Anorexia: Causes, Risk Factors, Types, Signs, Symptoms, Warning Signs, Diagnosis and Treatment

It is a mental health disorder characterized by an intense fear of gaining weight, abnormally low weight, and a distorted perception of body weight.

Anorexia nervosa is also known simply as anorexia.

People with this disorder try to control their body shape, a weight that extremely affects their lives.

To continue losing weight or to prevent weight gain, people generally limit their food intake.

To control calories, they may vomit after eating, or misuse laxatives, diet pills, diuretics, and enemas.

Alternatively, they can also try excessive exercise to lose weight.

People who suffer from anorexia nervosa are similar to people who suffer from bulimia nervosa.

Most people with bulimia are overweight, while people with anorexia nervosa have abnormally low body weight.

In people with anorexia nervosa, gaining weight causes intense fear.

Anorexia nervosa is a dangerous disorder, the main characteristics of which are abnormally low body weight, a fear of gaining weight, and a distorted focus on ideal body weight.

People struggling with anorexia will do almost anything to avoid gaining weight, even starving.

When people with anorexia look in a mirror, they don’t see an exact reflection. They think they are fat, even when their build is extremely thin.

People with anorexia restrict the amount and types of food they eat and regulate calories very closely. They maintain an intense fear of gaining weight and will employ any number of tactics to achieve weight loss.

Anorexia is not about food, and although it is a disorder that focuses on food, but it is about much more. Anorexia is the wrong way to deal with emotional problems.

Researchers believe that this way of handling emotional problems is about gaining control over the body. People with anorexia often equate their self-esteem with being thin.

Doctors diagnose anorexia nervosa in people of all ages and sexes, but 90-95% of those who have it are girls and women.

Anorexia is more common among teens. It is one of the most common psychiatric disorders in young women, and one of the most dangerous.

Research suggests that up to 3 in 100 teens are struggling with anorexia.

Causes of anorexia nervosa

This disorder is a combination of biological, emotional, and social factors.

There are many other contributing factors including: traumatic experiences, low self-esteem, emotional difficulties, and family environment, among others.

Below are some of the reasons that cause anorexia nervosa:

Genetic reasons

Research reports that a genetic predisposition to anorexia nervosa runs in families.

Patients with a first-degree relative – siblings, children, or parents who have the disorder are at increased risk for anorexia nervosa.

Changes in genes can make people more prone to developing anorexia.

Brain chemistry also plays a vital role in anorexia.

People with anorexia tend to have more stress-related brain hormones, high cortisol levels, and reduced norepinephrine and serotonin levels that are associated with a feeling of well-being.

Intellectual reasons

People with anorexia nervosa are often perfectionists and have a great spirit of improvement. They are excelling in everything and always please others.

They have all of these outward characteristics, but on the inside they feel worthless, inadequate, and needy.

Household and community pressures

In addition to cultural pressure, there is also family and social pressure that contributes to this disorder. It includes participation in activities that lead to leanness such as modeling, gymnastics, or ballet.

Excessive parental control can also put an emphasis on the child with the eating disorder.

Artistic, work and sports activities, dancers, actors, athletes and models are at high risk of anorexia nervosa.

Young athletes mostly lose weight due to suggestions made by their parents and coaches.

Mass media such as fashion magazines and television feature slim actors and models.

The media reflects that thinness can gain popularity and success. Finally, there is environmental and social pressure.

In today’s dominant culture, thinness is the ideal.

It’s easy for young girls to infer from movies, magazines, and social media that thinness leads to popularity and love.

The media is everywhere, so it is impossible to avoid the messages it sends about beauty.

Parents can help combat this risk factor by demonstrating healthy eating habits and teaching their children that all bodies are beautiful.

Weight alteration

When people intentionally or deliberately gain or lose weight, this could be the result of negative or positive feedback from the people around you.

These comments prompt patients to begin dieting.

Big lifestyle changes

A transition event, such as changing schools, the arrival of puberty, a new job, moving, the death or illness of a loved one, ending a romantic relationship, can also cause stress.

These changes can increase emotional stress and lead to anorexia.

Risk factor’s

Risk factors for people to develop eating disorders can be:

  • Those most at risk are young women in their teens.
  • Certain temperaments and personality types can increase the risk of developing anorexia.
  • People who tend to be perfectionists, obsessive, and anxious are at a higher risk.
  • Some people with anorexia believe that they need to be perfect if they want love and respect.
  • Others have an intense fear of humiliation and ridicule.
  • Mental health problems, including depression, obsessive compulsive disorder, and anxiety, are common in people with anorexia.
  • For some people, a triggering event can increase the risk of developing anorexia.
  • A history of trauma, such as sexual abuse or the death of a parent, increases the risk of developing an eating disorder.

Other high-risk groups are athletes and those in the performing arts, including dancers, actors, and models.

Pressure from coaches and parents can, even when unintentional, contribute to the problem.

Many anorexia patients enjoy the positive reinforcement they get when they lose weight the first time, so they continue to restrict food to get more praise and recognition.


Anorexia nervosa has been classified into two types.

Among people diagnosed with anorexia, there are those who restrict their food intake and those who eat a lot and purge.

In the restrictive type of anorexia, the person achieves weight loss by restricting calories.

In the purge type of anorexia, weight loss is achieved through the use of diuretics and laxatives or vomiting.

Signs and symptoms of anorexia nervosa

The physical symptoms and signs of anorexia nervosa are associated with starvation, but the disorder also involves behavioral and emotional problems that are associated with an unrealistic perception of body weight.

The physical signs and symptoms of anorexia are related to starvation, while the psychological signs are related to the distorted perception of body weight.

People with anorexia believe that they are fat.

To lose weight they could drastically reduce their food intake through diet or fasting.

They often exercise compulsively to burn calories, which can start to feel like an exercise addiction.

People with anorexia may also vomit to shed calories or use laxatives, diuretics, dietary supplements, or enemas.

Anorexia nervosa and bulimia nervosa are characterized by distorted body image and abnormal eating behaviors, but they are different disorders.

What differentiates anorexia from bulimia is body weight.

Doctors will provide a diagnosis of anorexia if the patient has a low body mass index.

They will diagnose bulimia if the patient has a normal or higher than normal body mass index.

The physical symptoms of anorexia nervosa include:

  • Extreme weight loss
  • Hair that thins, breaks, or falls out.
  • Dry and yellowish skin.
  • Brittle nails
  • Absence of menstruation.
  • Dizziness or fainting
  • Bluish coloration of the fingers.
  • Cold or swollen hands and feet.
  • Bloated or upset stomach.
  • Soft hairiness that covers the body.
  • “Squirrel-like cheeks” (enlarged parotid gland).
  • Fatigue.
  • Insomnia .
  • Cold intolerance
  • Constipation.
  • Dehydration
  • Low blood pressure.
  • Abnormal heart rhythms
  • Osteoporosis.
  • Swollen arms and legs

Signs of anorexia in mental health and behavior include:

  • Distorted self-perception (believing that they are overweight when they are thin).
  • Fear of gaining weight
  • Negative attitude to eat.
  • Not recognizing the seriousness of the disease.
  • Denial of hunger.
  • Preoccupation with food.
  • Obsessive-compulsive behavior.
  • Depression .
  • Exercise addiction.
  • Lying about the amount of food you have eaten.
  • Social retreat.
  • Irritability.
  • Suicidal thoughts
  • Unhappy mood or lack of emotion.
  • Reduced interest in sex.
  • Inability to remember things

Warning signs of anorexia

  • Skipping meals or making excuses not to eat.
  • Constantly weighing themselves.
  • Eating only a few types of food.
  • Refusing to eat in public.
  • Food is routinely cut into small pieces.
  • Compulsive exercise
  • Planning and preparing elaborate meals for others but without eating them.
  • Compulsive and self-induced vomiting and to get rid of eaten food.
  • The use of herbal products, laxatives, dietary supplements, and enemas.
  • Social disconnection.

Diagnosis of anorexia

  • Physical test: may include measuring your weight and height, checking vital signs such as temperature, blood pressure, heart rate, listening to lungs and heart, checking nails and skin, and examining the abdomen.
  • Laboratory exam – Includes complete blood count and detailed blood tests to check protein and electrolytes, as well as liver, kidney, and thyroid function.
  • Psychological test: a psychological evaluation about your feelings and thoughts.
  • Tests such as X-rays : can help check bone density or detect heart problems or pneumonia. EKGs can be used to look for irregularities in the heart.


Because anorexia nervosa includes both the body and the mind, treatment must be done through team efforts.

The people involved in the treatment of anorexia nervosa are dietitians, physicians, counselors, psychologists, and physicians.

Support from family members can make a big difference in the success of treatment.

Recovery can be easier with family supports.

Medications and hospitalization to treat anorexia nervosa: The first step in anorexia treatments is to stabilize and address any serious health problems. If the malnutrition is severe, hospitalization may be necessary until it reaches a less critical weight.

Doctors will monitor vital signs, look for medical complications, and stabilize them medically. If you are not in immediate medical danger, you can opt for outpatient treatment.

Nutritional Counseling to Treat Anorexia Nervosa : The second stage of anorexia treatment is going through nutritional counseling. You can learn about proper nutrition and healthy eating from the dietitian or nutritionist.

They will also help you stick to meal plans, which involve enough calories to maintain or achieve a normal, healthy weight.

Therapy for anorexia nervosa: Anorexia treatment needs proper counseling. Talk therapy or psychotherapy makes the patient aware of the feelings and thoughts that are fueling the eating disorder and changes them with the healthiest ones.

Another goal of counseling is to teach the person to handle stress, difficult emotions, relationships that are better than being self-destructive.

Neuromodulation: Neuromodulation treatment, such as transcranial direct current stimulation, deep brain stimulation, and repetitive transcranial stimulation as newer technologies, have been successful in treating anorexia nervosa, even in severe cases.

Therapies: The best treatment programs for anorexia nervosa have a combined approach that includes psychotherapy, family therapy, medicine, and nutritional counseling. This works well for patients who require on their behavioral health by developing a healthy relationship with food.

Massage, yoga, acupuncture, and other alternative treatments are also necessary.

It is important that the patient is as involved as possible in their own treatment plan, although this can be difficult, as many people with anorexia deny the severity of their problem.

Complications and side effects

Anorexia can cause serious and devastating complications, even death if it is not treated in time. Death can be the result of the physical complications of starvation and malnutrition.

It can happen suddenly, even if someone doesn’t seem to be starving. Death often results from an irregular heart rhythm (arrhythmia) or an electrolyte imbalance.

Electrolytes are minerals in the human body that carry an electrical charge. They are responsible for maintaining healthy blood and cell chemistry necessary for muscle function and other processes.

People get electrolytes like sodium, calcium, potassium, and magnesium through the foods they eat.

When people with anorexia practice self-starvation, they can develop a dangerous electrolyte imbalance.

Because electrolytes influence fluid balance throughout the body, an imbalance can cause severe dehydration and even kidney failure.

When the body does not have the essential nutrients it needs to function, it begins to slow down all its processes in an attempt to conserve energy.

As your heartbeat slows and blood pressure levels drop, your risk of heart failure increases.

The more severely malnourished a person with anorexia is, the more dangerous they can be. All organs of the body, including the brain, can be damaged.

This damage may not be completely reversible, even when someone is treated.

Other complications can include:

  • Reduced bone density (osteoporosis), which causes brittle bones and increases the risk of fractures.
  • Muscle loss and weakness.
  • Severe dehydration, which can cause kidney failure.
  • Fainting, fatigue, and general weakness.
  • In women, it can cause the absence of menstruation.
  • In men, it can cause a drop in testosterone levels.

In addition to physical complications, people with anorexia can develop various psychological disorders.

About half of all anorexia-related deaths are from suicide. Developing co-occurring mental disorders can only increase the risk of death from suicide.

Other common disorders in people with anorexia include:

  • Depression.
  • Anxiety.
  • Obsessive-compulsive disorders.
  • Alcohol and substance abuse disorders.

Prevention of anorexia

There is no guaranteed way that anorexia nervosa can be prevented.

Primary care physicians can help identify the symptoms of anorexia before it becomes a disorder. Health care begins with a review of eating habits.

The patient should see a psychologist if he is not satisfied with his appearance.

If a friend or member of your family is observed to have severe dieting habits, low self-esteem, and hates their body in terms of appearance, they should be advised to discuss these issues and seek professional help.

The problem must be treated not only by preventing it, but by assuming a healthy behavior, which allows knowing the advantages of eating healthy food.