Anorexia nervosa

What is anorexia nervosa?

Anorexia nervosa is an eating disorder and a mental health condition.

Types of anorexia nervosa

There are two main types of anorexia nervosa.

Restricting type
This is the most common type of anorexia nervosa. People with the restricting type of anorexia nervosa limit the amount of food they eat by:

limiting the number of meals they eat
reducing the amount of calories they eat
cutting out certain foods.

Sometimes they might also have obsessive rules about food, like eating only at specific times or from particular plates and bowls.

Binge-eating or purging type
This is when people limit how much they eat and they also binge-eat. Binge-eating is regularly eating too much food, even when you’re not hungry.

People with this type of anorexia nervosa might purge too. Purging can include vomiting up food, doing too much exercise or using laxatives or diuretics.

Signs and symptoms of anorexia nervosa

Anorexia nervosa is a serious medical condition. It can have physical, psychological and behavioural signs and symptoms.

Physical signs
Physical signs and symptoms of anorexia might include:

low body weight
tiredness, weakness and muscle aches
loss of or irregular menstrual periods
failure to start puberty
dizzy spells
shortness of breath
heart palpitations
feelings of cold
constipation
hair loss and thinning.

Psychological signs
Psychological signs and symptoms of anorexia might include:

distorted body image – sometimes people think they’re overweight when they’re not
preoccupation or obsessive thoughts about food, weight and body shape
low self-esteem
mood swings
depression or anxiety
withdrawal from family, friends and other social relationships
refusal to accept that weight is dangerously low even after warnings from family, friends and/or health professionals.

Behavioural signs
Behavioural signs and symptoms of anorexia might include:

excessive or compulsive exercise and/or food restriction
secretive behaviour about eating or exercise
avoidance of social situations that involve food
frequent weighing
aggressive behaviour when forced to eat ‘forbidden foods’
self-harm
obsessive behaviour in relation to food preparation and planning.

The long-term consequences of anorexia nervosa can be severe and include:

osteoporosis
problems with the heart and kidneys
a higher risk of suicide.

You don’t have to be ‘thin’ to have anorexia nervosa. Rapid weight loss in normal weight and overweight teenagers can be a sign of an eating disorder called atypical anorexia nervosa. Teenagers with atypical anorexia nervosa can also have many of the symptoms described above. And they can be just as unwell as underweight children and teenagers with typical anorexia nervosa.

What to do if you notice the signs of anorexia nervosa

If you notice that your child has changed eating habits, mood and behaviour – particularly in relation to food – you need to talk with your child and a health professional as soon as you can.

It’s best to keep your conversations with your child calm and non-judgmental. Emphasise your concerns about your child’s health and wellbeing, not your child’s weight and appearance.

If you’re not sure how to talk with your child about these issues, you could first visit your GP or a mental health professional and ask for help. You can also contact the Butterfly Foundation by calling the free national helpline on 1800 334 673, or using email or webchat.

Early assessment and help from a health professional can stop problem eating turning into an eating disorder. It might be easier to get your child to see a health professional now than later on. If you step in early, you might be able save your child from intensive treatment and a very long recovery time.

Diagnosing anorexia nervosa

There is no single test that can diagnose anorexia nervosa.

If your GP thinks your child might have anorexia nervosa, the GP will talk with your child about eating behaviour, habits and thoughts. The GP will also do a full physical examination and tests including a blood test, a urine test or an ECG.

The GP might then refer you to a specialist service to confirm your child has anorexia nervosa and recommend appropriate treatment.

Treatments for anorexia nervosa

There’s no single treatment that will work for all cases of anorexia nervosa. Treating anorexia nervosa requires a team of health professionals who have expertise in different areas.

Doctors will prescribe different treatment plans for different children, depending on age, stage of the illness, type and severity of the anorexia, underlying causes and many other factors.

Psychological therapy
If your child has anorexia nervosa, your child will need psychological therapy.

If possible, it’s very important that the whole family or some family members are involved in your child’s treatment. This is called family-based treatment.

If family-based treatment isn’t possible, other types of therapy might include:

one-on-one sessions with a psychologist or therapist
group therapy – working with a group of people who also have eating disorders.

Medication
There are no medications proven to treat anorexia nervosa. If your child has depression or anxiety as well as anorexia nervosa, there are some medications that might help treat these conditions.

Hospital
Sometimes a child with anorexia nervosa might need to go to hospital to be treated for the physical effects of the disorder. This will depend on the child’s weight, symptoms and other health issues.

Hospital treatment usually focuses on providing support at regular mealtimes to encourage children to eat healthy food and gain weight.

With treatment, people can recover from anorexia nervosa, but it’s also possible to relapse. If you notice that your child is showing the symptoms of anorexia again, see your doctor as soon as possible.

Causes of anorexia nervosa

We don’t know what causes anorexia nervosa. But there are some factors that can put children and teenagers at higher risk for anorexia nervosa.

These risk factors include:

being female
having a certain personality type – being a perfectionist or a high achiever
thinking in an obsessive way
dieting
having a family history of anorexia nervosa.

Although anorexia has no known cause, we do know that it isn’t your fault as a parent. If your child has anorexia, your love and support will be very important in helping your child get better.