Anorexia Nervosa

Individuals with anorexia nervosa are successful at losing weight; so successful that their body weight is at least 15% below normal weight.  (However, anorexics are typically 25-30% below normal weight by the time they seek treatment.)  In general, they achieve weight loss through extraordinary control of their food intake.

People with anorexia have an intense fear of being fat.  The disorder typically starts in adolescents who are overweight or who think they are overweight.  The respond by losing weight.  However, people with anorexia are never satisfied with their weight loss.

In anorexia, weight loss is achieved primarily through severe restriction of food intake, combined with excessive exercise and, in some cases, purging.

The DSM-IV identifies two subtypes of anorexics:

• the restricting subtype - These people severely limit caloric intake to achieve weight loss.
• the binge-eating subtype - These people eat relatively small amounts of food, but purge very consistently, often after every meal.

Similar to bulimia, anorexia nervosa is frequently comorbid with mood disorders, anxiety disorders, and substance abuse.  Anorexia nervosa is frequently comorbid with obsessive compulsive disorder (OCD).

As with bulimia, 90-95% of anorexics are female.  Onset is typically in adolescence, around age 13.

There are numerous medical consequences associated with anorexia nervosa.  The most common consequence is cessation of menstruation.  In fact, a woman must miss at least three consecutive menstrual cycles in order to receive a diagnosis of anorexia.  Other consequences include development of lanugo (downy hair on the limbs and cheeks), low blood pressure, and electrolyte imbalances.  The latter, as with bulimia, may lead to death.

Over time, up to 20% of people die as a result of this disorder.  Five percent die within 10 years of diagnosis.  Many of these deaths are suicides.  Mortality rates for eating disorders are the highest for any psychological disorder.

This page was last updated onTuesday October 21, 2003.