People with anorexia nervosa (AN) usually have a great fear of gaining weight. They may be obsessed with losing weight and being thin. They eat very little, or not at all, even when hungry. Their bodies begin to starve because they are not getting the nutrients they need. People with AN often have a distorted body image. They may insist that they are too fat, or that some parts of their bodies are too big, even when family and friends know that they are dangerously underweight.
The symptoms of AN vary and some people may not realize they are afraid of gaining weight. They insist they are healthy, despite being at a dangerously low weight. People behave in many different ways when they struggle with eating, try to hide weight loss or avoid weight gain.
A person with AN may:
- keep, hide, pick at, crumble or throw away food
- cut food into small pieces or move it around the plate
- spend much of their time focusing on food, reading recipes, preparing food for others
- wear baggy clothes or layers of clothing to hide weight loss, or to keep warm
- over-exercise (exercising even when it interferes with other activities, at inappropriate times, or despite injuries or other medical complications)
- withdraw from friends and become secretive
Everyone who is diagnosed with AN is at a dangerously low weight. They may have lost a lot of weight or failed to gain weight in normal growth and development. Low weight causes many complications and many of those problems will resolve when they gain weight. But, some of the complications can be permanent, especially for those who stay at a low weight for a long time, or who develop an eating disorder at a young age.
Common complications of AN include:
- anxiety, mood swings, depression
- weak, lack of energy
- dizzy, headaches
- low blood pressure
- stomach or intestinal problems
- low body temperature
- loss of bone density
- hair loss or thinning
- soft, fine hair that grows on the face and body (lanugo)
- tooth pain
- slowed heart rate
- abnormal heartbeat or heart attack
- stomach takes too long to empty
- kidney failure
- infertile, unable to get pregnant
- dry, yellow skin
- joint pain
- swollen hands or feet
- (for girls and women) irregular or no menstrual periods
AN can lead to many medical problems. You may not notice the effects of starving immediately, but it can still do serious damage to the body. Anorexia nervosa can result in death and is the mental health disorder with the highest mortality rate. A young woman with anorexia nervosa is 12 times more likely to die than other females her age.