Experts Explain What It Really Means When You Have Anorexia Nervosa - Exclusive

Do you ever struggle with your body image? You are not alone. Research from 2021 indicates that as many as 4% of women suffer from anorexia nervosa, an eating disorder "characterized by abnormally low body weight, distorted perception of weight, and intense fear of gaining weight," as psychotherapist Harjeet Kaur of Safe Space Therapy told The List.

If you have anorexia, you may drastically reduce your food intake or binge before forcing yourself to vomit, using laxatives, or exercising compulsively. You may also suffer from a cluster of negative thoughts and feelings. These disordered eating behaviors may emerge as a way to deal with difficult emotions, and by controlling what you eat, you may feel empowered in a world where you've previously felt powerless. The number on the scale, notes the Mayo Clinic, may even be your most significant measurement of self-worth.

An obsession with weight and food can disrupt your entire life, and "these conditions all lead to the outcome of starvation state," says Kaur. This can cause severe organ damage, and if left untreated, even death. Of all psychiatric diagnoses, anorexia is the second deadliest — only opioid addiction claims more lives each year, according to the American Psychiatric Association. Sadly, the numbers continue to grow: the rate of anorexia in females between the ages of 15 and 19 has steadily increased over the past century.

The National Association of Anorexia Nervosa and Associated Disorders says that genetics is the most significant risk factor for whether or not you will develop anorexia. However, "eating disorders typically occur as the result of a 'perfect storm' of biological, sociocultural, and psychological factors," Tessa Wooden, Assistant Clinical Director at Monte Nido & Affiliates, an eating disorder clinic, told The List. A family history of depression or substance abuse can also increase your risk, as can your brain chemistry, developmental challenges, and familial attitudes. "There are also common co-morbidities with eating disorders, such as OCD, depressive disorders, anxiety disorders, substance use disorders, and PTSD," notes Wooden.

The Journal of Eating Disorders reports a long-established cultural pressure, especially for girls and young women, to have the "perfect" body type. "One message we receive from society is, 'thinner is better,' which is not only untrue, but it is also dangerous," adds Wooden.

If you have a hobby or a career as a dancer, gymnast, model, figure skater, bodybuilder, or cheerleader, you may face particular scrutiny over your weight. And more subtle and common messaging — including scrolling across a "thinspiration" videos on social media — can even increase your risk for anorexia. These idealized and unattainable beauty standards can make you feel dissatisfied with your body, and body dissatisfaction is associated with higher frequencies of controlled and binge eating, poor self-regard, and depression — all symptoms of anorexia.

Anorexia has physical and emotional symptoms that extend beyond disordered eating. Physically, you may have abnormally low body weight, stop getting a period, find your nails and hair have gone brittle, suffer from chronic stomach pain, and even pass out due to dehydration, notes Johns Hopkins Medicine. In more severe cases, says the American Psychiatric Association, you could experience stress fractures, bone loss, muscle wasting, heart arrhythmia, and even seizures. Unfortunately, these physical signs don't appear the same in every person, and many times people with anorexia hide these symptoms as a part of the disorder.

Mood swings, isolation, irritability, sleep issues, and lack of libido are all common emotional signs of anorexia, according to the Mayo Clinic. You may also regularly skip meals and pass on invitations to eat in public. If questioned about your eating patterns, you may give excuses and lie. Because of how the disorder warps your view of yourself, you may even wear baggy clothes to hide what you believe to be an undesirable body.

Psychotherapist Harjeet Kaur told The List that "it is essential to recognize the onset of signs/symptoms and consult immediately with a medical doctor for treatment options. An individual with anorexia nervosa is severely malnourished and unable to make rational decisions." For this reason, someone who has an eating disorder needs extra support from friends and family to help with their recovery. 

Recovery from anorexia can be a long, hard road. Monte Nido and Affiliates' Clinical Regional Director Sherry Safavi admits to The List that "The treatment process is not linear; it's bumpy." If your anorexia was severe enough to land you in the hospital, your chance of relapse within the first two years is significant. But "recovery is possible and depends on one's severity of their condition, insight, and willingness to comply and the level of treatment they may need," Safavi notes.

Therapy — in particular family therapy — can be a successful intervention, says the American Psychological Association. Psychotherapist Harjeet Kaur agrees: "family [dialectical-based therapy] and individual feminist therapy has been shown to be most helpful." You may also work with a nutritionist to learn new, positive food practices or with a medical doctor to prescribe medication for your anxiety or depression. "It is essential to recognize it's not anyone's fault, ask for help, seek therapy, schedule regular visits with a primary care physician, and remind yourself food is medicine," adds Kaur. In a relatively short time, you can rebalance your weight and develop a healthy eating routine.

If you are struggling with an eating disorder, or know someone who is, help is available. Visit the National Eating Disorders Association website or contact NEDA's Live Helpline at 1-800-931-2237. You can also receive 24/7 Crisis Support via text (send NEDA to 741-741).