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Anorexia Nervosa – Causes, Symptoms and Treatment

Anorexia nervosa is a serious eating disorder characterized by extreme underweight, an intense fear of gaining weight, and a distorted body image.

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Things worth knowing about "Anorexia nervosa"

Anorexia nervosa is a serious eating disorder characterized by extreme underweight, an intense fear of gaining weight, and a distorted body image.

What is Anorexia Nervosa?

Anorexia nervosa is a serious mental health condition classified as an eating disorder. People affected by it severely restrict their food intake, leading to dangerous levels of underweight. A defining feature is an intense fear of gaining weight alongside a distorted body image -- individuals perceive themselves as overweight even when they are objectively severely underweight. Among all psychiatric disorders, anorexia nervosa has one of the highest mortality rates.

Causes

Anorexia nervosa develops from a complex interaction of biological, psychological, and social factors:

Biological factors: Genetic predisposition, alterations in serotonin and dopamine levels, and hormonal influences can increase the risk of developing the disorder.
Psychological factors: Perfectionism, low self-esteem, anxiety disorders, obsessive thinking, and a strong need for control are frequently observed.
Social and cultural factors: Societal ideals of thinness, social media pressure, family conflict, and traumatic experiences may all contribute to the development of the condition.

Symptoms

The symptoms of anorexia nervosa affect both physical and psychological well-being:

Physical Symptoms

Significantly low body weight (Body Mass Index below 17.5)
Absence of menstruation (amenorrhea)
Fine downy body hair (lanugo)
Hair loss, brittle nails, dry skin
Low blood pressure and slow heart rate (bradycardia)
Sensitivity to cold, dizziness, and fainting
Electrolyte imbalances that can lead to cardiac arrhythmias

Psychological and Behavioral Symptoms

Intense fear of weight gain despite being underweight
Distorted perception of body shape or size
Preoccupation with food, calories, and dieting
Avoidance of shared meals
Excessive exercise
Social withdrawal and mood changes

Diagnosis

Diagnosis is made by physicians or mental health professionals based on established clinical criteria from the ICD-11 (International Classification of Diseases) or DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Common assessments include:

Physical examination and measurement of height and weight (BMI calculation)
Blood and urine tests to identify nutritional deficiencies and electrolyte imbalances
Electrocardiogram (ECG) to monitor cardiac function
Psychological interviews and standardized eating disorder questionnaires

Treatment

Treatment of anorexia nervosa requires a multidisciplinary approach and typically involves:

Psychotherapy

Cognitive Behavioral Therapy (CBT) is one of the most evidence-based psychological treatments. Other approaches include family-based treatment (especially effective in adolescents), psychodynamic therapy, and Dialectical Behavior Therapy (DBT).

Nutritional Therapy

A gradual restoration of healthy body weight under the supervision of nutrition specialists is essential. This involves a structured meal plan with a carefully increased caloric intake over time.

Medical Treatment

There is no medication specifically approved for anorexia nervosa. However, antidepressants or other psychiatric medications may be prescribed to address co-occurring conditions such as depression or anxiety.

Inpatient Treatment

Severe underweight, physical complications, or acute risk of suicide may require inpatient or day-patient care in a specialized clinic or eating disorder unit.

Prognosis and Outlook

Anorexia nervosa is a chronic condition with a variable course. With early and consistent treatment, many individuals achieve full recovery. Without treatment, however, the disorder can become life-threatening. Factors associated with a poorer prognosis include a long duration of illness, very low initial body weight, and co-occurring psychiatric conditions.

References

World Health Organization (WHO): International Classification of Diseases, 11th Revision (ICD-11). Geneva, 2022.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Washington D.C., 2013.
Treasure J., Zipfel S., Micali N. et al. -- Anorexia nervosa. Nature Reviews Disease Primers, 2015. doi: 10.1038/nrdp.2015.74.

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