Getting early treatment for anorexia can help to speed up recovery and minimize some of the damage that malnutrition can do to your brain and body. It is important to get a diagnosis from a medical professional who can then direct you to the best treatment program and methods for you.
As a serious mental health condition with significant and even potentially life-threatening medical side effects, you should consult a professional if you suspect you might have anorexia. You can recognize some of the signs of the disorder in yourself and then take your concerns to a trained health provider as soon as possible.
More than one person dies every hour from anorexia, and death can often be sudden and unexpected. The sooner that you get professional help for an eating disorder, the better the potential for recovery.
Anorexia is not always visible externally. It may not be something you can see just by looking in the mirror. Seek help right away if you are asking yourself, “Am I anorexic?”
11 Questions to Ask Yourself: Warning Signs of Anorexia
Recognizing the warning signs of anorexia is important. If you answer affirmatively to these 11 questions, it’s a sign that you need help:
- Am I spending a lot of time thinking about food, weight, and body shape?
- Do I intentionally restrict myself from eating certain foods, or even anything at all, because I am afraid of getting fat?
- Do I feel the need to exercise to “burn” off something that I ate or excess calories?
- Am I rigid in my exercise routine and will not miss a chance to exercise even if the weather is bad or it really doesn‘t fit into my schedule?
- Am I afraid of social situations where there is eating, or do I avoid eating with others?
- Am I continually worried about how I look and perceive myself as fat no matter how much I weigh?
- Do I use weight loss pills, laxatives, diuretics, or diet supplements to try to lose weight?
- Am I continuing to lose weight despite feeling sick or sluggish?
- Are family members and friends commenting on my low body weight?
- Have I developed unusual eating habits to hide how much I’m actually eating?
- Do I dress in layers so people can’t see my actual size?
Signs of Anorexia
Anorexia impacts the body, brain, and spirit. There are emotional, behavioral, and physical signs to look for.
- Sensitivity to cold
- Skin issues, such as growing fine hair called lanugo and dry skin
- Brittle nails
- Hair loss
- Trouble remembering things, thinking clearly, or making sound decisions
- Stomach pain and bloating
- Lack of menstruation in women
- Loss of sex drive
- Excessive exercise
- Loss of muscle mass
- The appearance of “wasting away”
- Weakened immune system
- Sleep issues
- Unhealthy BMI (too low)
- Mood changes
- Fear of gaining weight
- Obsession with food and weight
- Suicidal ideations
- Low self-esteem
- Believing yourself to be fat when you likely are not (distorted body image)
- Refusing to eat
- Skipping meals
- Food restrictions
- Unusual eating habits like pushing food around your plate or cutting it really small
- Social withdrawal, isolation, and increased secrecy
- Lack of interest in social events, especially where food is involved
- Talking about dieting, food restriction, or body image frequently
Medical Definition of Anorexia
Anorexia is defined as an eating disorder and a mental illness. There are three main criteria outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) published by the American Psychiatric Association (APA) that are used to diagnose anorexia.
- Energy intake restrictions, such as food deprivation or low-calorie consumption, relative to what is necessary to maintain healthy body weight for your age, height, sex, and physical health
- Extreme fear of weight gain or getting fat, even though you are underweight
- Distorted body image, obsession over self-evaluated body weight and shape, and denial that your low body weight is a problem
You do not have to be significantly underweight to have anorexia either. You may have a subtype of anorexia (atypical anorexia) if you meet all other criteria for anorexia other than low body weight.
Who Is Best Trained to Diagnose Anorexia?
If you suspect you are anorexic, you should talk to your health care provider right away. The following providers can diagnose anorexia:
- Primary care providers and other physicians
- Counselors, therapists, or mental health providers
- Nutrition counselors
Ideally, a trained mental health professional with experience treating and diagnosing eating disorders will do the assessment to aid in the diagnosis of anorexia. This professional can also help you find the right treatment options for your situation.
How Is Anorexia Diagnosed?
There is no specific test that can determine whether or not you have an eating disorder. Many times, laboratory tests will come back normal even when a serious problem exists.
To diagnose anorexia, your medical or mental health provider will typically start with a physical exam. They will check your weight, assess if you have recently lost weight, and determine your BMI (body mass index).
A healthy BMI in the normal range will be between 18.5 kg/m2 and 24.9 kg/m2. A low BMI can be an indicator of anorexia. Your BMI can also help to determine the severity of the condition.
For example, the range of BMI for anorexia is as follows:
- Mild anorexia: BMI greater than or equal to 17.5 kg/m2
- Moderate anorexia: BMI between 16 and 16.99 kg/m2
- Severe anorexia: BMI between 15 and 15.199 kg/m2
- Extreme anorexia: BMI of less than 15 kg/m2
Your provider will also ask you questions about your physical health and potential symptoms, such as if you are sick often, whether you have constipation or bloating, whether you are cold often, if you are menstruating regularly (for women), and if you bruise easily. They will also interview you based on your eating and exercise habits as well as your views of your body image, food, and weight.
They may inquire about your psychological state and history, including questions about your self-esteem, feelings of depression and irritability, and mental acuity. They will also ask about family history (as anorexia is heritable), medication history, and any prior mental health or eating disorder treatment.
Treatment for Anorexia
Management of anorexia should be comprehensive and address the physical, emotional, and behavioral components of the disorder.
Treatment usually needs to start with medical care, often in an inpatient treatment center based on the severity of the malnutrition and eating disorder. Medical management can include refeeding, the use of medications, and medical monitoring until your weight stabilizes and your body begins to heal.
Nutrition rehabilitation and stabilizing weight loss are the initial goals of an anorexia treatment program.
Anorexia treatment will also include counseling and therapy sessions, which will generally mean both individual and group sessions to address the root causes of the disorder. Family therapy is often recommended to involve the entire family in recovery and build a strong support system for the individual.
You will learn how to identify negative thoughts and behaviors and work to build new and healthy habits and lifestyle changes. You will learn about potential triggers and warning signs of a relapse, and develop successful coping mechanisms for managing them.
Behavioral therapies can address your relationship with food as well as low self-esteem. Therapy will focus on distorted body image issues to make positive changes for a lasting recovery.
Treatment for Co-Occurring Disorders
Treatment programs will address any potential co-occurring disorders, such as substance abuse, depression, anxiety, or other mental health or medical conditions. It is common to have both an eating disorder and another mental illness.
When two mental health disorders are present, both issues will need to be managed through dual diagnosis treatment. If only one issue is addressed, relapse is likely.
Support groups can help to sustain recovery. They provide a safe environment made up of peers who can understand how you are feeling and offer support and encouragement.
Treatment for anorexia is diverse and individualized. It can be offered in a variety of settings, including both inpatient and outpatient programs.
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