The Warning Signs and Symptoms of Anorexia Nervosa

Anorexia nervosa is a complex eating disorder that can cause serious and potentially life-threatening complications. Individuals with this disorder have a strong fear of weight gain and a distorted perception of their body shape and weight. 

Treatment for anorexia nervosa can involve and include many approaches. Different types of talk therapy, including but not limited to cognitive behavioral therapy (CBT), may help reduce symptoms and associated risks. 

However, recognizing the signs of this eating disorder isn’t always easy. Below, we’ll explore the symptoms of anorexia disorder in more detail, including physical, behavioral, and emotional symptoms. 

Understanding anorexia nervosa 

Concerns about body weight can be common due to societal pressures. But for those with anorexia nervosa, these concerns are intense and lead to disordered eating behaviors. Individuals with this eating disorder take extreme measures to prevent weight gain.

They often have a false sense of what they look like, such as believing themselves to be above a healthy weight for their body size. This distorted view of their appearance can cause them to restrict their food intake or avoid gaining weight in other ways.

Diagnostic criteria for anorexia nervosa 

The symptoms of anorexia nervosa can take a toll on an individual’s physical, emotional, and mental health and well-being. With a formal diagnosis, those who have this eating disorder can begin treatment in order to recover.

In the following section, we’ll go over the criteria that mental health professionals use to formally diagnose anorexia nervosa. An individual who might be experiencing symptoms of anorexia nervosa should work with a health professional before a formal diagnosis can be concluded. Some of these symptoms can be signs of other disorders or health issues, so it's important not to self-diagnose and to see a professional for a formal diagnosis. 

These criteria from the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) are for informational purposes and include:

• Restriction of energy intake relative to requirements: Eating less than the body requires for enough energy. 
• Intense fear of gaining weight: Having strong fears about putting on any weight — no matter what one’s current body weight is. 
• Disturbance in the way one’s body weight or shape is experienced: Seeing or perceiving themselves in a different way than they really look.
• Undue influence of body weight or shape on self-evaluation: Focusing too much on body shape and weight when determining one’s self-worth and self-esteem.
• Denial of the seriousness of the current low body weight: Failing to recognize being at a low body weight and the physical effects this has on the body. 

Early warning signs of anorexia nervosa 

Starting treatment sooner rather than later can help lower the risk of developing serious medical complications from anorexia nervosa. But people might not know what to look for or how to talk to a loved one that they’re concerned about. Below, we’ll discuss early signs of this eating disorder. 

Excessive focus on body weight and shape 

Individuals with anorexia nervosa are often obsessed with their body weight, regardless of how much they actually weigh. To control their weight, they might limit their food intake or start dieting. For example, they might begin to restrict the number of calories they consume per day. 

Distorted self-image 

For those who have anorexia nervosa, the thought of gaining weight is frightening. These individuals have severe, ongoing fears of putting on weight. They might think they weigh too much — even if they’re below what is considered a healthy weight for them. 

They might see their body shape as larger than it actually is. This distorted body image can end up causing them to feel distressed about their appearance. 

Intense fear of gaining weight 

Many people worry about weight gain occasionally, such as during the holidays when it’s common to overindulge. However, individuals with anorexia nervosa have an extreme fear of putting on weight — even a slight amount. They check their weight obsessively and even weigh themselves multiple times a day to check for changes.

Avoidance of food and meal situations 

Being so fearful of gaining weight often results in unhealthy attitudes and behaviors toward food and eating. People with anorexia nervosa might start skipping meals to prevent weight gain. Or they might avoid eating altogether. 

Some individuals may only eat smaller portions of food in order to restrict their food intake. In some cases, people with anorexia nervosa might binge eat and purge through self-induced vomiting, laxatives, or other means on occasion. 

Physical symptoms of anorexia nervosa 

This eating disorder can cause physical changes, especially for those who avoid eating or severely limit their food intake. Not getting enough nutrients due to disordered eating habits may lead to physical signs that affect different parts of the body. Below, we’ll explore some of these symptoms. 

Significant weight loss 

Not eating enough food results in weight loss. For individuals with anorexia nervosa, this may occur rapidly rather than gradually. They might also continue to lose weight. Note that some medical causes can result in significant weight loss like this. In cases of anorexia nervosa, losing weight occurs without underlying medical causes. 

Insomnia and fatigue 

People need enough nutrients to support their energy levels. Individuals with anorexia nervosa don’t get the nutrients they need, resulting in frequent or constant feelings of fatigue or tiredness. They might also develop sleep problems, such as insomnia. 

Hair and skin changes 

A lack of nutrients can lead to noticeable changes in hair, skin, and nails. Individuals with anorexia nervosa might have brittle nails that split or break easily. They might also have thinning hair, hair loss, and/or dry skin from not getting enough nutrients from food. 

Menstrual irregularities or absence 

Restricting food intake can affect menstruation. In those who have anorexia nervosa, this may lead to missed periods or periods that stop completely. This is because the systems responsible for these cycles aren’t getting the nutrients needed to function. 

Behavioral and emotional symptoms 

Anorexia nervosa may have a significant impact on emotional wellness and behavior. Individuals with this eating disorder might behave in ways that are unhelpful or unhealthy for their mental and physical well-being. Changes in mood and emotions are also common. In the following sections, we’ll go over a few behavioral and emotional symptoms of anorexia nervosa. 

Preoccupation with food, calories, and dieting 

Those with this eating disorder may focus on food intake and weight as a way to have a sense of control over their life. They often become overly focused on what they eat, the amount of food they eat, and how many calories they’re consuming. 

They might spend an excessive amount of time planning their meals and focusing on the nutritional content of the foods they eat. 

Change and withdrawal from social activities 

People who have anorexia nervosa might begin to withdraw from social activities they usually take part in. Or they might pull away from friends and family and isolate themselves. 

This can happen on a regular basis, or they might only become isolated and withdrawn during meal times. For example, they might avoid going out to eat with others or sitting at the table during family meals. 

Mood swings and irritability 

Not getting enough nutrients due to food intake restriction makes it harder for the body and brain to function. Those with anorexia nervosa may develop sudden changes in mood or frequent mood swings as a result. 

They might have depression, irritability, or other mood changes without any obvious cause to those around them. These changes can affect different areas of their lives, such as their relationships, or job or school performance. 

Exercising excessively 

Limiting food intake or skipping meals aren’t the only ways that individuals with anorexia nervosa try to prevent weight gain. Some might also engage in intense exercises or physical activities.

For example, they might do strenuous workouts several times per week. Excessive exercise is an attempt to burn off calories so that they’ll lose more weight or will burn off any calories from food they'd recently eaten.

Seek professional help with SonderMind 

Talking to a therapist is a common treatment for anorexia nervosa. Individuals with early signs might seek a diagnosis and follow a treatment plan that a mental health professional provides. This may reduce the risk of eating disorder relapse and help them recover.

Talk therapy offers effective treatment for many mental health conditions, including eating disorders — even those not otherwise specified (EDNOS). Anyone experiencing symptoms of disordered eating should seek professional treatment to ensure they get the support they need and deserve.

If you’re dealing with concerns that are affecting your mental and emotional well-being, therapy can help. SonderMind provides a convenient way to connect with a licensed therapist who can help address your mental health concerns — whether you’re seeking online or in-person therapy. 

Connect with a SonderMind therapist today.