Anorexia nervosa is a serious eating disorder characterized by food restriction and a fear of gaining weight. It can cause a variety of devastating physical effects.

Keep reading to learn about the symptoms of anorexia and how it’s diagnosed and treated.

Signs and Symptoms of Anorexia

Although it is considered a mental health condition, anorexia affects virtually every part of the body. This disorder can present a wide range of physical and psychological symptoms.

Physical Symptoms

The physical symptoms of anorexia include but are not limited to the following:

  • Weight loss
  • Fatigue
  • Low blood pressure (hypotension)
  • Low body temperature (hypothermia), or feeling cold all the time
  • Gastrointestinal issues like stomach pain, constipation, or bloating
  • Lightheadedness, dizziness
  • Swollen hands/arms or legs/feet
  • Hair loss or thinning (alopecia)
  • Fine hair all over the body (lanugo)
  • Brittle nails
  • Lack of menstruation; missing your period or getting periods less frequently
  • Insomnia
  • Abnormal heart rhythms/irregular heartbeat
  • Dry or discolored (yellowish) skin
  • Teeth erosion and calluses on the knuckles from self-induced vomiting

These effects can be short term or long lasting depending on how severe your anorexia is. For example, fatigue may disappear a few weeks after treatment, but it will take much longer for your weight to return to normal.

Psychological Symptoms

The psychological symptoms of anorexia include but are not limited to the following:

  • Fear of gaining weight or being “fat”
  • Inaccurate view of one’s body and weight
  • Putting too much emphasis on weight and basing your self-esteem on your appearance
  • Dieting, fasting, or skipping meals
  • Counting calories obsessively
  • Refusing to eat certain foods or entire food groups, such as carbohydrates or fats
  • Preoccupation with food, even while restricting food intake; for example, you might cook a meal for family or friends but refuse to eat it yourself
  • Refusing to eat in front of others or in public
  • Denial of hunger
  • Developing food rituals, such as eating foods in a certain order or chewing excessively
  • Dressing in layers or baggy clothes to hide your body
  • Frequently weighing yourself or inspecting your body in the mirror
  • Exercising a lot, even when you’re sick, tired, or injured
  • Binge eating, followed by purging through a variety of methods: fasting, exercising, vomiting, laxatives, enemas, diet pills, stimulants, or diuretics
  • Lack of emotion; having a flat mood
  • Irritability
  • Withdrawing from loved ones

If you have anorexia, you could have a few or many of these symptoms. The type of anorexia can also affect symptoms, which you can read more about below.

Types of Anorexia

There are two different kinds of anorexia: restricting type and binge eating type. Individuals with the restricting type place severe limits on the amount and types of food they eat. Those with the binge eating type also restrict food, but they engage in binge eating and purging behaviors as well.

Anorexia can be difficult to spot. Contrary to the stereotype of an extremely thin young woman, this disorder affects people of all genders and backgrounds. People with anorexia can even appear to be a normal weight or a higher than average weight. It’s important to get help from a professional if you have any concerns about your eating and exercise habits.

Why Anorexia Is So Dangerous

Severe food restrictions deprive the body of essential nutrients. This makes anorexia a dangerous condition. In fact, anorexia nervosa has the highest mortality rate of any mental health condition. It affects most of the major systems in your body, including your heart, lungs, and gastrointestinal system.

The recovery process can also present some risks. People with anorexia may experience “refeeding syndrome.” This happens when someone who is severely malnourished starts eating again, leading to an abrupt shift in metabolism and electrolyte imbalances. Refeeding syndrome can affect most of your body’s organs and may lead to death. Individuals with severe cases of anorexia should seek treatment at a hospital to avoid these complications.

How Is Anorexia Diagnosed?

A doctor or mental health professional can diagnose anorexia nervosa using criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM). These are the criteria for anorexia from the DSM-V:

  • Restriction of energy intake relative to requirements, leading to a significant low body weight in the context of the age, sex, developmental trajectory, and physical health (less than minimally normal/expected).
  • Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain.
  • Disturbed by one’s body weight or shape, self-worth influenced by body weight or shape, or persistent lack of recognition of seriousness of low body weight.

A doctor will ask you about the symptoms you are experiencing. He or she may also order some laboratory tests, like blood tests or an electrocardiogram, although these may not always reveal the seriousness of the disorder. The body is very resilient. Lab tests can sometimes appear normal, even while someone is at risk of serious complications or death.

Some people do not meet all the criteria for anorexia or another type of eating disorder. That doesn’t mean they are at less risk. These people are often diagnosed with Other Specified Feeding or Eating Disorder (OSFED), which is just as serious as anorexia nervosa.

If your doctor does not diagnose you with anorexia but you are still concerned about your symptoms, you should talk to an eating disorder specialist. Getting help early on will prevent your symptoms from getting worse.

What Causes Anorexia Nervosa?

Eating disorders are complex illnesses and most of the time, multiple factors are present. It’s difficult to pinpoint exactly what causes anorexia, but here are some risk factors we know about.


Research suggests that genetics may account for 40-60% of eating disorder risk. Additionally, having a relative with anorexia increases your chances of developing an eating disorder.


Certain environmental factors increase your risk for an eating disorder:

  • Physical, emotional or sexual abuse, especially in childhood
  • Bullying
  • Trauma
  • Difficult life events such as divorce, death, or illness
  • Social/cultural pressures to look a certain way
  • Media portrayals of unrealistic bodies
  • Dieting

Physical Changes

Eating disorders commonly develop during adolescence. The physical changes associated with puberty may trigger body dissatisfaction, and an eating disorder may develop as a way to cope or change one’s appearance. Hormonal fluctuations can be another risk factor.

Can Anorexia Be Treated?

There are many effective treatments for anorexia nervosa. These include talk therapy, nutrition education, and medications. Usually, individuals will need a combination of treatments to fully recover. Eating disorders can lead to a variety of physical complications, so you may need to address some of those issues along with the psychological factors that are contributing to your illness.

If you are at a dangerously low weight or severely malnourished, you may be hospitalized first to restore your body weight to healthy levels. Then, you can work toward other aspects of recovery.

Anorexia is a chronic condition. People sometimes relapse into disordered eating thoughts and behaviors. It’s important to stick to your treatment plan, even if you feel better, and reach out for help if you relapse. Although anorexia is a complex disorder, it is possible to fully recover.

How to Get Help

If you think you might have anorexia, talk to your doctor or therapist. They may refer you to a specialist who can evaluate your symptoms. You can also reach out directly to an eating disorder treatment center, like Seeds of Hope. We have locations in Philadelphia, Exton, Paoli, and Lake Ariel, Pennsylvania. Our team of specialists can evaluate your symptoms and tell you if you have an eating disorder. Call us at (610) 644-6464, or fill out a contact form to set up an assessment.