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Am Fam Physician. 2004;69(7):1729-1730

What is anorexia nervosa?

Anorexia nervosa (say: ann-or-ex-ee-ah) is an illness that usually affects teenage girls. Teenage boys and grown-up women and men also can get it. People with anorexia think about being thin a lot of the time. They try to lose a lot of weight, and they are very worried about gaining weight. They think they are fat even though they are very thin. Anorexia is more than just a problem with food and weight. It is a way of using food and weight to deal with emotional problems.

What is the difference between anorexia and bulimia?

People with anorexia keep themselves underweight. They starve themselves by not eating enough food, they don't eat high-calorie foods, and they may exercise too much. People with bulimia (say: boo-lim-ee-ah) often eat huge amounts of food at one time and then make themselves throw up soon after eating. They also might take laxatives or water pills to keep from gaining weight. People with bulimia usually do not lose as much weight as people with anorexia.

Why do people get anorexia?

No one knows why some people get anorexia. People with this problem may think they would be happier and more successful if they were thin. They want everything in their lives to be perfect. They think that having a thin body is one way to be perfect. People who have anorexia usually are good students. They may be in many school and community activities. They blame themselves if they do not get perfect grades or if other things in their lives are not perfect.

Warning signs of anorexia

  • Deliberate starvation with a big weight loss

  • Fear of gaining weight

  • Refusal to eat

  • Denial of hunger

  • Constant exercising

  • Greater amounts of hair on the body or face

  • Thinning hair on the head

  • Sensitivity to cold

  • Absent or irregular periods

  • A feeling of being fat when the person is really too thin

What other problems can anorexia cause?

Girls and women with anorexia might stop having normal menstrual periods. People with anorexia have dry skin and might have fine hair growing on their body. The hair on their head may become thin. They may feel cold all the time, and they may get sick often. People with anorexia have a hard time concentrating. They are always thinking about food. It is not true that people with anorexia are never hungry. They are always hungry, but feeling hungry makes them think they have control over their lives and bodies. People with severe anorexia can even die of starvation.

How is anorexia treated?

Anorexia is hard to treat because people with anorexia believe there is nothing wrong with them. People who have had the eating problem for less than six months or who have lost only a little weight may not have to stay in a hospital. But for successful treatment, people must want to change. They also must have support from their family and friends.

People with more severe anorexia need to be in a hospital, usually in a special unit for people with anorexia and bulimia. Treatment involves more than changing the person's eating habits. People with anorexia often need counseling for a year or more so they can change the feelings that cause their eating problems. These feelings may be about their weight or problems with their family, or about problems with how they think about themselves. Some people with anorexia are given medicines for depression.

How can family and friends help?

People with anorexia feel safe, secure, and comfortable with their illness. Their biggest fear is gaining weight because that makes them feel like they don't have control over their bodies. People with anorexia will beg and lie to avoid eating and gaining weight. Family and friends should give love and support but not give in to the pleading of a person with anorexia.

Where can I get more information?

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