Anorexia nervosa overview

Overview

Anorexia nervosa is a serious eating disorder where a person severely limits how much they eat, often because of an intense fear of gaining weight. They may see themselves as overweight even when they are dangerously underweight. It is a mental health condition that affects both the body and the mind.

Anorexia is less common than some other eating disorders, but it affects people of all ages, genders, and backgrounds. About 1 in 100 people in the UK will have anorexia at some point in their life.

Anorexia can affect anyone, but it is most often diagnosed in teenagers and young adults, especially women. However, men, older adults, and children can also develop it.

Symptoms

Common symptoms

• Severely restricting food intake
• Intense fear of gaining weight or being 'fat'
• Distorted body image – seeing yourself as overweight when you are underweight
• Rapid weight loss or being significantly underweight
• Obsession with food, calories, and dieting
• Avoiding meals or eating in secret
• Excessive exercise
• Feeling cold all the time, tiredness, and dizziness
• Thinning hair, dry skin, and brittle nails

Symptoms in children

• Slowed growth and delayed puberty
• Not gaining weight as expected
• Preoccupation with body shape and weight
• Withdrawal from friends and activities

Symptoms in older adults

• Weight loss that may be wrongly attributed to ageing or other illnesses
• Increased health problems such as osteoporosis, heart issues, and electrolyte imbalances
• Less obvious preoccupation with weight but still restrictive eating

Causes

Main causes

• A mix of genetic, biological, psychological, and social factors
• Brain chemistry differences that affect appetite and mood
• Personality traits like perfectionism, high sensitivity, and low self-esteem
• Cultural pressure to be thin and beauty ideals

Risk factors

• Having a close family member with an eating disorder or other mental illness
• Dieting or weight loss attempts that get out of control
• History of bullying, abuse, or trauma
• Playing sports or doing activities that emphasize leanness (e.g., gymnastics, ballet, wrestling)
• A tendency toward anxiety, depression, or obsessive-compulsive traits

When to see a doctor

See a doctor urgently if:

• If you or someone you know is dangerously underweight, fainting, or having chest pain
• If there are thoughts of suicide or self-harm

Book a routine appointment if:

• If you notice signs of an eating disorder, such as restricting food, intense fear of weight gain, or extreme weight loss
• If you are concerned about your own or a loved one's eating habits and body image

Diagnosis

Diagnosis is made by a healthcare professional—usually a GP, psychiatrist, or eating disorder specialist. They will ask about your eating habits, feelings about food and weight, and check your physical health.

Tests that may be done

• Physical exam (weight, height, vital signs like heart rate and blood pressure)
• Blood tests to check for electrolyte imbalances, anaemia, and organ function
• Bone density scan if weight loss has been long-term
• Electrocardiogram (ECG) to check heart health

What to expect at your appointment

The doctor will ask private but important questions in a caring way. They may also involve family members if you are under 18. The process is meant to understand your situation fully so the best support can be offered.

Treatment

Treatment for anorexia usually involves a team approach, including a doctor, a therapist, and a dietitian. The goal is to restore a healthy weight, address the underlying mental health issues, and change unhealthy thoughts and behaviours around food.

Self-care at home

• Make a commitment to following your treatment plan
• Eat regular, balanced meals even when it feels hard
• Avoid weighing yourself too often
• Practice self-compassion and challenge negative thoughts
• Reach out to trusted friends or family for support

Medical treatments

Treatment may include specialised psychological therapy (such as family-based therapy for adolescents or cognitive behavioural therapy for adults), nutritional counselling to gradually normalise eating, and medical monitoring to manage physical complications. Medications are sometimes used to treat co-occurring conditions like depression or anxiety, but they are not a primary treatment for anorexia itself.

Living with this condition

Living with anorexia means working step by step toward recovery. It involves building a structured meal plan, attending therapy sessions, and learning to cope with difficult emotions without turning to food restriction. Progress can be slow, but every small step counts.

Lifestyle tips

• Set a regular schedule for meals and snacks
• Incorporate gentle physical activity like walking or yoga if approved by your team
• Establish healthy sleep habits
• Avoid triggers like diet talk or social media that promotes extreme thinness

Diet and exercise

A registered dietitian will help you develop a balanced eating plan that slowly increases calorie intake to support safe weight gain. Exercise is usually limited until weight is restored, as excessive exercise can worsen the condition. Gentle movement can be reintroduced later with medical guidance.

Mental health and emotional wellbeing

Anorexia often goes hand in hand with anxiety, depression, and obsessive thoughts. Therapy helps address these feelings and teaches healthier ways to manage stress and self-esteem. It is normal to feel scared or ambivalent about recovery, but with support, things can get better.

Prevention

It may not always be possible to prevent anorexia, but early recognition and intervention can stop it from becoming severe. Promoting a healthy body image, avoiding diet talk, and addressing low self-esteem early can reduce the risk.

Complications

If left untreated

• Severe malnutrition and organ damage (heart, kidneys, liver)
• Osteoporosis (brittle bones) due to lack of nutrients
• Hormonal imbalances leading to infertility or loss of menstruation
• Brain changes that affect thinking and mood
• Increased risk of depression, anxiety, and suicide

Long-term outlook

With early and consistent treatment, many people with anorexia recover fully. Recovery takes time, and there may be setbacks, but it is absolutely possible to regain a healthy weight, heal your relationship with food, and build a fulfilling life.

Find support

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