What is anorexia nervosa: signs and symptoms?
What is anorexia nervosa. Here is the definition, and how to detect it in someone you know.

Anorexia Nervosa was named and identified in the 1870's almost simultaneously by medical men in England, France and the United States. However, the American public knew virtually nothing about this condition until the 1970's. By the 80's the disease was quite common to the public and was joked about on "Saturday Night Live", featured in prominent newspapers such as "New York Times" and "Weekly World News", and in magazines such as "People", "Mademoiselle", and "Seventeen".

According to the American Anorexia Bulimia Association (AABA), one percent of all teenage American girls develop anorexia nervosa and up to 10% of those who develop it die from it. The National Eating Disorders Organization (NEDO) observes that 90-95% of all victims are female. Because untreated anorexia nervosa is a proven woman-killer, knowing the warning signs is essential to successful recovery.

There are two types of anorexia nervosa: restrictive and binge/purging. According to the Academy for Eating Disorders, restrictors maintain a low body weight through self-starvation and excessive exercise. In addition to calorie cutting, binge/purgers stuff themselves, then induce vomiting or misuse laxatives, diuretics, or enemas. Because of its resemblance to bulimia nervosa, a diagnosis for the latter group can be problematical. If a patient meets criteria for both anorexia and bulimia, she is diagnosed as an anorexic, binge/purging type. According to NEDO, one-third of anorexics develop bulimia.

The Academy for Eating Disorders notes that most clinicians will suspect anorexia in a patient who is 85% or less of normal body weight. But what is "normal"? Norms vary with individual body type and chemistry. For this reason, Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED) advises against relying on charts, tables or complex formulas. Instead, ANRED recommends a combination of subjective and objective factors. How do you feel? If the answer is "strong, energetic, and healthy," you're probably on the right track. Are your blood pressure, cholesterol and sugar levels good? Are you free of the back or joint pain associated with bone loss due to malnutrition? If so, these are signs that you have achieved a healthy weight.

Warning signs of anorexia nervosa, include:

Significant to extreme weight loss with no known medical illness

Ritualistic eating habits


Criticism and Intolerance of others

Excessive Exercise

Eating low- to no-fat, and low-calorie foods

Sufferer says she is fat, even when this is obviously untrue

hair loss

cold hands and feet



shortness of breath

dry, brittle skin



tooth and gum decay

dressing in baggy clothes


The anorexic skips meals, refuses to eat with others, and concocts strange dishes. She will grocery shop and cook tasty recipes for the entire family, but refuse to eat her own meals. There is always an excuse not to eat. In a subconscious cry for help, a binge/purger-type anorexic will often leave clues: empty food packages; foul-smelling bathrooms; running water (to cover sounds of vomiting); and overuse of breath fresheners.

Intolerance of others, excessive exercise, and hyper-competitiveness. These, according to ANRED, are related to a desire for perfection. The anorexic wants to be the best in everything.

Denial. The sufferer believes that the thinner she becomes, the closer she gets to perfection - even if she resembles a concentration camp inmate. Thus, from her point of view, there is no problem.

Depression and withdrawal. The Academy for Eating Disorders observes that adolescence is a time when self-esteem is vulnerable. Since onset of anorexia primarily occurs during the teen years, it is not surprising that sufferers have low self-esteem. The anorexic cannot feel good about herself because she's never thin enough to satisfy her standard of perfection.

Baggy clothes. These are used to hide wasting, and to keep warm.

Tooth and gum decay. According to ANRED, anorexics lack buffers in their saliva that protect teeth from acid produced by mouth bacteria. Some sufferers grind their teeth in their sleep.

Over time, these symptoms lead to real damage. In order to protect itself, the body begins to shut down. The following are medical consequences of advanced anorexia.

heart muscle damage resulting in death (This is what happened to Karen Carpenter). According to ANAD, the most common cause of death in late-stage anorexics is low potassium, which can cause an irregular heartbeat.

cessation of menstruation

kidney failure

lanugo, a fine body hair, on arms and face

muscle atrophy


Anorexia ia a serious condition. And it's not all about being skinny. It's about being in control. The anorectic may feel the only thing in her life she is able to control is her body weight. It's a power struggle. You can not simply tell her to eat.

Overcoming an eating disorder is a long and difficult journey, most people are never truly "healed". They fight the urges for the rest of their lives. You can, however, learn to control it.

If you or someone you know is suffering an eating disorder, please get medical help immediately. The sooner you are treated, the easier recovery will be and you will have less long-term effects.