Anorexia: Causes, Symptoms, and Treatment
- What is anorexia?
- What are the causes of anorexia?
- Symptoms of Anorexia
- Complications of Anorexia
- How is anorexia diagnosed?
- How is anorexia treated?
- Frequently Asked Questions About Anorexia
- The Benefits of Anorexia Treatment at Elytis Hospital
Anorexia is a serious eating disorder characterized by severe restriction of food intake, an intense fear of gaining weight, and a distorted body image. It can have serious physical and psychological effects and can be life-threatening if not treated in a timely manner.
At Elytis Hospital, patients suffering from anorexia can receive support from a psychiatrist, psychotherapy sessions, and guidance from an experienced nutritionist to help them overcome this challenge.
What is anorexia?
Anorexia, also known by its full name, anorexia nervosa, is a psychological disorder in which the affected person drastically restricts their food intake, even when they are underweight. This includes:
- Dietary restriction—a significant reduction in calories and the types of food consumed.
- An intense fear of gaining weight—even when one’s weight is well below the normal range.
- Body image distortion—an exaggerated perception of one’s weight or body shape, leading to constant dissatisfaction with one’s physical appearance.
What is the difference between anorexia nervosa and other eating disorders?
Eating disorders encompass several conditions, and anorexia is distinguished by:
- Severe food restriction: Unlike bulimia, which involves episodes of binge eating followed by purging, anorexia is characterized by consistently avoiding food.
- Severe underweight: People with anorexia often fall far below the weight considered healthy for their height and age.
- Focus on strict weight control: Other disorders, such as binge-eating disorder, involve a loss of control over food intake, without a constant obsession with weight.
How common is anorexia?
- Anorexia affects approximately 0.5–1% of the general population, mostly adolescents and young adults.
- It is much more common among women than among men, but an increasing number of cases in men have recently been diagnosed.
- The risk of serious complications or death is higher than with other eating disorders, which makes prevention and treatment essential.
- Risk factors include social pressure related to body image, emotional trauma, anxiety disorders, and genetics.
What are the causes of anorexia?
Anorexia nervosa does not have a single cause; it usually results from a complex interaction of genetic, biological, psychological, and social factors. Understanding these factors can help with prevention and effective treatment.
Genetic and biological factors
There is evidence that anorexia may be influenced by genetics and biology:
- Genetic predisposition – people who have relatives with eating disorders are at a higher risk of developing anorexia.
- Neurochemical imbalances—abnormal levels of serotonin, dopamine, or other neurotransmitters—can contribute to changes in appetite and emotional regulation.
- Hormonal factors—hormonal imbalances, including those related to leptin or stress hormones—can affect appetite and body image.
| Biological factor | Description | Impact |
| Genetic | Relatives with eating disorders | Increases susceptibility |
| Neurochemical | Serotonin, dopamine | It affects appetite and mood |
| Hormone | Leptin, cortisol | It affects feelings of hunger and stress |
Psychological factors
Eating disorders are often linked to certain psychological traits and emotional problems.
Perfectionism and Anxiety
- People with anorexia tend to set very high standards for themselves.
- Perfectionism can lead to excessive control over weight and eating habits.
- Anxiety related to body image or failure can exacerbate food restrictions.
Body Image Disorders
- Body image distortion is a central symptom of anorexia.
- Even underweight people perceive themselves as being “too fat.”
- This perception can lead to extreme diets, excessive exercise, or other unhealthy behaviors.
| Psychological factor | Event | Impact |
| Perfectionism | High standards for oneself | Severe dietary restriction |
| Anxiety | Fear of gaining weight | Obsessive-compulsive eating |
| Body distortion | Misperception of Weight | Staying Underweight |
Social and Cultural Factors
The social and cultural environment can have a serious impact on the development of anorexia.
Media Pressure and Beauty Standards
- Models and influencers with very thin bodies promote unrealistic standards.
- The media can lead to negative comparisons and dissatisfaction with one's own body.
- Advertisements, movies, and social media can reinforce the idea that a person's worth depends on their weight.
The Influence of Friends and Family
- Friends or family may convey messages about weight and appearance, either subtly or directly.
- The pressure to conform to the group or constant criticism can trigger or perpetuate anorexia.
- Positive social support can act as a protective factor, preventing the disorder from worsening.
| Social factor | Examples | Impact |
| Averages and Standards | Movies, commercials, social media | Body dissatisfaction is on the rise |
| The Group of Friends | Comments on Weight | It increases the risk of restrictive eating |
| Family | Criticism or Expectations | It influences eating behaviors |
Symptoms of Anorexia
Anorexia nervosa is characterized by a combination of physical, psychological, and behavioral symptoms. Recognizing these symptoms is essential for early diagnosis and treatment.
Physical signs
Physical signs are most evident in patients suffering from anorexia.
Rapid Weight Loss
- Dramatic weight loss in a short period of time is one of the most noticeable symptoms.
- Affected individuals may fall below 10–15% of their normal weight for their age and height.
- Weight loss may be accompanied by weakness, fatigue, and a decrease in muscle mass.
Hormonal and Growth Problems
- Hormonal imbalances include amenorrhea in women, low testosterone in men, hypothyroidism, and growth problems in adolescents.
- Metabolic and cardiovascular imbalances occur: slow heart rate, low blood pressure, osteoporosis.
- Other physical signs: dry skin, hair loss, brittle nails.
| Physical sign | Description | Impact on Health |
| Rapid Weight Loss | Significant reduction in body weight | Fatigue, weakness, risk of death |
| Hormonal Problems | Amenorrhea, hypothyroidism | Slowed metabolism, infertility |
| Growth Issues | Slowed Growth in Adolescents | Long-term impact on height and development |
| Dermatological signs | Dry skin, hair loss | Increased susceptibility to infections |
| Osteoporosis | Loss of bone density | Increased risk of fractures |
Psychological Signs
Anorexia is also accompanied by certain psychological signs that can be observed by loved ones or by specialists.
Excessive fear of gaining weight
- People with anorexia have an intense and irrational fear of gaining weight.
- This fear persists even when a person's weight is below the minimum healthy level.
- It can lead to anxiety, chronic stress, and social isolation.
The Obsession with Calories and Diets
- Counting every calorie consumed or restricting “forbidden” foods is common.
- People with this condition may spend hours thinking about food, planning meals, or completely avoiding certain food groups.
- This obsession can lead to strict eating rituals and a reduced quality of life.
| Psychological sign | Event | Impact |
| Fear of gaining weight | Constant fear and anxiety | Severe dietary restriction |
| The Obsession with Calories | Excessive counting, food avoidance | Nutritional Imbalances and Stress |
| Body distortion | Misperception of Weight | Staying Underweight |
Behavioral Signs
The behavior of people with anorexia is characterized by certain patterns that should be recognized.
Avoiding social gatherings
- People with anorexia may refuse to attend dinners, parties, or gatherings where food is served.
- Avoidance can be justified with various excuses, but the real reasons stem from anxiety related to eating.
- Social isolation can worsen psychological symptoms.
Food-Control Behaviors
- Strict restrictions on the amount and type of food.
- Excessive exercise or special rituals related to eating.
- Possible episodes of self-induced vomiting or the use of laxatives to control weight.
| Behavioral sign | Examples | Impact |
| Avoiding social gatherings | Declining an invitation to dinner with family or friends | Isolation, social stress |
| Dietary Control | Strict diets, excessive exercise | Weight loss, fatigue, metabolic imbalances |
| Compensatory behaviors | Vomiting, laxatives | Dehydration, electrolyte imbalances |
Complications of Anorexia
Anorexia can lead to severe complications, both physical and psychological. These effects usually result from severe food restriction and long-term nutritional imbalances.
Heart Problems
- Bradycardia – a slow heart rate, which can cause dizziness and fainting.
- Hypotension – low blood pressure, risk of stroke or shock.
- Heart failure—in severe cases, due to weakening of the heart muscle and electrolyte imbalances.
- Arrhythmias – fluctuations in heart rhythm that can be fatal.
| Heart problem | Case | Symptoms |
| Bradycardia | Loss of muscle mass, malnutrition | Fatigue, dizziness, fainting |
| Hypotension | Decrease in blood volume | Dizziness, syncope |
| Arrhythmias | Electrolyte Imbalances | Heart palpitations, risk of cardiac arrest |
| Heart Failure | Severe malnutrition | Shortness of breath, swelling, extreme fatigue |
Gastrointestinal disorders
- Chronic constipation – reduced dietary intake and fiber intake.
- Gastritis or an ulcer—caused by stress and extreme diets.
- Delayed gastric emptying – feeling full quickly, bloating.
- Pancreatitis or liver problems—in severe cases of malnutrition.
| Gastrointestinal disorder | Case | Symptoms |
| Constipation | A diet low in fiber and fluids | Abdominal discomfort, bloating |
| Gastritis / Ulcer | Dietary restrictions, stress | Abdominal pain, heartburn |
| Delayed gastric emptying | Calorie restriction | Bloating, a quick feeling of fullness |
| Liver problems | Severe malnutrition | Fatigue, jaundice in rare cases |
Bone and Hormonal Problems
- Osteoporosis and bone fragility—a loss of bone mineral density due to a deficiency of calcium and estrogen.
- Amenorrhea – the cessation of the menstrual cycle in women, affecting fertility.
- Hormonal imbalances—hypothyroidism, low testosterone in men.
- Slowed growth—in adolescents, anorexia can interfere with normal development.
| Bone/hormonal problem | Case | Effects |
| Osteoporosis | Calcium and Hormone Deficiency | Fractures, bone deformities |
| Amenorrhea | Decrease in estrogen | Temporary or Long-Term Infertility |
| Hypothyroidism | Malnutrition | Fatigue, slowed metabolism |
| Slowing growth | Calorie Restriction During Adolescence | Short stature, delayed maturation |
Impact on Mental Health
- Depression – a persistent feeling of sadness, lack of energy, and loss of interest in activities.
- Anxiety— especially related to weight and eating.
- Social isolation – avoiding interactions due to concerns about food or body image.
- Risk of suicide – Anorexia has one of the highest mortality rates among mental disorders.
How is anorexia diagnosed?
The diagnosis of anorexia nervosa is based on a careful assessment of physical, psychological, and behavioral symptoms, as well as on ruling out other medical or psychiatric conditions. It is essential that the assessment be conducted by specialists in mental health and nutrition.
Clinical Evaluation
Diagnosis begins with a complete medical history and a physical examination. The following are assessed:
- Body weight and body mass index (BMI).
- Recent changes in weight and eating habits.
- Physical signs and associated complications.
- Family and personal history of eating disorders or other mental health conditions.
| Component | What Is Being Evaluated | Importance |
| Weight and BMI | Underweight, rapid weight loss | Confirms the physiological criterion |
| Medical History | Previous medical conditions, treatments | Rule out other causes of weight loss |
| Physical symptoms | Amenorrhea, osteoporosis, weakness | Detection of Complications |
| Psychological symptoms | Fear of gaining weight, food obsessions | Confirms the DSM-5 criteria |
Psychological Assessment
Mental health professionals use interviews and questionnaires to assess:
- Body Image Perception and Fear of Gaining Weight.
- An obsession with weight control and diet.
- Associated psychological traits, such as perfectionism or anxiety.
| Psychological tool | Purpose | Examples |
| Structured Clinical Interview | Assessment of Symptoms | SCID-5, DSM-5 Interview |
| Self-reported questionnaires | Measuring Body Image Distortion and Eating Behaviors | EDE-Q, EAT-26 |
| Behavioral Observations | Identifying Food Rituals | Avoiding social gatherings, excessive exercise |
DSM-5 Diagnostic Criteria
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition), anorexia nervosa is diagnosed if the following criteria are met:
- Restriction of food intake that leads to significantly low body weight.
- An intense fear of getting fat or gaining weight, even if the person is underweight.
- Disturbances in the perception of body weight or its influence on self-esteem.
| DSM-5 Criterion | Description | Examples of manifestations |
| Dietary restriction | Severe calorie restriction | Strict diets, skipping meals |
| Fear of gaining weight | Weight-Related Anxiety | Intense fear, avoidance of high-calorie foods |
| Body distortion | Misperception of Body Image | He looks “fat” even though he’s underweight |
Additional Tests and Investigations
To assess the impact of anorexia on physical health, doctors may recommend:
- Blood tests (complete blood count, electrolytes, liver and kidney function tests).
- Electrocardiogram (ECG) for monitoring heart rhythm.
- Bone densitometry (DEXA) for the assessment of osteoporosis.
- Other hormonal or metabolic tests, if necessary.
How is anorexia treated?
The treatment of anorexia nervosa is complex and multidisciplinary, as the disorder affects both the body and the mind. Early intervention significantly increases the chances of a full recovery.
Treatment Team
Treatment usually involves a team consisting of:
- Attending physician or internal medicine specialist —monitors the patient’s physical condition and any complications.
- Psychiatrist or psychologist—treats mental health issues and related disorders.
- Nutritionist or dietitian —creates personalized meal plans and monitors weight regain.
- Other specialists—such as an endocrinologist, cardiologist, or physical therapist—if complications arise.
Psychological Intervention
Psychological intervention in the form of psychotherapy is essential for the recovery of patients diagnosed with anorexia.
Cognitive Behavioral Therapy (CBT)
- It helps patients identify and change dysfunctional thoughts and behaviors related to weight and eating.
- It is effective in reducing food-related anxiety and eating rituals.
Family Therapy
- Involve the family in the recovery process, especially when it comes to adolescents.
- It teaches parents how to promote healthy eating and reduce conflicts related to food.
Other Forms of Therapy
- Interpersonal therapy—to improve social relationships and reduce isolation.
- Dialectical behavior therapy—useful in cases involving impulse control disorders or self-harm.
Nutritional Intervention
- Getting back to a healthy weight is the first step.
- The meal plans are personalized and designed to help you gain weight gradually.
- Nutritional supplements or vitamins may be recommended to correct deficiencies.
| Nutritional Goal | Method | Monitoring |
| Weight Gain | Gradual Diet Plan | Weekly BMI and Weight Monitoring |
| Dietary Re-education | Learning About Portion Sizes and Meal Frequency | Food diary, supervision by a nutritionist |
| Correcting Deficits | Vitamin/Mineral Supplements | Regular blood tests |
Drug treatment
- Medications do not directly treat anorexia, but they can be used to treat associated disorders, such as depression, anxiety, or obsessive-compulsive disorder.
- The decision to prescribe medication is made by the psychiatrist after a careful evaluation of the patient.
| Type of medication | Purpose | Comments |
| Antidepressants (SSRIs) | Reducing Depression and Anxiety | Better results after weight stabilization |
| Anxiolytics | Reducing Acute Anxiety | Short-term use |
| Mood Stabilizers | Regulating Emotional States | Careful monitoring of side effects |
Emergency Care and Hospitalization
- Hospitalization may be necessary if weight drops dangerously, electrolyte imbalances occur, or heart problems develop.
- Treatment may include assisted refeeding and constant monitoring of physical condition.
- In severe cases, treatment may take place at a specialized facility for eating disorders.
Frequently Asked Questions About Anorexia
Here are some of the most common questions about anorexia.
Can anorexia also occur in men?
Yes, anorexia also affects men, although it is more commonly diagnosed in women. In men, the symptoms may be harder to recognize, and social pressure related to muscle mass can contribute to the development of the disorder.
| Appearance | Men | Women |
| Prevalence | ~10–25% of cases | ~75–90% of cases |
| Common trigger | The Desire for Muscle, Body Image | Fear of gaining weight, social pressure related to weight |
| Distinctive features | Excessive exercise to build muscle mass | Severe calorie restriction, obsession with weight |
How long does treatment for anorexia last?
The duration of treatment depends on the severity of the disorder and the patient’s response to interventions. Some people may need several months of intensive therapy, while others require long-term treatment (years) to prevent relapse.
| Estimated duration | Type of treatment | Purpose |
| 3–6 months | Psychological and Nutritional Therapy | Weight stabilization and reduction of dysfunctional eating behaviors |
| 6–12 months | Combination therapy + medical monitoring | Consolidating Changes and Preventing Relapse |
| In 1 year | Psychological support and regular follow-up | Maintaining Long-Term Recovery |
Can anorexia occur in young children?
Although less common, anorexia can also occur in preadolescent children. In such cases, early detection is essential to prevent growth and developmental problems.
Symptoms in children:
- A consistent refusal to eat certain foods
- An obsession with “healthy foods” or skipping meals
- Rapid weight loss and delayed physical development
Are there any specific genetic risk factors?
Studies suggest that anorexia has a significant genetic component. People who have first-degree relatives with eating disorders or other mental health disorders are at greater risk.
| Genetic factor | Estimated risk | Comments |
| Family history of anorexia | 5 to 10 times greater | Predisposition to severe dietary restriction |
| Family history of depression/anxiety | Increases vulnerability | It influences psychological and behavioral mechanisms |
Can anorexia go away completely?
Yes, a full recovery is possible, especially if treatment begins early and involves a multidisciplinary approach. However, there is a risk of relapse, particularly during periods of emotional stress or social pressure.
Strategies for preventing relapse:
- Maintaining a Healthy Relationship with Food
- Continuation of periodic psychological counseling
- Monitoring Weight and Physical Health
Does anorexia affect fertility?
Yes, anorexia can lead to amenorrhea (absence of menstruation) and hormonal problems that affect fertility. Regaining weight and returning to a healthy eating pattern can usually restore fertility, but in severe cases, long-term complications may arise.
The Benefits of Anorexia Treatment at Elytis Hospital
- Personalized, Multidisciplinary Approach – The Elytis Hospital team includes doctors, psychologists, nutritionists, and eating disorder specialists who work together to develop a treatment plan tailored to each patient.
- Comprehensive medical monitoring – Patients receive regular physical examinations and tests to prevent cardiac, hormonal, and nutritional complications.
- Intensive psychological support programs—cognitive-behavioral therapy, family therapy, and individual counseling—help individuals rebuild a healthy relationship with food and reduce anxiety.
- Modern facilities and a safe environment – Elytis Hospital offers a welcoming and safe setting that supports long-term recovery, including through support groups and rehabilitation activities.
The medical team at Elytis Hospital is here to help you take care of your health and that of your loved ones. Make an appointment right now and get the support you need!
References:
- “Anorexia Nervosa.” Johns Hopkins Medicine, 2019, www.hopkinsmedicine.org/health/conditions-and-diseases/eating-disorders/anorexia-nervosa
- “Anorexia Nervosa – Symptoms.” HSE.ie, www2.hse.ie/conditions/anorexia-nervosa/
- Cleveland Clinic. “Eating Disorders: Anorexia.” Cleveland Clinic, Cleveland Clinic, Aug. 9, 2024, my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa
- Mayo Clinic. “Anorexia Nervosa.” Mayo Clinic, Mayo Clinic, Aug. 9, 2024, www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591
Last medical review: August 19, 2025