Anorexia Nervosa: What Happens

Content provided by Healthwise

What Happens

Anorexia nervosa almost always begins with a plan to follow a strict weight-loss diet. Limiting foods then leads to malnutrition and unhealthy weight loss. As malnutrition sets in, the brain and metabolism change. This limits the appetite, how the body can use food, and the person's ability to think clearly and make good decisions.

After anorexia starts, it is very difficult for the person to return to normal eating without help. When left untreated, anorexia can continue for a lifetime. This leads to long-term malnutrition or starvation—and sometimes death.

If you struggle with anxiety, tend to finish the things you start, and strive for perfection, you may be at risk for crossing the line from dieting to anorexia.^{5 2} For some people, anorexic eating habits can meet a need for personal control and self-esteem. Some teens may fall into this pattern as a way to cope with big changes and challenges.

Early treatment of anorexia offers the best chance of recovery. The more irrational eating habits that a person develops, the harder it is to return to a healthy outlook on nutrition. Because people who have anorexia tend to strongly deny that they have a problem and are secretive about their eating, family members or loved ones usually seek help for them on their behalf.

As the illness advances, irrational behaviors begin. These can include:

• Making rules about food—for example, eliminating dairy products or meat because they are perceived as "high-calorie."
• Creating rituals about how food should be eaten—chewing food a certain number of times.
• Developing a fear of food—fearing weight gain if any food at all is eaten.
• Losing the ability to feel hunger or learning to ignore the feeling of hunger.
• Exercising too much.
• Taking laxatives or water pills (diuretics) or making yourself vomit because of fear of gaining weight (bulimia).

People who have anorexia can become socially withdrawn and lose interest in the outside world.⁶

Starvation and malnourishment from anorexia commonly cause complications, such as osteoporosis or an irregular heartbeat. Often other mental health conditions occur along with anorexia, such as depression. Treating a mood disorder is an important part of treating anorexia.

A person who has anorexia is usually seen by a health professional for other complaints that are related to anorexia. These may include:¹

• Fatigue and lack of energy.
• Abdominal pain and, sometimes, constipation.
• Absence of menstrual periods.
• Frequent vomiting (although the person does not admit that it is self-induced).
• Symptoms of depression.
• Suicide risk.
• Joint pain (from excessive exercise or an electrolyte imbalance).

Last updated:	September 25, 2007
Author:	Jeannette Curtis
Reviewed By:	Kathleen Romito, MD - Family Medicine, W. Stewart Agras, MD - Psychiatry
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC