Health A to Z: Overview - Anorexia nervosa

Anorexia nervosa (often called anorexia) is an eating disorder and serious mental health condition.

People who have anorexia try to keep their weight as low as possible. They may do this in different ways, such as not eating enough food, exercising too much, taking laxatives or making themselves sick (vomit). This can make them very ill because they start to starve.

They often have a distorted image of their bodies, thinking they're fat even when they're underweight.

Men and women of any age can get anorexia, but it's most common in young women and typically starts in the mid-teens.

Signs and symptoms of anorexia include:

• if you're under 18, your weight and height being lower than the minimum expected for your age
• if you're an adult, having an unusually low body mass index (BMI)
• missing meals or eating very little
• thinking about food a lot and being very careful about what you eat, such as avoiding eating any foods you see as fattening
• believing you're fat when you're a healthy weight or underweight
• your periods stopping (in women who have not reached menopause) or not starting (in younger women and girls)
• physical problems, such as feeling lightheaded or dizzy, hair loss or dry skin

Some people with anorexia may also make themselves sick or do an extreme amount of exercise.

Some use medicines to reduce their hunger (appetite suppressants), help them poo (laxatives) or make them pee (diuretics) to try to stop themselves gaining weight from any food they do eat.

Getting help and support as soon as possible gives you the best chance of recovering from anorexia.

If you think you may have anorexia, even if you're not sure, see a GP as soon as you can.

They will ask you questions about your eating habits and how you're feeling. They will probably weigh you, and check your heart rate, blood pressure and temperature.

They may also want to do some blood tests and to check your overall physical health.

If they think you may have anorexia, or another eating disorder, they should refer you to an eating disorder specialist or team of specialists.

It can be very hard to admit you have a problem and to ask for help. It may make things easier if you bring a friend or loved one with you to your appointment.

You can also talk in confidence to an adviser from eating disorders charity Beat by calling its helpline on 0808 801 0677.

Getting help for someone else

If you're concerned that a family member or friend may have anorexia, let them know you're worried about them and encourage them to see a GP. You could offer to go along with them.

Read more about advice for parents on eating disorders and how to help someone with an eating disorder.

You can recover from anorexia, but it may take time and recovery will be different for everyone.

Your treatment plan will be tailored to you and should consider any other support you might need, such as for depression or anxiety.

If you're over 18, you should be offered a type of talking therapy to help you manage your feelings about food and eating so that you are able to eat enough to be healthy.

Talking therapies that are commonly used to treat anorexia in adults include:

• cognitive behavioural therapy (CBT)
• Maudsley anorexia nervosa treatment for adults (MANTRA)
• specialist supportive clinical management (SSCM)

If you're under 18, you should be offered family therapy. You may also be offered another type of talking therapy, such as CBT or adolescent-focused psychotherapy.

Find out how to get mental health support for children and young people.

Long-term anorexia can lead to severe health problems associated with not getting the right nutrients (malnutrition). But these will usually begin to get better once your food intake starts improving.

Possible complications include:

• problems with muscles and bones – including feeling tired and weak, osteoporosis, and problems with physical development in children and young adults
• fertility problems
• loss of sex drive
• problems with the heart and blood vessels – including poor circulation, an irregular heartbeat, low blood pressure, heart valve disease, heart failure, and swollen ankles, feet and legs (oedema)
• problems with the brain and nerves – including difficulties with concentration and memory or, less often, fits (seizures)
• kidney or bowel problems
• having a weakened immune system or anaemia

Anorexia can also put your life at risk. It's one of the leading causes of deaths related to mental health problems. Deaths from anorexia may be due to physical complications or suicide.

We do not know exactly what causes anorexia and other eating disorders. You may be more likely to get an eating disorder if:

• you or a member of your family has a history of eating disorders, depression, or alcohol or drug addiction
• you have been criticised for your eating habits, body shape or weight
• you're overly concerned with being slim, particularly if you also feel pressure from society or your job – for example, ballet dancers, jockeys, models or athletes
• you have anxiety, low self-esteem, an obsessive personality or are a perfectionist
• you have been emotionally, physically or sexually abused