What is Anorexia Nervosa?

A person with anorexia nervosa has an intense fear of gaining weight. They tend to have an excessive preoccupation with food and limit their food intake, even though they are very thin. Anorexia is characterized by unhealthy methods of weight control, including excessive exercise; pill, diuretic or laxative abuse; and fasting or binge eating. Anorexia is a way of using food or starving oneself to gain control of life. Most people with anorexia are female.

What are some signs of anorexia?

A person with anorexia may exhibit the following:

  • low body weight for her or his height
  • distorted body image (wearing baggy clothes, thinking he or she is fat)
  • unable to maintain normal body weight
  • exercising excessively, even when tired or injured
  • taking pills to urinate or have a bowel movement
  • intense fear of gaining weight
  • self-induced vomiting
  • belief that they are fat even when very thin
  • weighing food and counting calories
  • pushing food around on plate but not eating

What forms of treatment are effective for anorexia nervosa?

Behavioral monitoring and nutritional rehabilitation are introduced to normalize weight. Psychotherapy is also used to target and address irrational weight and body image preoccupations. Interventions include prescribing a proper diet, monitoring weight gain, and admitting patients who are unable to gain weight to a specialty inpatient program. Specialty programs combine close behavioral monitoring with psychological therapy. These programs are generally highly effective in achieving weight gain in patients unable to gain weight in outpatient settings. The fear of fatness and body dissatisfaction characteristic of the disorder tend to extinguish gradually over several months if target weight is maintained, and 50-75% of patients eventually recover.

What is outpatient care for anorexia treatment?

With outpatient care, the patient receives treatment through visits with members of their health care team. Often this means going to a doctor’s office. Outpatients usually live at home.

Some patients may need “partial hospitalization.” This means that the person goes to the hospital during the day for treatment, but sleeps at home at night.

In some cases, inpatient care is required, which means the patient goes to a hospital and stays there for treatment. After leaving the hospital, the patient continues to get help from her health care team and becomes an outpatient.

What should I do if I think someone I know has anorexia?

If someone you know is showing signs of anorexia, you may be able to help.

  1. Set a time to talk. Confer privately with your friend. Make sure you talk in a quiet place where you won’t be distracted.
  2. Tell your friend about your concerns. Be honest. Tell your friend about your worries about her or his not eating or over-exercising. Tell your friend you are concerned and that you think these things may be a sign of a problem that needs professional help.
  3. Ask your friend to talk to a professional. Your friend can talk to a counselor or doctor who knows about eating issues. Offer to help your friend find a counselor or doctor and make an appointment, and offer to go with her or him to the appointment.
  4. Avoid conflicts. If your friend won’t admit that she or he has a problem, don’t push. Be sure to tell your friend you are always there to listen if she or he wants to talk.
  5. Don’t place shame, blame, or guilt on your friend. Don’t say, “You just need to eat.” Instead, say things like, “I’m concerned about you because you won’t eat breakfast or lunch.” Or, “It makes me afraid to hear you throwing up.”
  6. Don’t give simple solutions. Don’t say, “If you’d just stop, then things would be fine!”
  7. Let your friend know that you will always be there no matter what.

Adapted from “What Should I Say? Tips for Talking to a Friend Who May Be Struggling with an Eating Disorder” from the National Eating Disorders Association.

For further information

For more information about anorexia nervosa, contact the following organizations: