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Anorexia—Adult

(Anorexia Nervosa—Adult)

by Michael Jubinville, MPH

Definition

Anorexia is an eating disorder. A person is obsessed with losing more weight than needed. Losing weight may involve exercising too much, taking laxatives or diuretics, or inducing vomiting.

Causes TOP

The cause of anorexia is not known. It appears to be a mix of your genes, way of life, and environment.

Risk Factors TOP

Anorexia is more common in young women. Your risk is also higher for:

Low self-esteem
Feelings of helplessness
Wanting to be perfect
Fear of gaining weight
Pressure to be thin
Other people in your family have the same problems
Emotional stress
Other mental health problems, such as depression or anxiety
Way of life that highlights being thin as ideal

Symptoms TOP

Anorexia may cause:

Excess weight loss
Obsession with food, and how much fat and calories are in it
Dieting even when thin
Strong fear of gaining weight, even when underweight
Body dysmorphia—you see yourself as overweight when you’re not
Basing self-evaluation heavily on body weight or shape
Loss of monthly periods in women
Excess exercising
Feeling cold, mainly in the hands and feet
Being secretive about food
Hair loss or growth of fine hair on the body
Fainting or lightheadedness
Constipation
Heart palpitations

Anorexia often leads to:

Osteoporosis —makes the chances of broken bones higher
Heart problems, which can be deadly if arrhythmias start

Body Dysmorphia

Diagnosis TOP

You will be asked about your symptoms and health history. Your answers and a physical exam may point to anorexia. You may also have:

Blood tests
ECG —to check how the heart is working
Bone density tests
A psychological exam

Treatment TOP

The goal is to return to and keep a healthy weight. A healthy weight is above 85% of your ideal weight. The intake of calories is slowly added to. For serious anorexia, care may start in a hospital.

This can be done with:

Nutritional Consultation

You will learn how to eat a healthful diet. You will also learn what your healthy weight and calorie goals are.

Counseling

This can help address harmful thought patterns, help you gain weight, and make you feel better about yourself. There are many different types of therapy. You may need more than one type:

Cognitive behavioral therapy (CBT). CBT helps you learn to handle stress. You will change how you think. This will help you gain control of your feelings. You will also find out the cause of the problems you’re having.
Interpersonal —To help you learn and cope with concerns about the people in your life.
Family—Families tend to play a role in eating disorders. Many people can't get better unless their families help with making changes. They will learn about anorexia and how to support you.

Medicines TOP

Medicines will depend on other problems you may have. The most common are:

Antidepressants—To balance brain chemicals. They are not useful without counseling.
Vitamins and minerals to keep up adequate nutrition.
Hormone replacement to resume periods and prevent bone loss.

Prevention TOP

There is no way to prevent anorexia since the cause is unknown.

RESOURCES:

National Association of Anorexia Nervosa and Associated Disorders
http://www.anad.org

NEDA—National Eating Disorders Association
https://www.nationaleatingdisorders.org

CANADIAN RESOURCES:

Canadian Mental Health Association
https://cmha.ca

National Eating Disorder Information Center
http://www.nedic.ca

References:

Anorexia nervosa. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114614/Anorexia-nervosa . Updated June 15, 2017. Accessed August 31, 2018.

Anorexia nervosa. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/psychiatric-disorders/eating-disorders/anorexia-nervosa. Updated March 2018. Accessed August 31, 2018.

Anorexia nervosa. Office on Women's Health website. Available at: https://www.womenshealth.gov/mental-health/mental-health-conditions/eating-disorders/anorexia-nervosa. Updated August 28, 2018. Accessed August 31, 2018.

Casper RC. How useful are pharmacological treatments in eating disorders? Psychopharmacol Bull. 2002;36(2):88-104.

Last reviewed May 2018 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 8/31/2018

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