What is anorexia nervosa?
Anorexia nervosa is one of the most well-known and common eating disorders, typically characterized by a severe limitation of food intake. Aside from extreme caloric restriction and disordered eating habits, people with anorexia often have:
- An intense fear of gaining weight
- A distorted perception of one’s own weight and body shape and size
- An obsession with what is considered a "normal" weight (or desire for extreme weight loss)
Some people with restrictive eating disorders, including anorexia nervosa, do not lose weight due to genetic differences in how their bodies respond to restriction. And some people who do lose weight due to AN may not be considered to be at an “abnormally low weight” by medical charts, but are in fact weight-suppressed relative to their individual biology.
It is important to note that body weight is far from the most telling sign a person is battling AN. It is very common for a person with AN to be in a body that is not at an extremely low weight. This type of anorexia may be classified as atypical anorexia nervosa (AAN).
People in larger bodies, straight-size bodies, and even those in bodies that by society’s diet culture standards consider fit and healthy, can be very sick and suffer from AN or AAN.
Co-occurring mental health disorders
It is not completely understood why some individuals develop eating disorders such as AN and others do not, but there is evidence that this eating disorder commonly co-occurs with certain types of mental illness.
When examining the health risks of anorexia, it has a very high rate of comorbidity—or, co-occurrence—with mood disorders, including depression and several types of anxiety. The drive for or preoccupation with thinness is also often connected to rigid thinking patterns, including perfectionism. And a growing number of studies have linked the condition to autism.1
Combined, these types of unhelpful or irregular thought and behavioral patterns can lead to the development or maintenance of anorexia nervosa.
Physical health risks of anorexia
The restriction of energy, vitamins, and nutrients that results from anorexia nervosa and other eating disorders can lead to a host of physical problems and severe health consequences. Malnutrition from AN can cause both short and long-term physical complications as the body struggles to cope with an inadequate supply of fuel.
Even among people who all struggle with AN, genetic differences influence which types of medical complications will develop for each person. It isn’t possible to control how one’s body responds to eating disorder behaviors, and even if an individual doesn’t experience every single health problem on a list, that in no way means their eating disorder is less serious or less risky.
Without adequate nutrition, the body is not able to perform necessary cellular repairs, maintain organ function, keep electrolytes levels stable, regulate blood sugars, or keep hormones balanced, resulting in a number of physical symptoms.
Cardiovascular disease is one of the most significant health risks from AN and can result from the combination of imbalanced electrolytes and diminished nutrition. It can lead to:
- Arrhythmias—or, irregular heart rhythms
- Pericarditis—the swelling and irritation of the sac of fluid that surrounds the heart
- Sudden cardiac arrest
- Shrinking of the heart muscle
Heart damage caused by AN leads to an estimated one-third of all deaths associated with the disorder.2
Hormonal imbalances can also cause numerous problems for individuals struggling with anorexia nervosa. Reduced production of sex hormones can impact fertility and bone health, increase the risk of fractures, decrease energy levels, and cause a variety of other issues.
Gastrointestinal issues of all types are also very common for people with anorexia nervosa. This can include:
- Chest pain
- Weakening of gastrointestinal muscles
Those with severe anorexia nervosa also have an increased risk of developing hepatitis, gastroparesis, and potentially life-threatening problems with intestinal function.
Mental and emotional health risks associated with anorexia nervosa
In addition to the many physical health risks posed by AN, the mental and emotional effects of the disorder can also be significantly dangerous.
AN has a tragically high comorbidity rate with suicidality, with the condition increasing the odds of someone committing suicide by up to 32 times. It’s estimated that 1 in 5 people with anorexia attempt suicide.3
Depression and anxiety
The heartbreaking statistics may be tied to AN’s profound connection to depression and anxiety. Anywhere from 50-70% of people with anorexia nervosa have been found to simultaneously experience major depressive disorder, and 24-71% are thought to struggle with co-occurring anxiety disorders.4
It’s possible for someone to experience these conditions before developing signs and symptoms of anorexia nervosa, and many people who struggle with the eating disorder are also at higher risk of developing these mood disorders. Still, hormonal and cognitive changes caused by AN can also have a deep and direct impact on mood, either triggering or helping maintain episodes of depression and a number of anxiety disorders.
While these conditions commonly occur together, it is not fully understood whether they develop at the same time, or whether the eating disorder triggers the onset of other mood disorders or vice versa.
Substance use disorder also has a high overlap with anorexia nervosa, with an estimated 27% of people struggling with AN also reporting a substance use disorder diagnosis. Again, these two conditions share many mental health underpinnings which can drive both disorders.5
Finding treatment for anorexia nervosa
It’s estimated that 10% of people with anorexia nervosa die within 10 years of being diagnosed with the disorder, while 20% die within 20 years of initial onset.2 Although AN is a serious eating disorder with the potential for causing deadly medical complications, many anorexia treatment centers exist which can be healing and life-saving.
Therapy to treat anorexia
A number of treatment modalities have been developed to help people heal from this dangerous condition, including cognitive behavioral therapy (CBT), which has long been the leading therapeutic option for people struggling with anorexia nervosa. Other forms of therapy have also been found to help, including:
Some medications have also been found to help and may be used in treatment.
If you or a loved one are struggling with anorexia nervosa, reaching out to a doctor or mental health provider can be an important first step toward getting help. Full recovery is always possible, and it’s never too late to start on the path toward healing.