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Anorexia nervosa

Eating disorder - anorexia

Anorexia nervosa is an eating disorder that makes people lose more weight than is considered healthy for their age and height.

Persons with this disorder may have an intense fear of weight gain, even when they are underweight. They may diet or exercise too much or use other ways to lose weight.

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Causes

The exact causes of anorexia nervosa are not known. Many factors may be involved. Genes and hormones may play a role. Social attitudes that promote very thin body types may also be involved.

Risk factors for anorexia include:

Anorexia often begins during the pre-teen or teen years or young adulthood. It is more common in females, but may also be seen in males.

Symptoms

A person with anorexia usually:

People with anorexia may severely limit the amount of food they eat. Or they eat and then make themselves throw up. Other behaviors include:

Other symptoms of anorexia may include:

Exams and Tests

Tests should be done to help find the cause of weight loss, or see what damage the weight loss has caused. Many of these tests will be repeated over time to monitor the person.

These tests may include:

Treatment

The biggest challenge in treating anorexia nervosa is helping the person recognize that they have an illness. Most people with anorexia deny that they have an eating disorder. People often enter treatment only when their condition is serious.

Goals of treatment are to restore normal body weight and eating habits. A weight gain of 1 to 3 pounds per week is considered a safe goal.

Different programs have been designed to treat anorexia. Sometimes the person can gain weight by:

Many patients start with a short hospital stay and follow-up with a day treatment program.

A longer hospital stay may be needed if:

Care providers who are usually involved in these programs include:

Treatment is often very difficult. Patients and their families must work hard. Many therapies may be tried until the patient overcomes this disorder.

Patients may drop out of programs if they have unrealistic hopes of being "cured" with therapy alone.

Different kinds of talk therapy are used to treat people with anorexia:

Medicines such as antidepressants, antipsychotics, and mood stabilizers may help some anorexic patients when given as part of a complete treatment program. These medicines can help treat depression or anxiety. Although medicines may help, none has been proven to decrease the desire to lose weight.

Support Groups

The stress of illness can be eased by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

Anorexia nervosa is a serious condition that can be life-threatening. Treatment programs can help people with the condition return to a normal weight. But it is common for the disease to return.

Women who develop this eating disorder at an early age have a better chance of recovering completely. Most people with anorexia will continue to prefer a lower body weight and be very focused on food and calories.

Weight management may be hard. Long-term treatment may be needed to stay at a healthy weight.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Talk to your health care provider if someone you care about is:

Getting medical help right away can make an eating disorder less severe.

Related Information

Weight loss - unintentional
Bulimia
Dehydration
Electrolytes
Arrhythmias

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.

Becker AE, Mickley DW, Derenne JL, Kibanski A. Eating disorders: evaluation and management. In: Stern TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 37.

Fisher Ca, Hetrick SE, Rushford N. Family therapy for anorexia nervosa. Cochrane Database Syst Rev. 2010 Apr 14; (4):CD004780. PMID: 20393940 www.ncbi.nlm.nih.gov/pubmed/20393940.

Rosen DS, American Academy of Pediatrics Committee on Adolescence. Clinical report: identification and management of eating disorders in children and adolescents. Pediatrics. 2010;126:1240-53. PMID: 21115584 www.ncbi.nlm.nih.gov/pubmed/21115584.

Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet. 2010;375(7914):583-93. PMID: 19931176 www.ncbi.nlm.nih.gov/pubmed/19931176.

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Review Date: 3/10/2014  

Reviewed By: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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