Condition Basics

What is anorexia?

Anorexia is a type of eating disorder. People who have it have an intense fear of gaining weight. If you have anorexia, you may strictly limit the amount of food you eat. You can become so thin that it becomes dangerous.

Anorexia is both a physical and psychological problem. It almost always begins with dieting. Over time, strictly limiting foods leads to malnutrition and unhealthy weight loss.

It can occur in children, teens, young adults, and adults. Anyone can have anorexia, no matter their gender. Your best chance to recover from anorexia is to get treatment early. If not treated, it can lead to serious health problems and starvation.

What causes it?

There is no single cause of anorexia. It may be due to a mix of genetics, family and social factors, and personality traits. For example, you may be more likely to have anorexia if someone in your family has it or if you do a sport that stresses body size, like gymnastics.

What are the symptoms?

If you think you might have anorexia, you might weigh much less than is healthy or normal for your natural body frame. Even so, you may still feel like you weigh too much. You probably feel a strong need to control your food and weight. People who care about you might say that you obsess over dieting.

How is it diagnosed?

There isn't a single test to diagnose anorexia. But anorexia has a serious effect on your health, eating habits, and your mental health. Your doctor will evaluate changes in your weight, check for signs of malnutrition or starvation, and ask you about fears or changes in how you see your body.

How is anorexia treated?

Because anorexia is a physical and mental health condition, your healthcare team may include a doctor, a dietitian, and a counsellor. Treatment can help you get back to a weight that is right for you, learn good eating habits, and learn to feel better about yourself. If your weight has dropped too low, or you aren't medically stable, you may need treatment in a hospital.

What should you do if you think someone has an eating disorder?

If you think your child has an eating disorder:

• Talk to them. Tell your child why you're worried. Let them know you care.
• Make an appointment for you and your child to meet with a doctor or a counsellor.
• Be prepared to share your concerns or bring someone you trust to do this with you.

If you're worried about someone you know:

• Tell someone who can make a difference, like a parent, a teacher, a counsellor, or a doctor. A person with an eating disorder may say that they are okay and don't need help. You can help by encouraging them to talk to someone they trust.

What Increases Your Risk

There is no single cause for an eating disorder such as anorexia, bulimia, or binge eating. But certain things put a person at greater risk for getting an eating disorder. Some of these things include:

• a family history of an eating disorder
• struggling with depression, anxiety, low self-esteem, or obsessive behaviours
• feeling a need to be perfect
• social or cultural pressure about thinness or weight
• negative feelings about your body
• taking part in sports or activities that encourage thinness, such as modelling or dance
• having a history of stressful life events

Having risk factors for it doesn't mean you'll get an eating disorder. But knowing some of the things that can add to your risk may help you see a problem early when it is easier to treat.

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Prevention

There is no known way to prevent an eating disorder. But knowing the early signs and seeking treatment right away can help prevent problems caused by an eating disorder. Early treatment may be the best way to keep your eating disorder from getting worse.

Symptoms

People who have anorexia often strongly deny that they have a problem. It's most often up to their loved ones to get help for them. If you're worried about yourself or someone else, you can look for certain signs.

If you have anorexia:

• have a much lower weight than is healthy for your body
• not see your body shape or weight accurately
• base your self-esteem on how you view your body
• often feel anxiety and guilt about eating
• have negative health symptoms as a result of weight loss, such as hair loss, feeling cold, loss of menstrual periods, feeling tired, and having a hard time thinking clearly

Your life can become focused on controlling your weight. You may:

• obsess about food, weight, and dieting
• strictly limit how much you eat
• have special ways of eating food or making it look like you've eaten when you haven't
• exercise a lot, even when you are sick.
• vomit or use laxatives or water pills (diuretics) to avoid weight gain

What Happens

Anorexia almost always begins with dieting. Over time, strictly limiting foods leads to weight loss that isn't healthy.

Malnutrition changes your brain and metabolism. This limits your appetite and how your body uses food. It also limits your ability to think clearly and make good decisions. As the illness gets worse, behaviours that aren't rational begin. You might make rules about food, mealtime, exercise, or other behaviours.

Starvation and malnourishment from anorexia can cause other problems, such as osteoporosis or an irregular heartbeat. Other mental health conditions like depression often occur along with anorexia.

After anorexia starts, it can be very hard to return to normal eating without help. Early treatment offers the best chance to recover. You may need treatment at an inpatient clinic. Some people with anorexia deny that they have a problem. You may need support from your loved ones to be willing to get help.

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When to Call a Doctor

Call 911 or other emergency services immediately if:

• You have severe anorexia, and starvation has become life-threatening.
• You or someone you know is thinking seriously of suicide or has recently tried suicide. Serious signs include these thoughts:
  • You have decided on how to kill yourself.
  • You have set a time and place to do it.
  • You think there is no other way to solve the problem or end the pain.
• You feel you cannot stop from hurting yourself or someone else.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away.

• Call or text Canada's suicide and crisis hotline at 988.
• Call Talk Suicide Canada: 1-833-456-4566 or text 45645 (4 p.m. to midnight ET).
• Kids or teens can call Kids Help Phone: 1-800-668-6868 or text CONNECT to 686868.
• Go to the Talk Suicide Canada website at https://talksuicide.ca or the Kids Help Phone website at https://kidshelpphone.ca for more information.

Consider saving these numbers in your phone.

Call your doctor now if you have been diagnosed with anorexia nervosa and:

• Are not able to pass urine.
• Have a pounding heartbeat, skipping heartbeats, or a slower-than-normal heart rate.
• Have been fainting.
• Have severe belly pain; are vomiting up blood; or have black, sticky (tarry) stools. These signs may mean that there is bleeding in the digestive tract.
• Have severe pain anywhere in your body, such as the joints or torso.

Call your doctor if you:

• Have signs of anorexia, including rapid weight loss, eating very little, and being overly concerned about weight and appearance.
• Have lost a lot of weight and can't stop losing weight.
• Fear gaining even a small amount of weight, and this interferes with eating healthy meals.
• Notice that you are secretive or lie about your eating habits.
• See yourself as fat and feel that you must diet, even if others have commented on your weight loss.
• Have been making yourself vomit or are abusing laxatives or diuretics (bulimia).
• Are not having menstrual periods when you should.
• Feel the need to exercise a lot, and don't give yourself healing or rest time when you are injured or exhausted.
• Have been diagnosed with anorexia and feel dizzy.

Watchful waiting

Watchful waiting is when you wait and see if behaviours will become healthy again instead of getting treatment right away. This isn’t a safe way to handle a possible eating disorder.

Getting early treatment improves your chances of overcoming anorexia.

Exams and Tests

There is no single test that can diagnose anorexia. But this illness has a serious effect on your health, eating habits, and your mental health. If your doctor thinks that you may have anorexia, they will evaluate your weight with what is appropriate for your body, check for signs of malnutrition or starvation, and ask about any fears or changes in how you see your body.

Common exams and tests for anorexia include:

• A medical history of your physical and emotional health.
• A physical exam. This may include checking your heart, lungs, blood pressure, weight, mouth, skin, and hair for problems from malnutrition.
• Screening questions about your eating habits.
• A mental health assessment, to check for depression or anxiety.
• Blood tests, to check for signs of malnutrition.
• X-rays. They can show if your bones have been weakened by malnutrition.

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Treatment Overview

All people who have anorexia need treatment. Treatment can help you get back to and stay at a healthy weight.

Because anorexia is both a physical and mental health issue, you may work with:

• A doctor. They will treat the medical conditions that have been caused by anorexia, such as osteoporosis, heart problems, or depression.
• A registered dietitian. They will help you learn healthy ways to eat and to understand what good nutrition is.
• A mental health professional. They will help you cope with the emotional reasons behind anorexia.

If your weight has dropped too low or you aren't medically unstable, you may need to be treated in a hospital.

There are no medicines to treat anorexia. An antidepressant medicine may help if you also have depression, an anxiety disorder, or obsessive-compulsive disorder.

Anorexia can take a long time to overcome and there may be ups and downs in the treatment process. You may need to monitor symptoms and continue with your treatment plan for the long term.

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Self-Care

Here are some things you can do to take care of yourself during recovery from an eating disorder.

Stick to your treatment plan.

Go to any counselling sessions you have. If you can't go, or don't think the sessions are helping, talk to your counsellor. Take any medications you've been prescribed exactly as directed.

Work on healthy eating habits.

Listen to what counsellors and nutrition experts say about balanced eating. Aim for 3 meals and 3 snacks at set times each day. Try to incorporate as much variety as you can, and choose foods that will provide your body with energy, like carbohydrates, protein, and fats.

Learn healthy ways to deal with stress.

Managing stress is important in recovery. Find what works for you. Try things like journaling, volunteering, reading, or meditating.

Take it easy on yourself.

Focus on your good qualities. Don't blame yourself for your disorder. And remember that recovery takes time and that you can make progress one goal at a time.

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