Patient information from BMJ

Anorexia

Last published:Sep 17, 2024

Anorexia is a serious medical condition. It can impact your health and can even be life-threatening.

Getting help can be hard but is the most important step you can take. Treatments can help you feel better about yourself so that anorexia does not take over your life.

What is anorexia?

Anorexia is an eating disorder. If you have anorexia, you will try to keep your weight as low as possible, even though you’re already underweight.

People with anorexia can experience lots of different feelings which can vary from person to person. You might feel that restricting food helps you feel in control, or that losing weight would make you happier. Having anorexia can also make it hard to see that you are already underweight.

You might not know why you feel this way. Feelings of guilt or shame might stop you from getting help.

It’s important to understand that anorexia can be life-threatening. Eating enough food is important to keep your body working properly. Not getting enough nutrients can lead to serious long-term problems like issues with your bones, muscles or heart.

That’s why it’s important to recognise whether you have anorexia, and take steps to get help and support.

If you're worried someone you know has anorexia, see our anorexia information that's written for friends and family.

What are the signs of anorexia?

The main signs of anorexia are:

• Restricting your food

• Doing things to stop you from gaining weight

• Having a deep fear of gaining weight

• Thinking you’re overweight when actually, you’re very underweight.

Eating very little or avoiding eating are signs of anorexia. You might also do lots of exercise, take laxatives (medicines that make you go to the toilet), and make yourself vomit.

You worry all the time about your weight, and might constantly weigh or measure yourself. You may also believe your value as a person depends on your body weight.

Anorexia can affect your health in lots of ways. You may:

• Stop having periods, if you're female

• Feel tired and weak

• Have aching muscles

• Feel dizzy

• Feel short of breath

• Feel your heart pounding

• Have fine hair on your body and face

• Get cold easily, especially in your hands and feet

• Start to lose your hair

• Start to get yellow teeth (this happens when you make yourself vomit a lot)

• Get constipated

• Feel full or get stomach pains after eating only a little food

• Get dehydrated, which makes you feel thirsty, sick, and exhausted

• Get dry, yellowish skin.

Most of these things happen because the body isn’t getting enough nutrients.

Having anorexia for a long time can cause heart problems like, abnormal heart rhythms and heart failure. It can also cause weak bones, fertility problems (difficulty getting pregnant and keeping a pregnancy), headaches, and problems with eyesight.

Getting help

Asking for help is the best thing you can do to start recovering from anorexia. This may be hard, especially if you do not think there is anything wrong. You should talk to a doctor if you can. Or tell a friend or family member who can help you talk to your doctor.

You might not realise that you have anorexia. Your doctor might have noticed some signs and they might ask you questions to find out if you have anorexia. Although you might feel ashamed or embarrassed, it's important to be honest about your eating habits.

Your doctor might do some tests to check your health. They might refer you to a team that is specially trained to treat eating disorders.

What are the treatment options for anorexia?

You are more likely to recover from anorexia if you get treatment quickly. Even if you have had anorexia for a long time, though, you should still get help.

Treatment for anorexia includes talking treatment to change how you think about food, and support to help your body get healthy.

Talking treatment

A key part of anorexia treatment is changing how you think about yourself and food. Talking treatment can help you do this. It involves having conversations with someone specially trained to help people with eating disorders.

They will talk to you to understand your feelings and help you figure out why you might not want to eat. These chats can teach you new ways to feel better about yourself and food so you can start eating in a healthy way.

Different types of talking treatments include:

• Cognitive behaviour therapy (CBT)

• Specialist supportive clinical management (SSCM)

• Maudsley anorexia nervosa treatment for adults (MANTRA)

• Focal psychodynamic therapy.

If you’re under 18 years old, you will be offered family therapy. This is where other family members are involved so everyone can support you in getting better.

Each type of talking treatment is slightly different. If one doesn’t feel right, you can always try a different type to see what works best for you.

Keeping your body healthy

A big part of treating anorexia is making your body healthy again. To do this, you will need to start changing the way you eat. You will need to eat enough to reach a healthy weight, and make sure your body is getting enough nutrients to work properly.

This might sound hard, but support from healthcare professionals can help. They will:

• Keep track of your health, like checking your blood sugar and organ function

• Help you with an eating plan

• Make sure that you’re drinking a healthy amount

• Give you vitamin and mineral supplements if you need them.

Treatment with medicines

There are no medicines that can treat anorexia. But some people with anorexia have other conditions like depression, anxiety, or OCD (obsessive-compulsive disorder).

If you have another condition, it will be treated alongside your anorexia. You might be offered medicines like antidepressants to treat your other condition.

Where treatment will happen

Anorexia treatment can happen in different places depending on your health and how you're feeling.

Many people with anorexia can live at home and visit a clinic for treatment. But some people need to be admitted to hospital. This may be because:

• Home treatment hasn’t worked

• You’re very underweight or are quickly losing weight

• Your health is at risk

• You might be at risk of harming yourself.

Your doctor or specialist team will decide if you need to go to hospital. They will be able to watch your health closely and give you the best chance of getting better.

If someone with anorexia is very sick and doesn't want help, doctors might have to make them go to hospital to get better. This happens only if there are no other options. Your doctor’s main goal is to keep you safe and healthy.

What happens next?

Your doctor or specialist team will keep checking in with you until you reach a healthy weight and your mental health has improved. Even after you recover, they may still want to make sure you’re staying healthy and feeling better.

Everyone’s recovery journey is different. Some people find it very hard to recover from anorexia.

Research shows that out of every 100 people with anorexia, 5 people die from the condition. However, out of the people that survive:[1]

• About 5 in 10 people will recover completely

• About 3 in 10 people will improve, but not recover completely

• About 2 in 10 people will continue to have anorexia.

Where to get more help

Many people with anorexia find it helpful to talk to others who have been through similar experiences. Your doctor can refer you to a local support group where you'll find useful resources and services. These groups might also connect you with someone who understands what you’re going through.

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