Anorexia Nervosa

Overview

Anorexia nervosa is a serious mental health condition in which a person severely limits how much food they eat, often because they have an intense fear of gaining weight or a distorted view of their body. It is not about vanity or choice — it is a real illness that affects both the mind and body. With the right help, recovery is possible.

Anorexia is one of the most talked-about eating disorders, but it is relatively uncommon. It affects a small but significant number of people, and it can happen at any age.

Anorexia can affect anyone, regardless of gender, age, background, or body size. It is most often diagnosed in teenage girls and young women, but men and boys also develop it, as do older adults.

Symptoms

Common symptoms

• Very low body weight or rapid weight loss without a medical reason
• Intense fear of gaining weight or becoming 'fat'
• Restricting food, skipping meals, or eating very tiny portions
• Avoiding eating around other people
• Excessive exercise even when tired or unwell
• Preoccupation with food, calories, or dieting
• Feeling fat even when underweight
• Wearing layers to hide weight loss or stay warm
• Fatigue, dizziness, feeling cold, or poor concentration

Symptoms in children

• In children, growth may slow down or stop
• They may lose weight or fail to gain expected weight
• They may avoid meals, hide food, or show new food rules
• They may become withdrawn, irritable, or anxious
• They may complain of stomach aches before or after meals

Symptoms in older adults

• Older adults may have weight loss linked to grief, illness, or life changes
• They may have more physical symptoms like falls, confusion, or heart problems
• They may use diet rules or 'healthy eating' to restrict food
• Family and doctors may miss anorexia because weight loss is blamed on ageing or other conditions

Causes

Main causes

• There is no single cause; anorexia develops from a mix of biological, psychological, and social factors
• Some people may have a genetic or family history of eating disorders or mental health conditions
• Unhelpful thoughts about body image and low self-esteem can play a role
• Stressful life events, such as loss, abuse, trauma, or bullying, can trigger the illness
• Cultural pressure to be thin and diet culture can contribute

Risk factors

• Being female, although males also develop anorexia
• Being a teenager or young adult, though it can start at any age
• Having a family member with an eating disorder or mental illness
• Having an anxious, perfectionistic, or highly self-critical personality
• Playing sports or doing activities that focus on weight, such as ballet, gymnastics, or wrestling
• Having depression, anxiety, or obsessive-compulsive traits
• A history of dieting or weight-related criticism

When to see a doctor

See a doctor urgently if:

• If you or someone you know has fainted, has chest pain, severe weakness, or feels unable to eat or drink
• If there are thoughts of self-harm or suicide, seek help immediately

Book a routine appointment if:

• Make an appointment with a healthcare provider if you have concerns about someone's eating habits or weight, or your own
• If you notice new food rules, secret eating, or rapid weight loss in yourself or a loved one, don't wait for 'proof' of a problem

Diagnosis

A doctor makes a diagnosis of anorexia nervosa by listening to your history, asking about eating habits, body image, and weight changes, and doing a physical examination. They may also talk with family or close friends with your permission to get a fuller picture.

Tests that may be done

• A physical examination, including weight, height, blood pressure, and heart rate
• Blood tests to check electrolytes, blood sugar, kidney and liver function
• An electrocardiogram (ECG) to check the heart's rhythm
• A bone density scan if underweight for a long time, to check bone health
• Urine tests to check hydration and other body functions

What to expect at your appointment

Your doctor may ask very personal questions about food, weight, feelings, and habits. This is to understand your situation, not to judge you. They may also refer you to a specialist eating disorder team. A diagnosis is an opportunity to start recovery, not a label to fear.

Treatment

Treatment for anorexia nervosa usually involves a team of professionals. It focuses on restoring physical health, building a healthier relationship with food, and addressing the emotional and psychological issues behind the illness. Treatment may be provided in the community, through an outpatient clinic, or in hospital depending on your physical health and safety.

Self-care at home

• Follow the advice of your care team and attend appointments regularly
• Work with a dietitian or doctor to create a balanced, structured eating plan
• Avoid weighing yourself every day; let your care team monitor your weight
• Reach out to trusted friends or family when you feel low or tempted to restrict
• Be patient with yourself — recovery can take time and is not a straight line
• Avoid triggering diet talk or images on social media

Medical treatments

Medical treatment for anorexia is primarily psychological, not medication-based. It may include talking therapies such as family-based therapy for children and young people, cognitive behavioural therapy, or specialist eating disorder therapy. A healthcare provider may sometimes offer medication to help with related conditions like depression or anxiety, but this is always alongside psychological support and nutritional care, never as a stand-alone treatment. A doctor will monitor your physical health closely, and if there are dangerous complications, you may need inpatient care in a hospital.

When is surgery considered?

Surgery is not a treatment for anorexia nervosa. If someone with anorexia needs an operation for an unrelated health condition, their medical team will first work to stabilise their weight and physical health as much as possible before any surgical procedure.

Living with this condition

Living with anorexia means learning to rebuild your life around health rather than the illness. On a daily basis, this may include eating regular meals, attending therapy, taking medications if prescribed, and practising coping skills for difficult thoughts. Recovery often involves small, consistent steps and plenty of self-compassion.

Lifestyle tips

• Keep a regular meal and sleep schedule to support physical recovery
• Find relaxing activities that do not revolve around food, such as music, art, or spending time in nature
• Limit time on social media accounts that promote dieting or unrealistic body ideals
• Stay connected with people who support you and make you feel safe
• Learn to ask for help when thoughts or urges feel overwhelming

Diet and exercise

In anorexia, eating enough is the first priority. Exercise may need to be paused or reduced because the body is already under stress. Work with your doctor or dietitian to build a safe, balanced approach to food and movement. For some people, gentle physical activity can slowly be reintroduced as part of recovery, but it should be guided by your care team.

Mental health and emotional wellbeing

Anorexia often comes with anxiety, depression, shame, and obsessive thoughts about food and body. These are part of the illness, not personal weaknesses. Talking therapies can help you challenge unhelpful patterns and develop healthier ways to cope with emotions.

Prevention

There is no guaranteed way to prevent anorexia, but early help makes a big difference. Encouraging balanced attitudes toward food, weight, and body image in families, schools, and communities can help reduce risk. If you notice worrying signs early, seek professional advice rather than waiting.

Vaccines

There is no vaccine to prevent anorexia nervosa. Keeping up to date with routine vaccinations is still important for overall health, especially for people recovering from an eating disorder.

Screening programmes

There is no routine national screening test for anorexia. In general practice, doctors may ask questions about eating habits, weight, and body image during check-ups, especially if they have concerns. Being open about these topics can help you get support earlier.

Complications

If left untreated

• Severe malnutrition
• Heart problems, including abnormal rhythms or heart failure
• Osteoporosis, or weak and fragile bones
• Kidney and liver damage
• Infertility and loss of periods
• Severe dehydration and electrolyte imbalances
• Long-term digestive problems
• Increased risk of depression, anxiety, and suicidal thoughts

Long-term outlook

Anorexia is a serious illness, but recovery is possible. Many people make significant progress with the right support. Recovery can take months or years, and it is normal to have setbacks along the way. With early, consistent care and a strong support network, most people can rebuild their health and live a meaningful, fulfilling life.

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