There are a lot of myths out there about anorexia. Here are some FAQs if you’re looking for the facts.
Anorexia is an eating disorder involving fear of weight gain and stress around your body image. Over time, it can cause weight loss that leads to health complications.
The behaviors connected to anorexia — like restricting food, overexercising, and sometimes purging — are often driven by strong anxiety about getting bigger, even when the person falls into a low weight range.
With treatment, you can develop a more positive relationship with food, your body, and your self-image.
Anorexia revolves around calorie restriction, fasting, and for many, compulsive exercising.
If you experience anorexia, these behaviors can feel like a relief because they help you manage how you feel about your body. But mental health professionals call these behaviors “maladaptive,” meaning they tend to harm more than help overall.
While restricting food is what comes to mind for many when they think of anorexia, there’s more to it than that.
There are actually a couple of subtypes of anorexia, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):
- Restricting type. This type of anorexia involves cutting down food intake and/or exercising to make up for eating food.
- Binge eating/purging type. In addition to restricting food, someone with this subtype will experience cycles of binge eating and purging.
It’s also not uncommon to have both subtypes at once.
How common is anorexia?
According to the DSM-5, about 0.4% of young females experience anorexia each year. Earlier
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Who does anorexia impact?
It’s a common misconception that anorexia only affects upper- and middle-class women. In reality, anyone can experience it — but these misconceptions could still impact how soon someone gets treatment or what kind of treatment they get.
Anorexia usually starts in the teen and young adult years. While it can affect people who are younger or older, it rarely does.
Anorexia could be anywhere from 2 to 10 times more common in women than in men, depending on which study you look at.
Still, men with anorexia may be less likely to report it because of the stigma tied to the eating disorder. This could delay care that would otherwise help them recover.
While one of the key symptoms of anorexia is weight loss, it doesn’t just look one way. Many physical and emotional symptoms can accompany anorexia, and some of these can depend on how long you’ve had anorexia and how severe it is for you.
For example, one person with anorexia may feel more socially isolated. Someone else may spend more time cooking and preparing food for others while not eating any of it themselves.
What are some signs and symptoms of anorexia?
Physical symptoms of anorexia can include:
- weight loss
- dizziness or faintness
- irregular or no periods
- hyperpigmentation (areas of darker skin)
- callused knuckles
- dry hair and nails
- slow wound healing
- lower immunity
Emotional and mental symptoms can include:
- constant thoughts about weight, food, and body image
- extreme fear of getting bigger
- need to feel in control
- rigid thinking
- depression, anxiety, or irritability
- food rituals
- isolation or holding back from social situations
- insomnia or other sleep problems
- fear of eating in public
Are people with anorexia always ‘thin’?
People with anorexia may have a smaller body, but this isn’t always true. It’s not possible to tell if someone has anorexia or another eating disorder just by looking at them.
One key symptom of anorexia is losing a significant amount of weight in a short amount of time. People with atypical anorexia tend to start out at higher weights. They might not register as low weight according to scales like the BMI, even though they have an eating disorder.
One recent study involving military veterans found that atypical anorexia is more common than many experts thought.
What’s the difference between anorexia and bulimia?
Anorexia and bulimia are both eating disorders that can cause serious health complications. While there’s some overlap between the two, the symptoms and behaviors around each are also different.
Anorexia mainly revolves around food restriction (and sometimes binging and purging). Meanwhile, bulimia involves only binging and purging. A bulimia diagnosis tends to apply when an anorexia diagnosis isn’t a better fit.
For example, someone with the binge eating and purging type of anorexia wouldn’t also have bulimia, according to the DSM-5.
Both of these eating disorders stem from unhappiness around body image and a fear of weight gain.
Living with anorexia can make you feel isolated or stuck in your own head. You might experience shame and thoughts of not being good enough.
Healing isn’t as easy as just changing a few behaviors, because in many cases, these behaviors are actually maladaptive (unhelpful) coping mechanisms. In addition, people don’t always recognize that anorexia is harming their health.
Part of recovery might involve finding coping mechanisms that support your overall well-being.
Can anorexia affect my social life?
Anorexia can affect your social life. For many people with anorexia, eating in public sparks anxiety. People with anorexia may even avoid eating with others at home, preferring to spend dinner time in their room or somewhere else.
Rigid food and exercise habits might also take priority over spontaneous get-togethers with friends that might involve food.
Because anorexia can wall you off from even the people you usually go to for support, it tends to cause social isolation. While it can feel difficult to climb out of that isolation, treatment can help break down this feeling and make it easier to start reconnecting.
Are some people more likely to live with anorexia?
There are some risk factors for anorexia, or factors that mean you have higher chances of experiencing anorexia. Some of these include:
- being female
- living with type 1 diabetes
- having an anxiety disorder
- having a close family member with an eating disorder
- having a close family member with a mental health condition
- being bullied
People who have experienced trauma in childhood are also more likely to develop eating disorders like anorexia.
What causes anorexia?
Anorexia is influenced by several different biological and environmental factors, including:
- brain chemistry
- family behaviors
- how your culture views weight and body size
- body image
It’s also not uncommon for someone with anorexia to have a personal or family history of anxiety, depression, or obsessive-compulsive symptoms.
The first step is reaching out for help. You can talk to your doctor, who may refer you to an eating disorder specialist or another treatment program.
If you’re under 18 years old, you can also talk with an adult you trust who can help you find treatment and support.
How is anorexia diagnosed?
Anorexia can be diagnosed by a healthcare professional, such as:
- a pediatrician
- a family practitioner
- a psychiatrist
This often starts with a mental and physical evaluation. Your healthcare professional might use criteria in the DSM-5 to diagnose anorexia. These criteria include:
- restricting food in a way that causes weight loss that impacts health
- having a fear of gaining weight
- viewing your body as larger than it is
- having a sense of self that’s tied closely to your body size
- lacking recognition that your weight loss is posing health risks
What kinds of treatment can help?
Care for anorexia will depend on your unique needs and symptoms. For example, someone with a secondary health complication may need a different level of healthcare than someone without that complication.
From least to most involved, treatment options for anorexia can include:
- outpatient treatment
- intensive outpatient treatment
- partial hospitalization
- residential care
Each type of treatment can involve a combination of:
- therapy, such as cognitive behavioral therapy (CBT) and family therapy
- group sessions
- nutritional counseling
If you’re interested in what treatments are available for anorexia, you can learn more about them here.
What’s the difference between inpatient and outpatient care for anorexia?
Outpatient programs can help people who need support for anorexia but are able to keep up their day-to-day routine at home. If you’re in outpatient care, you might have therapy or nutritional counseling once or several times a week.
Inpatient hospitalization is likely to help people who need more intensive care for anorexia. Inpatient care can involve a stay at a hospital or treatment center, and could include medical and mental health care.
What should I do if I think someone I know has anorexia?
Approaching a loved one about a topic like this can be tough. One helpful way to start is to come from a place of curiosity and support rather than blame, shame, or accusation.
It can help to read up on anorexia symptoms and treatments ahead of time so you’re equipped with the facts. You might find a private moment to talk, and let them know what behaviors and habits you’ve noticed.
Listen to their side of the story and let them know you’re there for them. If they’re ready, you can also offer to help them take the first steps to connecting with treatment, whether it’s making a phone call, doing an online search, or setting up an appointment.
Anorexia can take a significant toll on the mind and body. But with the right treatment, you can develop a positive relationship with food, your body, and yourself.
Many people make a full recovery from anorexia. While no recovery journey is exactly the same, each path to healing starts with one step.