse often suffer from anorexia nervosa, along with post-traumatic stress disorder (PTSD), panic attacks, and self-destructive behaviors. They learn silence, secrecy, and shame.

About half of people with anorexia nervosa also have other mental health issues, such as an anxiety disorder, obsessive-compulsive disorder, or social phobia. A third to half may suffer from a mood disorder like bipolar disorder or depression. Alcohol abuse and drug addiction are common in people who suffer from anorexia nervosa and other eating disorders. Mental health therapies are part of the process of recovery from eating disorders.

People with anorexia nervosa often:

  • Spend a lot of time thinking about food and calories.
  • Run their lives according to strict rules about eating.
  • Skip meals and avoid eating in public.

Retraining the brain to develop a healthy attitude toward eating is vital to recovery from anorexia. It’s important to get treatment because people with anorexia nervosa can get seriously ill — or even die — from the disorder.

Scientists continue to explore the behavioral, psychological, and cultural factors that influence anorexia nervosa. Although the roots of the disorder remain elusive, researchers suspect that genetics plays a role in more than half of cases [see Genetics].

Warning signs of anorexia nervosa include:

  • Focus on weight and morbid preoccupation with dieting
  • Secrecy, rituals, and odd behaviors related to eating habits, such as cutting food into tiny pieces or pushing it around the plate
  • Excessive exercise
  • Wearing large or baggy clothes to disguise weight loss
  • Noticeable personality changes and social withdrawal

People with anorexia nervosa often deny that they have a problem. They don’t want to gain weight, so they reject help.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Is Anorexia Nervosa Hereditary?

New understanding of the role of genetics in eating disorders is bringing  hope to the families of people who are diagnosed with life-threatening anorexia nervosa.

For decades, anorexia nervosa was considered to be the direct result of family stress and peer pressure. In the popular imagination, rIsk factors for anorexia nervosa include being young, female, and having an overachieving personality and dysfunctional family dynamics. Today, doctors understand that eating disorders occur in all types of families.

Research suggests that genetic factors influence who is vulnerable to the disorder. Although experts think 50-80% of cases result from genetics, no specific gene has yet been linked to the disorder.

While anorexia nervosa tends to run in families, the disorder results from multiple factors. Studies of genes at the molecular level have not pinpointed any DNA variants that directly cause anorexia nervosa. However, a recent gene sequencing study at the University of Iowa identified previously unobserved and ultra-rare mutations that appear to influence anorexia nervosa and other eating disorders. Scientists think the disorder may result from a genetic predisposition, triggered by life events and family environment.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Anorexia Nervosa Detected?

Symptoms of anorexia nervosa usually appear in adolescence. The average age of onset is 17. Rarely, children under the age of 10 or women in their 30s develop the disorder. Peer pressure, identity issues, and family stresses often seem overwhelming as teens move from childhood into adolescence. Cultural stereotypes about beauty and body shape influence young people in not-so-subtle ways.

The most common signs of anorexia nervosa include weight loss, excessive exercise, preoccupation with body weight, and an irrational fear of becoming fat. Many young women with anorexia nervosa stop having periods. People with anorexia nervosa often hide their weight loss by wearing loose clothes and lying about how much food they have consumed.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Anorexia Nervosa Diagnosed?

While there is no test to diagnose anorexia nervosa, a physician may suspect an eating disorder based on an individual’s abnormal weight. Healthy adults usually have a body mass index (BMI) of between 18.5 and 24.9. Anorexia is diagnosed in an otherwise healthy adult whose BMI falls below 17.5. Severe malnutrition is diagnosed in people whose BMI is lower than 15.

The following tests can help diagnose anorexia nervosa:

  • Blood tests reveal abnormal nutrient levels. As someone recovers from anorexia nervosa, blood tests are used to track nutrient values as they return to normal levels.
  • An electrocardiogram (EKG) records the electrical activity in the heart and measures heart rate and rhythm.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Anorexia Nervosa Treated?

Treatment for anorexia nervosa is a multidisciplinary process. With treatment, about 60% of people with anorexia nervosa make a full recovery. Another 20% make a partial recovery but remain very focused on food and weight.

Medical treatment

In consultation with the doctor, a dietitian (food and nutrition expert) creates meal plans to help people gain weight safely. Most people work with a team that includes a mental health clinician, dietitian, and medical support.

Slow, steady weight gain is vital because “refeeding syndrome” is a potentially life-threatening complication of anorexia nervosa. The risk of developing complications is greater when significant weight loss is followed by rapid weight gain. The body’s delicate balance can be disrupted by too-aggressive nutritional treatment.

During recovery, problems may arise that require medical treatment. Some people experience tremor, seizures, or other neurological problems caused by abnormal levels of phosphate, potassium, and magnesium (electrolytes) during the early stages of refeeding. When malnourishment is severe, hospitalization may be necessary to correct drastic electrolyte imbalances.

The best way to prevent complications is to limit both calories and fluids when restarting food in someone who is severely malnourished. Vitamin B1 (thiamine) supplements are given at the beginning of refeeding and continued twice daily for 7-10 days. Problems can usually be avoided by closely monitoring food intake to avoid a rapid increase in the number of daily calories.

Mental health treatment

A mental health clinician typically coordinates care in an eating disorder treatment setting. People with anorexia nervosa often suffer from perfectionism, which makes them feel that they can never be thin enough. They tend to restrict eating as a way to control high levels of anxiety. Psychological treatment to address flawed thinking and poor self-image often involves a number of different therapies:

  • Individual, group, and family psychotherapy. The multifaceted approach focuses on thinking and behaviors. A psychotherapist works one-on-one to support the individual. Family therapy helps parents and adolescents work through relationship problems or interpersonal issues.
  • Cognitive behavioral therapy (CBT) is the leading evidence-based treatment for adults with eating disorders. It can also be adapted for younger people with anorexia nervosa. The treatment addresses cognitive factors like negative body image, core beliefs about self-worth, and perfectionism. CBT also helps with behavioral factors like dietary restriction, self-harm, and body avoidance.
  • Dialectical behavioral therapy (DBT) combines Eastern wisdom with techniques for healthy emotional regulation. The focus is on acceptance (rather than change) and coping with difficult emotions. The DBT approach helps people cope with feelings that tend to trigger unhealthy eating patterns. DBT teaches skills ranging from mindfulness to distress tolerance, emotion regulation, and interpersonal effectiveness.
  • Motivation to Change therapy is a therapeutic intervention that works best when someone is ready for behavioral change. Therapy includes support, education, and efforts to increase motivation. The goal is to move someone from denial to acceptance about anorexia nervosa.

Pharmacotherapy. Although not a first-line treatment, medications can help people whose anorexia is related to obsessive-compulsive disorder or other treatable mental illnesses. Specialized treatment may be needed to address various mental health diagnoses.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Does Anorexia Nervosa Progress?

While symptoms vary widely, people with anorexia nervosa can experience life-threatening damage to vital organs like the brain, heart, and kidneys.

Over time, anorexia nervosa causes a range of worsening medical problems:

  • Bone loss and muscle weakness
  • Bloating and skimpy bowel movements
  • Feeling cold all the time and having a low body temperature
  • Itchy, scaly or blotchy skin
  • Fine, downy, dark hair on arms, chest, face, and face
  • Deficits in memory and attention
  • Trouble sleeping
  • Decreased ability to recognize hunger
  • Low blood pressure
  • Headaches and nausea
  • Ulcers
  • Slow wound healing
  • Damage to the colon and digestive system
  • Liver and kidney disease
  • Cardiovascular complications and congestive heart failure

As the disorder progresses, anorexia nervosa can cause various cardiovascular complications, ranging from dizziness and fainting to irregular heart rhythm. In very severe cases, imbalances in electrolytes like potassium and magnesium can lead to life-threatening heart failure. Medical complications account for more than half of all deaths in people with anorexia nervosa.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Do I Prevent Anorexia Nervosa?

If anorexia nervosa is suspected, seek professional help early. In general, people don’t simply “outgrow” the disorder. Sometimes, an intervention with family and friends serves as a “wake-up call” for someone who needs help. Sadly, many people with anorexia nervosa refuse treatment, at least initially. The death rate is 10 times higher in people with anorexia nervosa than in the general population.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Anorexia Nervosa Caregiver Tips

The most important thing you can do for a loved one with anorexia nervosa is to be supportive. Try these helpful strategies:

  • Get an accurate diagnosis.
  • Don’t try to reason with someone who has a distorted body image.
  • Look into a treatment center that specializes in eating disorders.
  • Recognize that weight gain is the cornerstone of treatment.
  • Find therapists who can help people with anorexia nervosa develop new patterns of thinking and self-awareness.
  • Create a strong support system. The free recovery group Overeaters Anonymous welcomes people with anorexia nervosa as well as other eating disorders. Find a local group.
  • Connect with others for support. Family support groups can be very helpful for parents who are struggling to help an adolescent with anorexia nervosa.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Anorexia Nervosa Brain Science

Scientists are studying the complex brain changes caused by anorexia nervosa. Neuroimaging shows subtle but measurable differences in the brains of people with anorexia nervosa compared with those who have never suffered from the disorder.

The brains of people with anorexia nervosa show a different reward response, react differently to feedback, and have altered serotonin — a key neurotransmitter — pathways.

Differences are found not just in people who are currently suffering from anorexia nervosa, but also in those who have recovered from the disorder. No one knows whether neurobiological differences occur before someone has anorexia nervosa and are physical predictors of the illness — or if these neurobiological differences are “scars” from prolonged starvation.

Individuals with anorexia nervosa have difficulty experiencing pleasure. Compared to people who don’t have anorexia nervosa, the brains of people with anorexia nervosa — or those who have recovered — don’t respond normally to food. The findings suggest that brain circuitry is altered in regions that control taste pleasantness and reward mechanisms.

MRI studies have shown that both active and recovering individuals with anorexia nervosa show enlargement of a particular area of the brain. Research showed increased gray matter in a brain region called the orbitofrontal cortex, which tells the body when to stop eating. Even when someone recovers from the disorder, changes in the brain remain.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Anorexia Nervosa Research

The American Brain Society proudly champions and supports Anorexia Nervosa research.  We diligently vet each research project to ensure we are selecting research with the most promising outcomes.

Highlighted Projects

Taste Preferences, Brain Reward Circuitry Activation, And The Neurobehavioral Effects Of Weight Restoration In Anorexia Nervosa
Angela Guarda, MD

This study has the potential to identify reward-circuitry mechanisms involved in Anorexia Nervosa and to direct the development of future, personalized, treatment options and medical therapies.

Role of Oxidative Stress in Patients with Anorexia Nervosa
Timothy H. Moran, Ph.D.

Weight restoration is necessary but not sufficient for recovery from Anorexia Nervosa and relapse rates following successful inpatient treatment and nutritional rehabilitation remain significant. The goal of this project is to examine oxidative stress as a potential biological mechanism underlying propensity towards relapse in patients with Anorexia Nervosa.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

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