Anorexia Nervosa

Learn more about anorexia nervosa, one of the most common eating disorders among teens. This article looks at how to diagnose anorexia, some facts and statistics of anorexia nervosa, as well as common complications and treatment options for sufferers of anorexia.

Anorexia nervosa is one of the most common teen eating disorders, along with bulimia. The name comes from Latin, with anorexia meaning “without appetite” and nervosa, referring to the nervous system. Although sometimes called simply anorexia for short, the full name makes clear that it is a disorder with both physical and psychological components. Loss of appetite (anorexia) can happen from a variety of circumstances, such as stress or having influenza. But anorexia nervosa is something different.

Diagnostic Criteria for Anorexia Nervosa

The Diagnostic and Statistical Manual of Mental Disorders (DSM) specifies that a person with anorexia nervosa (called an anorectic or anorexic) meets the following criteria:

  • has a weight at least 15% below ideal weight
  • has a Body Mass Index (BMI) of 17.5 or less
  • if a woman past menarch, has missed 3 menstrual periods in succession
  • is preoccupied with body weight and shape
  • has an extreme fear of gaining weight

In addition, two subtypes are recognized.

  • Restricted Diet Type is anorexia with neither binging nor purging.
  • Binge Eating/Purging Type is anorexia with regular binge eating or purging in addition to restriction of intake.

It is absolutely crucial to recognize that a person who does not exactly meet these criteria or the criteria for bulimia may still be suffering from an eating disorder and be at risk. If you suspect that you or someone else has an eating disorder, seek assistance, even if the person does not meet all these criteria.

Anorexia Nervosa Facts and Statistics

Anorexia nervosa affects about .25 to 1 percent of girls in secondary school, and about three quarters of the cases begin between ages 11 and 20. Women account for about 90-95% of all anorectics, but only 75% of pre-adolescent cases. Although it is not an official term, some use manorexia to refer to a male anorexic. Another term, drunkorexia, has been coined to refer to the Binge Eating type of anorexia nervosa but with binge drinking substituted for binge eating. Drunkorexia also broadly applied to people who have any combination of an alcohol problem and an eating disorder. This is one example of a very serious problem that does not fit the DSM criteria.

Anorexia has been a problem for a long time. It is now thought that the case of a woman with “consumption” recorded by Richard Morton in 1686 may be the earliest recorded case of anorexia nervosa. It was certainly known by the nineteenth century, because in 1873 the name anorexia nervosa was coined by a London doctor named Sir William Gull (1819-1890).

But despite its long history, not many people knew much about it until recently, and now it may be better known for the people who suffered from it than for what it truly is. Musician Karen Carpenter and gymnast Cathy Rigby are perhaps two of the most famous sufferers, but even news coverage has not helped people understand it very well. It was with Carpenter’s death from complications related to anorexia nervosa, that people began to take notice.

Origins of Anorexia Nervosa

The fact is, despite popular belief, that anorexia nervosa is not the fault of the person who has it. This belief is rooted in incomplete understanding of the origins of anorexia by people who acknowledge only the sociocultural component (the influence of a society that celebrates thinness) and personal component (poor habits and vanity) to the exclusion of the biological underpinnings. Although it is not clear how, it is fairly certain by now that genetic factors and biological factors - as well as family, sociological, and psychological influences - underlie occurrences of anorexia nervosa.

Related Issues and Complications

People with anorexia nervosa often have other disorders, including depression, withdrawal, and insomnia. Obsessive-compulsive behavior is frequently observed, with one study showing that anorexics spend 70-85 percent of their day occupied with food-related thoughts.

Anorexia nervosa has a number of physical complications, including:

  • slowed heart-rate
  • low blood pressure
  • constipation
  • anemia
  • dry, flaking skin
  • lanugo (soft hair growth on the face, back, and limbs
  • alopecia (loss of hair on the head)
  • brittle nails
  • osteoporosis
  • tooth decay and bad breath in patients who purge

In addition, anorexia nervosa has a number of very dangerous physical complications, mostly as the result of the effects of starvation, including malnutrition, electrolyte imbalance and cardiac arrest. In fact, though anorexia nervosa is the rarest of the eating disorders, it is the most deadly, not only of eating disorders but of all psychiatric disorders, and the leading cause of death for young women who are 15 - 24 years of age. Some studies show that anorexics are as much as 10 times more likely to die as people who do not have anorexia nervosa and between 6% and 20% of people with anorexia will die as a result of having the disorder, most of them by suicide.

Treatment of Anorexia Nervosa

One of the greatest hindrances to treatment is the patient’s resistance. Often, the anorexic denies that there is a problem and is unreliable about providing accurate information. Sources agree that the treatment of anorexia nervosa must be multi-faceted to address the wide range of symptoms and causes, and that life-threatening physical symptoms have top priority, with weight gain being one of the first issues to be addressed. Hospitalization is sometimes necessary.


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