Learning how to spot these signs may help you understand if you or a loved one are struggling with AN and determine the best way to seek out treatment.
What is Anorexia Nervosa?
Anorexia nervosa may have several physical signs, but the condition is a mental health disorder. It’s characterized by a number of mental health issues, including a distorted body image, extreme fear of gaining weight, and fixation on the concepts of food, calories, weight, and eating.1
These issues can manifest in many ways, but they primarily look like attempts to actively lose or prevent weight gain. This can include everything from excessive exercise to severely restrictive eating patterns and strange rituals around food and eating.1
Due to the behaviors associated with anorexia nervosa, many people who struggle with the condition present at a low body weight, though this is not always the case. People of all body weights and sizes can have AN, so when looking for the signs of anorexia nervosa, it isn’t enough to just look for extreme weight loss.
Common Signs of Anorexia
Since AN touches all aspects of health, there are many physical symptoms of anorexia, along with mental and emotional signs and symptoms.
Again, the condition can manifest in different ways, but some of the most common signs of AN include:2
- Weight loss
- Refusal to maintain a healthy weight to sustain proper body function
- Food and calorie restriction
- Extreme obsession with food and weight
- Distorted body image, such as a perception of being fat, no matter what the reality is
- Social withdrawal
- Fear of gaining weight
- Excessive exercise
- Missing meals and refusing to eat, especially around others
- Elaborate food rituals and unusual eating habits
- Sleep difficulties
- Mood swings
- Fatigue and muscle weakness
- Mental confusion, memory issues, and poor judgment
- Stunted growth in those under 18 (not within an appropriate weight and height range for their age)
Anorexia nervosa also commonly co-occurs with many other mental disorders, including:6
- Anxiety disorders
- Depressive disorders
- Obsessive-compulsive disorders
- Developmental disorders
- Autism spectrum disorder
- Attention deficit hyperactivity disorder (ADHD)
Anorexia can impact people of all ages and genders, although it is most common in young women and typically begins in adolescence.1
How to Spot the Signs of Anorexia
When looking for the signs of anorexia nervosa, it’s important to pay attention not just to physical signs but emotional and behavioral changes as well.
When someone restricts calories and food intake, their body will slow down many of its essential processes to try and conserve energy. This can mean that a person will feel sluggish and fatigued and appear sluggish and tired to others.
Certain bodily functions can be impaired because they’re not ingesting enough food to provide the energy and nutrients the body needs to function correctly. For example, they may have difficulties regulating their body temperature and frequently feel cold. They may experience cognitive impairments, such as being unable to remember things as easily, making poor choices, and having problems concentrating. They will often experience low moods and be overly irritable.
Someone with anorexia will also likely isolate themselves, spend less time with friends and family, become more secretive, and stop participating in activities they used to enjoy.
Much of the self-isolation involved with anorexia nervosa has to do with the shame, guilt, or burden of experiencing an eating disorder. Many people find their condition challenging to speak about and may self-isolate as a coping mechanism. The high overlap between AN and depression is another reason many people with this condition may not frequently reach out. And others will self-isolate in an attempt to hide their true eating habits or body shape.
Anorexia causes a distorted body image and an obsession with food and being fat. The person will often comment about needing to “burn” off foods or calories and engage in excessive exercise, even when the weather is bad, getting up very early or staying up very late to fit it in, and to the point of injury.3
They may often discuss their body and being fat, frequently compare their body to others, or judge their worth or the worth of others on things like body weight, shape, and appearance.
The Importance of Recognizing the Signs of Anorexia
Anorexia can have severe medical and mental health consequences and is a potentially life-threatening mental health condition. Eating disorders are the second most deadly mental illness, behind only opioid addiction and overdose.4
It is, therefore, vital for someone with anorexia to get help as soon as possible. Early intervention and treatment for anorexia can enhance the speed of recovery, minimize symptoms, and improve outcomes. Recognizing the signs of anorexia and seeking professional help for the disorder can be lifesaving.
Helping Someone Get Treatment
Someone struggling with AN or other eating disorders is often either in denial that there is a problem or does not recognize the severity of the issue. Loved ones are essential in helping someone with anorexia realize the need for specialized professional treatment.
If you recognize the signs of anorexia in a loved one, you should talk to them and express your concern and support.
Here are tips for discussing concerns about a possible eating disorder:5
- Educate yourself first on the risk factors and signs of anorexia, treatment options, and how to approach someone you suspect may have an eating disorder.
- Rehearse your conversation ahead of time. It can be helpful to write down bullet points.
- Find the right time and place to have the conversation in private.
- Use “I” statements and focus on your concerns and the behaviors you have personally witnessed.
- Be calm, firm, and honest while sticking to the facts.
- Understand that there might be a negative reaction. Keep expressing your support and aim to reduce potential shame.
- Encourage them to get professional help. Offer to help them with their treatment and recovery journey.
This won’t be an easy conversation. But be persistent. The earlier someone with anorexia seeks treatment, the better their chances of a full recovery.
- Anorexia Nervosa. (May 2022). National Alliance for Eating Disorders. Accessed November 2023.
- Overview – Anorexia. (January 2021). National Health Service. Accessed November 2023.
- Heradstveti O, Holmelid E, Klundby H, Soreide B, Sivertsen B, Sand L. (2019). Associations Between Symptoms of Eating Disturbance and Frequency of Physical Activity in a Non-Clinical, Population-Based Sample of Adolescents. Journal of Eating Disorders; 7(9).
- Eating Disorder Statistics. (May 2023). National Association of Anorexia Nervosa and Associated Disorders (ANAD). Accessed November 2023.
- How to Help a Loved One. (n.d.). National Eating Disorders Association. Accessed November 2023.
- Marucci S, Ragione L, De Iaco G, Mococci T, et. al. (2018). Anorexia Nervosa and Comorbid Psychopathology. Endocrine, Metabolic & Immune Disorders; 18(4):316-324.