Anorexia Nervosa

Anorexia Nervosa

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

• What is anorexia nervosa?
• Who is at risk for anorexia?
• What causes anorexia?
• How is anorexia diagnosed?
• What are anorexia symptoms and signs (psychological and behavioral)?
• What are anorexia symptoms and signs (physical)?
• How is anorexia treated?
• What is the prognosis (outcome) of anorexia?
• Anorexia Nervosa At A Glance

What is anorexia nervosa?

Anorexia nervosa, commonly referred to simply as anorexia, is one type of eating disorder. More importantly, it is also a psychological disorder. Anorexia is a condition that goes beyond out-of-control dieting. A person with anorexia initially begins dieting to lose weight. Over time, the weight loss becomes a sign of mastery and control. The drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. The individual continues the endless cycle of restrictive eating, often accompanied by other behaviors such as excessive exercising or the overuse of diuretics, laxatives, and/or enemas in order to reduce body weight, often to a point close to starvation in order to feel a sense of control over the body. This cycle becomes an obsession and, in this way, is similar to any type of addiction.

Who is at risk for anorexia?

Approximately 95% of those affected by anorexia are female, but males can develop the disorder as well. While anorexia typically begins to manifest itself during early adolescence, it is also seen in young children and adults. In the U.S. and other countries with high economic status, it is estimated that about one out of every 100 adolescent girls has the disorder. Caucasians are more often affected than people of other racial backgrounds, and anorexia is more common in middle and upper socioeconomic groups. According to the U.S. National Institute of Mental Health (NIMH), an estimated 0.5%-3.7% of women will suffer from this disorder at some point in their lives.

Many experts consider people for whom thinness is especially desirable, or a professional requirement (such as athletes, models, dancers, and actors), to be at risk for eating disorders such as anorexia nervosa.

What causes anorexia?

At this time, no definite cause of anorexia nervosa has been determined. However, research within the medical and psychological fields continues to explore possible causes.

Some experts feel that demands from society and families could possibly be underlying causes for anorexia. For many individuals with anorexia, the destructive cycle begins with the pressure to be thin and attractive. A poor self-image compounds the problem.

Other researchers feel that this disorder can stem from a particular dysfunction often seen in families of anorexia patients. In one particular type of dysfunction, family members become so interdependent that each cannot achieve their identity as an individual. Thus, family members are unable to function as healthy individuals and are dependent on other family members for their identity. In children, part of this dysfunction includes a fear of growing up (especially girls). Restrictive dieting may prevent their bodies from developing in a normal manner and, in their thinking, restricts the maturational process and maintains the parent-child relationship that the family has come to rely on. Other family situations that have been suggested, but not proved, as possibly being related to the development of anorexia nervosa include high parental expectations, poor communications skills, and problems with conflict management.

Some studies also suggest that a genetic (inherited) component may play a role in determining a person's susceptibility to anorexia. Researchers are currently attempting to identify the particular gene or genes that might affect a person's tendency to develop this disorder.

Although no organic cause for anorexia has been identified, some evidence points to a dysfunction in the part of the brain (hypothalamus) which regulates certain metabolic processes. Other studies have suggested that imbalances in neurotransmitter (brain messenger chemicals involved in signaling processes) levels in the brain may occur in people suffering from anorexia.