People who intentionally starve themselves suffer from an eating disorder called anorexia nervosa. The disorder, which usually begins in young people around the time of puberty, involves extreme weight loss that is less than what is considered minimally normal. Many people with the disorder look emaciated but are convinced they are overweight. Sometimes they must be hospitalized to prevent starvation.
People with anorexia typically starve themselves, even though they suffer terribly from hunger pains. One of the most frightening aspects of the disorder is that people with anorexia continue to think they are overweight even when they are bone-thin. For reasons not yet understood, they become terrified of gaining any weight.
Food and weight become obsessions. For some, the compulsiveness shows up in strange eating rituals or the refusal to eat in front of others. It is not uncommon for people with anorexia to collect recipes and prepare gourmet feasts for family and friends, but not partake in the meals themselves. They may adhere to strict exercise routines to keep off weight. Loss of monthly menstrual periods is typical in women with the disorder. Men with anorexia often become impotent.
Specific Symptoms of Anorexia
A person who suffers from this disorder is typically characterized by their refusal to maintain a body weight which is consistent with their build, age and height. The minimum level of severity is based, for adults, on current body mass index (BMI) (see below) or, for children and adolescents, on BMI percentile. The ranges below are derived from World Health Organization categories for thinness in adults; for children and adolescents, corresponding BMI percentiles should be used.
The individual usually experiences an intense and overwhelming fear of gaining weight or becoming fat. This fear is regardless of the person’s actual weight, and will often continue even when the person is near death from starvation. It is related to a person’s poor self-image, which is also a symptom of this disorder. The individual suffering from this disorder believes that their body weight, shape and size is directly related to how good they feel about themselves and their worth as a human being. Persons with this disorder often deny the seriousness of their condition and can not objectively evaluate their own weight.
Many women with anorexia develop amenorrhea, or the absence of her menstrual period, but this is no longer a required criteria in the updated 2013 DSM-5 to receive an anorexia diagnosis.
There are two types of anorexia nervosa:
- Restricting type– The person restricts their food intake on their own and does not engage in binge-eating or purging behavior.
- Binge eating/purging type — The person self-induces vomiting or misuses laxatives, diuretics, or enemas.
Body Mass Calculator:
Body Mass Index or BMI is a tool for indicating weight status in adults. It is a measure of a person’s weight in relation to their height. Below are the BMI ranges corresponding to degree of severity in anorexia.
- Mild: BMI ≥ 17 kg/m2
- Moderate: BMI 16–16.99 kg/m2
- Severe: BMI 15–15.99 kg/m2
- Extreme: BMI < 15 kg/m2
This entry has been adapted for DSM-5 criteria; diagnostic code 307.1.
Psych Central. (2014). Anorexia (Anorexia Nervosa) Symptoms. Psych Central. Retrieved on November 1, 2014, from http://psychcentral.com/disorders/anorexia-anorexia-nervosa-symptoms/
Symptom criteria summarized from:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Last reviewed: By John M. Grohol, Psy.D. on 22 Jun 2014
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