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Anorexia Nervosa

Anorexia Nervosa is characterized by self-starvation and excessive weight loss.

Primary Features:

• Refusal to maintain a normal body weight for age and height: loss of at least 15 per cent of normal weight
• Intense fear of gaining weight or becoming fat
• Distorted body image (feeling fat even when too thin)
• In females, amenorrhea (absence of menstrual periods)

Associated Features:

Physical Characteristics:

• Low body weight:
• Slowed heart rate; low blood pressure
• Reduced body temperature; Sensitivity to cold
• Loss of menstrual periods (women)
• Reduced testosterone levels (men)
• Lowered resistance to infection
• Growth of body hair (lanugo)
• Dizziness & fainting
• Muscular weakness
• Fatigue

Behavioral Characteristics:

• Excessive dieting, food control, and fasting
• Compulsive exercising (initially high energy level followed by chronic fatigue)
• Insomnia and early morning awakening
• Wearing layers of clothes to hide weight loss and combat sensitivity to cold
• Food rituals (e.g., eats the same meal everyday, counting food bites, cutting food into tiny pieces)
• Collecting recipes and liking to cook/bake for others but refusing to eat
• Frequent weighing
• Excessive focus on job and/or school work
• Binge-eating (many anorexics periodically binge and purge)
• Over-involvement in organizations or clubs or social activities
• Tension at mealtimes (avoids eating with others)
• Compulsive patterns (e.g., highly organized)

Emotional and Attitudinal Characteristics:

• Intense fear of becoming fat
• Perfectionistic tendencies (thinnest, smartest, neatest, etc.)
• Depression and/or anxiety
• Self-absorption
• Irritability
• Decreased interest in sex
• Distorted body image
• Façade of normalcy (seemingly "has it altogether")
• Low self-esteem; self-loathing
• Denial (usually doesn’t want help)
• Dichotomous thinking; all or nothing; (e.g., viewing foods as "good" or "bad")
• Obsessive thinking; constant preoccupation with food control
• Difficulty identifying and expressing negative emotions (e.g., anger)
• Need to be socially withdrawn & isolated