Anorexia nervosa is a serious mental illness in which a person restricts what they eat and drink, alongside fear of weight gain and a distorted view of their own body. It occurs at every body size, age, gender and background, and a person does not need to look unwell to be seriously unwell.
Key points
- Anorexia nervosa is a serious mental illness in which a person restricts what they eat and drink, alongside fear of weight gain and a distorted body image.
- It occurs at every body size, age, gender and background, and a person does not need to look unwell to be seriously unwell.
- Atypical anorexia, where every feature is present but the weight criterion is not met, is just as serious.
- Anorexia carries the highest mortality of any eating disorder, from medical complications and from suicide.
- NICE recommends a talking therapy first at every age, and says single measures such as body mass index (BMI) must not decide whether treatment is offered.
Symptoms
- Fear of gaining weight; judging oneself mainly by weight or body shape; restricting what is eaten or drunk, often following rigid personal rules.
- Compensatory behaviours intended to undo eating; avoiding meals with others or withdrawing socially.
- Tiredness, dizziness, feeling cold, digestive problems, periods stopping, and in time effects on the heart, bones, teeth and kidneys.
Causes and risk factors
- A mix of biological, psychological and social factors: family history, perfectionism, low self-esteem, difficulty tolerating uncertainty.
- Bullying or comments about eating or appearance, bereavement, trauma; not caused by the media alone or by families.
Treatment
- Adults: individual eating-disorder-focused CBT (CBT-ED), MANTRA, or specialist supportive clinical management.
- Children and young people: anorexia-nervosa-focused family therapy (FT-AN) first, putting parents and carers at the centre of supporting eating.
- Single measures such as BMI or duration of illness must not decide whether treatment is offered.
When to speak to a professional
- Food, eating, weight or body shape takes up much of your thinking, or you are restricting what you eat or drink.
- Contact your GP or NHS 111 the same day if you feel faint or dizzy, have chest pain or an irregular heartbeat, or cannot keep fluids down.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.