Eating disorder - anorexia nervosa
Anorexia is an eating disorder that causes people lose more weight than is considered healthy for their age and height.
People 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.
The exact causes of anorexia 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.
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:
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:
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. They often seek 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 (lb) per week is considered a safe goal.
Different programs have been designed to treat anorexia. These may include any of the following measures:
To start, a short hospital stay may be recommended. This is followed by 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. People and their families must work hard. Many therapies may be tried until the disorder is under control.
People 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 people 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.
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.
Anorexia 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.
Anorexia can be dangerous. It may lead to serious health problems over time, including:
Talk to your health care provider if someone you care about is:
Getting medical help right away can make an eating disorder less severe.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.
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Lock J, La Via MC; American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter for the assessment and treatment of children and adolescents with eating disorders. J Am Acad Child Adolesc Psychiatry. 2015;54:412-425. PMID 25901778
Tanofsky-Kraff, M. Eating disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 219.
Thomas JJ, Mickley DW, Derenne JL, et al. Eating disorders. In: Stern TA, Fava M, Wilens TE, et al, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 37.
Last reviewed on: 2/2/2016
Reviewed by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.