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  • Need to be socially withdrawn & isolated