Anorexia is an eating disorder that involves severe calorie restriction and often a low body weight. It’s a complex condition that has mental, behavioral and physical symptoms. Treatment for anorexia is essential due to its life-threatening complications.
Anorexia (anorexia nervosa) is an eating disorder in which you restrict the number of calories you consume, resulting in a nutrient deficit and often — but not always — a very low body weight. People with anorexia also have an intense fear of gaining weight and a distorted body image. They often don’t recognize the seriousness of the condition.
If you think frequently about food and your weight, you’re not alone. This is very common — especially in today’s society. But obsessing over food and your weight can be a sign of a bigger problem. If you — or a loved one — develop a deep concern or fear of gaining weight, seek professional help as soon as possible. Anorexia is both a mental and physical condition. Without treatment, it can lead to malnutrition, serious health issues and even death.
There are two subtypes of anorexia nervosa based on eating behaviors:
Anorexia nervosa affects 0.3% to 1% of people in the United States. It more commonly affects people assigned female at birth (AFAB). But it can develop in people of any age, gender, race, ethnicity, sexual orientation and economic status.
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Anorexia involves physical, behavioral and mental signs and symptoms.
You can’t tell if a person has anorexia just by their appearance. You don’t need to have underweight (BMI under 18.5) to have anorexia — people without underweight can also have anorexia. This is called atypical anorexia. In addition, someone can have underweight without having anorexia.
Emotional and mental signs of anorexia include:
It’s common to have other mental health conditions alongside anorexia, so you may have additional mental and emotional symptoms.
Behavioral signs of anorexia include:
Physical signs of anorexia may include:
Physical signs and symptoms of anorexia that are side effects of starvation and malnutrition include:
Anorexia is a complex condition. There’s no single cause. Research suggests that a combination of certain factors might be responsible, like:
It’s important to note that there’s no single path to an eating disorder or anorexia. For many people, irregular eating behaviors (also called disordered eating) make up an inappropriate coping strategy that becomes permanent over time. This disordered eating pathway is true for some, but not all, who develop anorexia.
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A healthcare provider can diagnose anorexia nervosa based on the criteria for it listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The three criteria include:
The DSM-5 criteria classify the severity of anorexia according to body mass index (BMI). People who meet the criteria for anorexia but don’t have underweight despite significant weight loss have atypical anorexia.
If you have signs and symptoms of anorexia, a provider will do a complete medical history and physical exam. The provider will likely ask questions about your:
A person with anorexia or any eating disorder will have the best recovery outcome if they receive an early diagnosis. If you or someone you know is experiencing signs and symptoms of anorexia, be sure to talk to a provider as soon as possible.
Laboratory tests alone can’t diagnose anorexia. But your healthcare provider may use various tests to rule out any medical conditions that could cause weight loss. Tests can also evaluate the physical effects of anorexia.
These tests may include:
The biggest challenge in treating anorexia is helping the person recognize and accept that they have a serious condition. Many people with anorexia deny they have an eating disorder. They often seek medical treatment only when their condition is life-threatening. This is why it’s important to diagnose and treat anorexia in its beginning stages.
The goals of anorexia treatment include:
People with eating disorders, including anorexia, often have additional mental health conditions, like:
These conditions can further complicate anorexia. If you have one or more of these conditions, your healthcare team will recommend treatment for them, as well.
Treatment options will vary depending on your needs. You may receive treatment through residential care (inpatient hospitalization) or outpatient care based on your current medical and mental health state. Treatment for anorexia most often involves a combination of:
Psychotherapy (talk therapy) is a type of individual counseling that focuses on changing your thinking and behavioral patterns. Treatment includes practical techniques for developing healthy attitudes toward food and weight. It also involves approaches for changing how you respond to difficult situations. There are several types of psychotherapy, including:
Family support is very important to anorexia treatment success. Family members must understand the eating disorder and recognize its signs and symptoms.
Family-based therapy for anorexia — also called the Maudsley Method — involves family-based refeeding. This means putting the caregivers and family in charge of helping the person with anorexia get the appropriate amount of nutrition. Studies show that it’s the most effective method to restore health to a person with anorexia under the age of 18.
People with eating disorders might also benefit from group therapy, where they can find support and openly discuss their feelings and concerns with others who share common experiences.
Some healthcare providers may prescribe medication to help manage anxiety and depression, which often exist alongside anorexia. The antipsychotic medication olanzapine (Zyprexa®) may be helpful for weight gain. Sometimes, providers prescribe medications to help with menstrual period regulation.
Hospitalization might be necessary to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications. These include heart disorders, severe depression, and suicidal thoughts or behaviors.
The most serious complication of treating anorexia is a condition called refeeding syndrome. It can happen when a seriously malnourished person begins to receive nutrition again. Basically, their body can’t properly restart the process of using food for energy (metabolism).
Since refeeding syndrome can have serious and life-threatening side effects, people with anorexia need to receive medical treatment and/or guidance.
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Every person’s anorexia recovery journey is different. The important thing to remember is that it’s possible to recover from anorexia. Treatment often involves many components. And each of these components can take different amounts of time.
No matter where you or a loved one is in their journey, it’s essential to continue working toward recovery.
It’s not always possible to prevent anorexia. But it’s helpful to start treatment as soon as you develop signs of it.
In addition, encouraging healthy eating habits and realistic attitudes about food and body image during childhood might help prevent the development or worsening of eating disorders.
The prognosis (outlook) for someone with anorexia varies depending on certain factors, like:
Anorexia gets worse the longer it goes untreated. People with anorexia often won’t admit they have a problem and might resist treatment or refuse to follow the treatment plan.
Without treatment, anorexia is potentially life-threatening. Eating disorders, including anorexia, are among the deadliest mental health conditions. People with anorexia are five times more likely to die prematurely and 18 times more likely to die by suicide.
The good news is that anorexia can be treated, and someone with anorexia can return to a healthy weight and healthy eating patterns. Unfortunately, the risk of relapse is high, so recovery from anorexia usually requires long-term treatment. Support of family members and friends can help ensure that the person receives — and sticks to — their needed treatment.
Malnutrition and starvation can affect nearly every organ in your body. Severe organ damage may be irreversible even after you’ve recovered from anorexia.
Complications that can result from untreated anorexia include:
In addition to physical complications, people with anorexia often have other mental health conditions. Without treatment, these conditions could lead to self-harm, suicidal thoughts or suicide attempts. If you’re having suicidal thoughts, call the Suicide and Crisis Lifeline at 988. Someone will be available to talk with you 24/7.
A note from Cleveland Clinic
It’s common to have feelings of shame, embarrassment and/or fear when it comes to eating disorders. Know that it’s OK to ask for help. Seeking care for anorexia and other mental health conditions is no different from seeking medical care for a physical condition. It may not feel like it now, but it’s possible for you to feel better both mentally and physically.
If you’re concerned a loved one has anorexia, you may not know how to confront them or get them help. Lean on medical professionals for guidance. They can provide you with resources and strategies for effectively — and empathetically — talking to your loved one. The sooner your loved one can get a diagnosis and treatment, the better.
Last reviewed on 08/09/2024.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy