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Anorexia Nervosa: Teen Version

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KEY POINTS

  • Anorexia nervosa is an eating disorder. If you have anorexia, you see yourself as being overweight when you are not. You are so afraid of becoming overweight that you eat as little as possible.
  • Treatment involves learning healthy eating habits, therapy, and possibly hospitalization if your condition is severe and life threatening.
  • If you can’t appreciate yourself for who you are, not what you look like, or what you weigh, get professional help.

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What is anorexia nervosa?

Anorexia nervosa is an eating disorder. If you have anorexia, you see yourself as being overweight when you are not. You are so afraid of becoming overweight that you eat as little as possible.

Anorexia can be a very severe physical and mental illness. You could die from starvation or you may think about suicide. If you are pregnant, anorexia can affect your health and your baby’s growth.

What is the cause?

The exact cause of anorexia is not known. It may be caused by a mix of physical, mental, and social factors, and traits that are inherited from parents. Part of the cause in many cultures is thinking that being thin means being beautiful. This illness is most common in teens and young women. Athletes, dancers, models, and actors who focus on low weight to perform better may also develop anorexia.

You may be at risk of developing anorexia if you:

  • Have a family history of anorexia or other eating disorders
  • Have a family or personal history of depression, bipolar disorder, anxiety disorders, or obsessive-compulsive personality disorder
  • Have a history of physical or sexual abuse

What are the symptoms?

Signs and symptoms may include:

  • Not eating for long periods, eating very little, or eating only food that is very low in calories
  • Binge eating, which means eating large amounts of food in a short period of time, and purging, which means making yourself throw up or using laxatives or water pills
  • Ritualistic eating such as cutting your food into tiny pieces or never eating in front of other people
  • Exercising too much
  • Brittle hair and nails
  • Losing a lot of weight such as being more than 15% below a healthy body weight
  • Feeling weak, dizzy, and cold all the time
  • Feeling depressed or anxious about your weight
  • Having trouble sleeping
  • Constipation
  • Thinking about dieting and losing weight all the time
  • Fearing weight gain even when you are underweight
  • Denying that you are seriously underweight or that you have an eating disorder
  • If you have diabetes, skipping insulin doses to lose weight

Anorexia may cause other health problems including:

  • For females, if your weight gets very low, you may not have monthly periods. Hormone changes result from low weight and low levels of body fat. This can happen if you exercise a lot also.
  • For males, low amount of the hormone testosterone
  • Weakening of your bones called osteoporosis
  • Low amount of red blood cells called anemia
  • An imbalance of minerals called electrolytes in your body
  • Heart and blood vessel problems such as low blood pressure, abnormal heart rhythms, and heart failure
  • Kidney and bowel problems
  • Death

The risk of suicide is much greater if you have anorexia.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your provider will ask about your eating habits and other behaviors. You may have blood tests, X-rays, or other tests.

How is it treated?

You may have a hard time seeing that you have a problem and need treatment. Anorexia does not go away or get better on its own. Treatment involves learning healthy eating habits, getting to and keeping a healthy weight, and learning to think about your weight differently. Your healthcare provider may suggest that you meet with a dietitian to create a healthy eating plan. You may need therapy to help you change how you think about yourself and food.

Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns even after you stop going to therapy. It can help you learn to manage stress and improve self-esteem.

Family therapy may be helpful. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family to make changes.

There are no medicines known to treat anorexia nervosa. Medicine may be prescribed if you also have problems with anxiety or depression.

You may need to go for treatment every day or be hospitalized if your condition is severe and life threatening.

If you have anorexia, you may think constantly about weight and food for many years. Even after you reach a healthy weight, you may need to continue treatment for many months. Being under a lot of stress can cause your symptoms to get worse. The earlier you seek treatment, the more successful it is likely to be.

How can I take care of myself?

  • Get support. Talk with family and friends. Join a support group in your area.
  • Learn to manage stress. Ask for help at home and school or work when the load is too great to handle. Find ways to relax. For example, take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
  • Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a variety of healthy foods. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Stay physically active as advised by your provider.
  • Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take your medicines as directed by your provider or therapist. Take mineral and vitamin supplements only if advised by your healthcare provider.
  • Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse. See your healthcare provider regularly to have your weight, blood pressure, heart rate, and temperature checked.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

What can be done to help prevent anorexia?

  • Learn all you can about anorexia. Don’t let what you see online, on TV, or in magazines affect your self-esteem. Question advertisements or articles that make you feel bad about your body shape or size. Are they trying to sell you something? Is what they say and show true? Or, have the pictures been air-brushed or computer generated to make the person look so perfect?
  • Eat a variety of foods in healthy amounts. No single food is always bad or always good.
  • Try to accept your body’s unique shape and size. It is much more important to be healthy than to be skinny.
  • Learn to like yourself for who you are, not what you look like, or what you weigh. Treat yourself with respect. Choose to value yourself based on goals, accomplishments, talents, and character.
  • If you think someone has an eating disorder, talk with that person. Encourage the person to seek professional help.

For more information, contact:

Developed by Change Healthcare.
Pediatric Advisor 2019.4 published by Change Healthcare.
Last modified: 2019-08-12
Last reviewed: 2019-05-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2018 Change Healthcare LLC and/or one of its subsidiaries
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