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Anorexia nervosa (AN) is one of the most widely-known eating disorders, but even a condition this recognizable can come with a number of hidden characteristics or manifest in ways many people may not be aware of or be able to easily spot.
Learning more about the hidden characteristics of anorexia can be a helpful way to see signs of the condition in loved ones or yourself and ensure you seek appropriate care before it's too late.
Before learning about hidden anorexia characteristics, it may be helpful to learn more about the condition overall.
Anorexia nervosa is a serious mental health condition that manifests as an intense fear of gaining weight. This symptom is generally supported by unhelpful thoughts or behaviors, including:1
Severely limited food intake or frequent attempts to diet/lose weight
Distorted body image (e.g., imagining one is bigger than one actually is)
Obsession over food or diet
Extreme weight loss
As with other eating disorders, AN is caused by a number of connected issues, including environmental, biological, and psychological factors. Yet, while anorexia cases generally share the same symptoms or risk factors, each case presents differently, including those that involve "hidden" anorexia nervosa characteristics.
Sometimes, people may struggle with the primary characteristic of anorexia nervosa (an extreme fear of weight gain), but not present the same way as most people with AN. These cases are often called atypical anorexia nervosa (AAN).
Most commonly, AAN is diagnosed when someone exhibits all the common anorexia traits but is not in a lower-weight body. Symptoms of AAN include:2
Unfortunately, people with AAN also share many common consequences to mental, physical, and emotional health as those with AN.2 In fact, the only characteristics of anorexia nervosa that aren't as severe in people with atypical anorexia nervosa are the effects on bone mineral density.8
Yet, the maintenance of an average or above-average body weight may make many people miss the signs of AAN, making it even more important to know the hidden characteristics of anorexia.
Hidden anorexia characteristics
Anorexia nervosa often manifests in a very physical way, but the disorder is ultimately a mental health condition, impacting people in a number of ways that may not be outwardly visible.
At the same time, the effects of the severe caloric restriction that often accompany anorexia nervosa can also present as a number of signs and symptoms that may not be readily recognizable as part of AN on their own.
The poor nutrition that arises from AN can result in various compounding issues, including a weakened immune system response that can lead to the person regularly getting sick or having difficulty overcoming illnesses.6
Hair loss and muscle weakness are other lesser-known symptoms of anorexia, both of which result from restricted food intake brought on by the condition, as well as the hormonal changes that often accompany extreme caloric restriction or low body weight.3
People with AN are also more likely to experience a sensation of coldness or may more quickly turn blue when feeling cold due, in part, to a decreased amount of body fat and hormonal dysfunction.3
The many cardiac problems brought on by anorexia nervosa may also be difficult to pinpoint as part of the condition. Cardiac complications seen in individuals with AN include low blood pressure and slow heart rate, which can result in fainting and other issues.7 Still, without the full context of a person's lifestyle or habits, these symptoms can be mistaken for similar conditions.
When it comes to eating habits, anorexia characteristics may not be obvious, especially given how prevalent diet culture is in our society. Restrictive eating behaviors that can sometimes signal a bigger issue include cutting out certain foods or food groups (e.g., becoming vegan or vegetarian or cutting out sweets) for reasons other than allergies or true intolerances, skipping meals, or avoiding social eating. While these behaviors can be driven by factors other than an eating disorder, they are sometimes subtle hints that someone is struggling with anorexia.
Hidden psychological characteristics of anorexia nervosa
An intense desire to stay thin, obsession with body shape and weight, and low self-esteem are more well-known psychological drivers of anorexia nervosa. However, the condition can be related to other mental health troubles.
Frequent co-morbid (or co-occurring) conditions with AN include:4
The complex connection between these conditions can make it difficult to see tell-tale anorexia traits or make it hard to know which symptoms are being caused by which condition.
Many people who struggle with AN also exhibit clinical perfectionist tendencies.5 This can manifest as the tendency to focus on "negative" qualities, harsh judgment of themselves or others, anxiety, and extreme or unrealistic demands on themselves or others.
If you or a loved one are exhibiting lesser-known characteristics of anorexia nervosa or AAN, it's time to seek out help. These conditions are dangerous and potentially even deadly, so the sooner appropriate care is sought, the better.
Thankfully, there are several treatments and therapies available for individuals who need help recovering from eating disorders. Seeking help represents the first step, but it's important to remember through it all that recovery from anorexia nervosa and atypical anorexia nervosa is entirely possible.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
Resources
Anorexia nervosa. (n.d.) Johns Hopkins Medicine. Accessed July 2024.
Marucci, S., Ragione, L. D., De Iaco, G., Mococci, T., Vicini, M., Guastamacchia, E., & Triggiani, V. (2018). Anorexia Nervosa and Comorbid Psychopathology. Endocrine, Metabolic & Immune Disorders Drug Targets, 18(4), 316–324.
