Understanding anorexia nervosa: Causes, symptoms, and treatments

In a society that often suggests that people’s self-worth is linked to their appearance, it’s no wonder that many of us have a complicated relationship with weight. A recent national poll found that more than 50% of Americans expressed a desire to lose weight between 2017 and 2021. And approximately 9% of the U.S. population will experience an eating disorder in their lifetime.

It can be very difficult to identify an eating disorder, but recognizing the signs and symptoms can potentially save someone’s life. For example, compulsive exercising, obsessive calorie counting, and refusing to eat around other people may all be signs that someone has anorexia nervosa. 

What is anorexia nervosa?

Anorexia nervosa is an eating disorder that involves extremely restricted food intake and causes low body weight. People with anorexia have an intense fear of gaining weight and may severely limit food, eat small quantities of only certain foods, or avoid food altogether to keep their weight as low as possible.

Anorexia has the highest death rate of any mental health condition, with approximately 5% of people dying within four years of their diagnosis. People with anorexia have an increased risk of developing medical complications like anemia, heart problems, and bone loss. Anorexia also comes with a higher likelihood of additional mental health concerns, like anxiety, depression, obsessive-compulsive disorder (OCD), and suicidal thoughts or attempts.  

Recognizing these common signs and symptoms can help connect people with the care they need. 

• Extremely restricted eating
• Extreme thinness (although someone can experience anorexia and not be underweight) 
• Intense fear of gaining weight, even when severely underweight 
• Hiding weight loss with baggy clothing
• Distorted body image or denial that thinness is a concern 
• Noticeable weight loss
• Obsession with calorie counting and dieting
• Refusal to eat certain foods or food categories (not including those with restrictive diets, like people who follow a vegan or gluten-free diet)
• Avoiding eating around other people
• Compulsive exercising

Over time, anorexia can also cause physical problems like brittle nails, thinning hair, dry skin, severe constipation, and low blood pressure.

Remember that any one of these symptoms could be present in someone without anorexia, so it’s important not to jump to conclusions. Keep in mind that it’s not appropriate to comment on someone’s weight or eating habits in front of other people. And you should only bring it up if you have a close personal relationship with the person. If you do bring it up, be sure to do so gently and without accusing them of anything, or you may do more harm than good.

Common causes of anorexia nervosa

Anorexia is thought to be caused by a combination of biological, psychological, and environmental factors, including: 

• Genetics: Family and twin studies suggest that there may be a genetic predisposition to eating disorders like anorexia.
• Temperament: Anorexia has been linked to certain personality traits, such as perfectionism, sensitivity, low self-esteem, and people-pleasing behaviors. 
• Interests and activities: Participating in activities that focus on body shape and size — like ballet, modeling, and wrestling — can increase your risk of anorexia and other eating disorders. 
• Societal influence: Today’s diet culture and media obsession with weight may contribute to unhealthy habits and ideals around weight and food. 

Potential treatments for anorexia nervosa

Recovering from anorexia is a gradual process that often requires a collaborative approach to care. The following treatments can be effective in helping people normalize their eating behaviors, restore a healthy weight, and manage associated symptoms and concerns. 

Therapy 

Therapy is one of the most effective treatments for managing anorexia. With the support of a therapist, you’ll learn to challenge irrational thoughts about weight and food, manage anxiety and other challenging emotions, and develop the coping skills to prevent relapse. In addition to one-on-one therapy like cognitive behavioral therapy (CBT), group therapy and family therapy can also help you learn how to understand and manage your symptoms. 

Nutritional counseling 

Anorexia can lead to malnutrition, so working with a nutritionist or dietician is an important part of treatment and recovery. With nutritional counseling, people have an opportunity to create goals to maintain a healthy weight, adopt mindful eating practices, and build a more positive relationship with food. 

Medication management

Although medications are not considered a first-choice treatment for anorexia, some people benefit from using medication to manage specific symptoms or address comorbid conditions. For example, antidepressants can help treat symptoms of depression or anxiety that may be linked to anorexia.  

Support system

Having a strong support system also plays a major role in recovering from anorexia. If you haven’t shared your eating disorder with others, consider having an open and honest conversation with a trusted family member or friend who can support you throughout the recovery process. 

Many people also benefit from joining a support group or online community dedicated to helping people with eating disorders. These platforms offer a safe and confidential space to share a common experience and offer advice on navigating the road to recovery. 

Find care with Rula

Having an eating disorder like anorexia can be isolating and even dangerous, but it’s important to know that help is available. Access to therapy, nutritional counseling, and other forms of treatment can help people better understand the condition and learn how to improve their health and well-being going forward. 

At Rula, we can connect you with a therapist who accepts your insurance so you can get the support you need. With Rula’s easy-to-use therapist-matching program, you can find the right provider for your needs in less than 30 seconds and begin treatment as soon as tomorrow. And if medication management is part of your treatment plan, we can connect you with a psychiatrist to find the right solution for you. 

Find a therapist with Rula