If your friend or loved one is struggling with AN, you may want to:
- Research anorexia nervosa to have an accurate understanding of the condition.
- Develop a healthy dialogue with the individual about your concerns.
- Work to compassionately guide them toward help with a mental health professional or treatment facility.
- Support and encourage them once they enroll in treatment while understanding that recovery is a process.
Keep reading to find out more about how to help someone with anorexia nervosa.
Spotting the Signs of Anorexia Nervosa
One of the biggest challenges of eating disorders like AN is determining when and whether someone is struggling with the condition. Even for someone experiencing these thoughts and behaviors directly, it may be difficult to acknowledge a problem.
To help, there are some common signs and symptoms of anorexia nervosa that you can look out for. But it’s important to keep in mind that these signs don’t necessarily signal an eating disorder; rather, they point to an increased likelihood that your friend or loved one may be struggling with the condition.
Psychological Signs and Symptoms
Anorexia nervosa is characterized by a number of psychological signs and symptoms, some of which may be more obvious to outsiders than others.
The severity of these effects can also vary, with some people experiencing them to a degree that significantly impacts their ability to function in everyday life.
Anxiety disorders have a huge overlap with anorexia nervosa. One study on the subject found that up to two-thirds of people who struggle with AN simultaneously struggle with an anxiety disorder. [1]
In people with AN, anxiety can often manifest as perfectionism or obsession. This often presents as a deep concern over weight, food, and body shape and size.
Outward signs of this type of anxiety may include:
- Moving food around on their plate, rather than eating it
- Refusing to eat around other people or showing anxiety or discomfort around mealtimes
- Excessively exercising, even when in discomfort or when doing so would be a significant inconvenience
- Using diuretics, laxatives, or similar measures to quickly evacuate any ingested food or drink
Other than anxiety, a number of other mental health conditions have been found to commonly co-occur with anorexia nervosa.
Some studies have shown a high overlap between AN and depressive disorders, though various methods have been used to track these numbers. Substance use disorder has also been linked to anorexia nervosa in some research.
And while low self-esteem and negative body image aren’t necessarily considered mental health disorders, both are very common in people who struggle with AN.
People with anorexia nervosa tend to have a distorted view of their own body, viewing themselves in a very negative light and as significantly overweight, regardless of their actual weight or body shape.
It’s also possible for social and cultural factors to impact a person’s risk of developing anorexia nervosa.
Sometimes, childhood struggles can trigger the onset of anorexia nervosa later on in life. Many people who struggle with AN have reported instances of trauma in their past, or are simultaneously diagnosed with post-traumatic stress disorder.
And while its influence is often overblown, growing up in an environment that pushes diet fads and health trends can potentially prime someone to develop disordered eating habits.
Many places in the United States, especially American high schools, foster unrealistic beauty standards that can lead to body dysmorphia and impact a person’s risk of developing an eating disorder.
Physical Signs and Symptoms
As their disorder goes on, and malnourishment may begin to set in, a person struggling with anorexia nervosa may also develop a number of physical signs and symptoms.
One of the more common physical signs of AN is rapid weight loss or lower body weight.
The concept of “underweight” varies significantly from person to person and hinges on a number of factors. But the DSM-5, the official record of all mental health disorders, defines someone with anorexia nervosa as being at or below the 85th percentile of weight for their age and height. [2]
There may also be some visual cues, including bones that are visible beneath the skin, although some people have bones that appear more pronounced even at a healthy weight.
AN can also lead to disrupted hormone levels in the body. This imbalance can have a number of physical effects, including:
- Blotchy or yellow skin
- Frequent dry mouth
- Sensitivity to cold
- Mood swings
- Mental fogginess
- Confusion/memory loss
- Brittle hair or nails
The malnutrition that often accompanies anorexia can bring on other physical issues, such as:
- Osteoporosis, or the weakening of bones
- Significant loss in muscle mass
- Heart issues, including abnormal heart rhythms and heart failure
And at its most severe, anorexia can be fatal. This can be due to organ damage suffered as a result of the condition, but it can also be linked to the higher risk people with AN experience dying by suicide. [3]
Regardless, anorexia nervosa is a serious mental health condition, and a person struggling with it should be encouraged to seek professional help immediately.
Talking to a Loved One About Anorexia
Talking to a loved one about seeking help for anorexia nervosa isn’t easy. It can feel invasive and nerve-wracking, and you may worry about damaging your relationship.
But ultimately, the most important thing is for your loved one to find help. And even if you’re not a trained mental health professional, there are some things you can do to be there for the person you care about.
Do Your Research
Researching more about anorexia nervosa is a great place to start.
Many people have misconceptions about the condition, making it more difficult to understand or sympathize with a friend or loved one who may be struggling.
One of the most important things to understand is that the person isn’t just making a choice or following a diet trend. It is a medically-accepted fact that disordered eating behaviors can be triggered by genetic and environmental influences.
Often, people who struggle with AN are born with genes that predispose them to develop the condition. And certain aspects of their environment, including instances of trauma or modeled behavior by parents, can “switch on” these genes, setting the stage for unhelpful thoughts and behaviors.
Plan a Discussion
Once you feel comfortable with the subject, it may be time to talk to your loved one about anorexia nervosa.
Try to choose a caring, comfortable, and private environment to have the talk. It’s especially important for the person you’re speaking with to feel safe where they are. Often, having the discussion in that person’s home or room in your shared home is a good idea. [4,5]
Rather than talking, have the main aim of the conversation be listening to the other person and understanding where they’re coming from. Rather than judgment and questions, be ready to meet them with compassion. If you’re feeling angry or emotional, it may not be the best time to have this discussion.
It’s also normal for someone to respond to this type of discussion with some defensiveness or aggression. Talking about an eating disorder is not easy for anyone involved, and it may take multiple conversations to make progress. Don’t expect instant results from the first conversation.
Speak Supportively
While having your talk, it’s important to be careful with the language you use. Acting judgmentally or critically may turn your loved one off, make them feel attacked, or encourage them to shut down.
Instead, express your concerns using “I” statements, such as, “I’m worried about you because you seem unhappy and uncomfortable in your body.” Encourage the person to respond with how they feel and their concerns.
Tell them you are willing to help them get assistance with every step of the recovery process. It may be helpful to look up some information before your talk, such as the number of mental health professionals or appropriate treatment facilities.
During the discussion, you may offer this information to your loved one. You can further offer to drive them to their first session if you think it would help.
Determining the Best Course of Treatment for Your Loved One
The best course of treatment for someone struggling with anorexia nervosa will depend on the severity of their symptoms.
Many people only seek help for their condition when their symptoms become severe. In this case, they may need hospitalization and then time at an inpatient facility to recover.
At its most critical, the early stages of recovery focus on stabilizing someone’s mental and physical health. Once they’re considered past the point of a health crisis, someone can move to an inpatient facility. Here, they will spend anywhere from several weeks to many months receiving care and counseling from treatment specialists in a safe, controlled environment.
When a patient and their doctors feel they have enough control over their unhelpful thoughts and behaviors, they can begin outpatient care, which involves a more normal, autonomous life while seeing a mental health professional regularly.
Generally speaking, it is best to start by seeing a mental health professional who specializes in treating eating disorders. There are many different treatments that have been shown to be potentially effective at treating anorexia nervosa, and this professional can help offer more specific advice to your friend or loved one.
What Role Can Friends and Family Play in Recovery?
That’s not to say that friends and family have no role to play in recovery. In fact, they are often vital parts of a person’s support system in both early and long-term recovery.
Many mental health experts see family as an ally in treatment. That’s because family members who are aware of their loved one’s struggles can encourage them to stick with their programs, even when things get hard.
Family and friends may also help someone navigate the difficult and often stressful issue of insurance. Ensuring their treatment is covered can be a huge relief for many people in recovery, as programs can be lengthy, and expensive.
And, as a friend or loved one, you can be someone the person can turn to when stress arises. This can be critical, as stress tends to make people especially vulnerable to relapse.
Overall, simply having a loved one who supports them can make all the difference in maintaining long-term recovery. And while on a road that’s especially difficult, someone can benefit from all the help they can get.
Resources
- Kaye, W. H., Bulik, C. M., Thornton, L., Barbarich, N., & Masters, K. (2004). Comorbidity of anxiety disorders with anorexia and bulimia nervosa. The American journal of psychiatry, 161(12): 2215–2221.
- DSM-IV to DSM-5 Anorexia Nervosa Comparison. (2016). National Library of Medicine. Accessed December 5, 2022.
- Bulik, C., Thornton, L., Pinheiro, A.P., Plotnicov, K., Klump, K., Brandt, H., Crawford, S., Fichter, M. M., Halmi, K., Johnson, C., Kaplan, A.S., Mitchell, J., Nutzinger, D., Strober, M., Treasure, J., Woodside, D. B., Berrettini, W.H., Kaye, W.H. (2008). Suicide Attempts in Anorexia Nervosa. Psychosomatic Medicine, 70(3).
- Let’s Talk About Eating Disorders. (n.d.). National Institute on Mental Health. Accessed August 30, 2022.
- What to Say and Do. (n.d.). National Eating Disorders Collaboration. Accessed August 30, 2022.