Anorexia

Anorexia symptoms and signs may include:

• Weight loss and loss of body fat

• Hiding weight loss or being proud of weight loss (everyone is different)

• Not eating at all or eating very little/less than you need

• Avoiding meal times and skipping meals

• Having a negative body image – believing yourself to be overweight, unattractive, etc

• Obsessions with food, recipes, fat, nutrition, calories

• Talking about food a lot

• Anxiety and depression

• Feeling the need to be perfect or be in control

• Exercising a lot or becoming obsessed with exercise

• Irregular or absent periods in women

• Loss of libido (sex drive) and loss of erection in men

• Tiredness/fatigue (usually from eating less than your body needs)

• Hair loss/thinning

• Feeling cold all the time

• Feeling as though you are unable to concentrate

• Changes in mood i.e. being irritable, angry, etc

• Gut issues e.g. constipation, bloating, diarrhoea

• Weakened muscles

• Use of laxatives or slimming pills

This list of anorexia symptoms is not exhaustive; different people display different behaviours and may undertake different activities to achieve and maintain their weight loss. In fact, it is important to note that many people who have an eating disorder or anorexia may not appear to be very thin or underweight. Although weight loss is a common characteristic, anorexia is a mental illness with physical effects. Therefore, psychological factors and behaviours around food are really important symptoms of anorexia that may be present even if the person appears to be a relatively ‘normal’ weight.

There are a number of serious health issues that can arise as a result of prolonged low weight or weight loss, and we list these below. These issues may arise for people who have untreated anorexia for a long period of time. Please note, this list may be difficult to read for some people and you may wish to skip this section of the article.

• Heart related problems, due to loss of heart muscle, which may ultimately lead to heart failure

• Low blood pressure

• Kidney disease

• Infertility

• Osteoporosis

To find out more about anorexia symptoms, visit the Beat website.

It’s really important to seek help for anorexia as soon as possible – keep reading to find out more about how a person might receive an anorexia diagnosis, and what may happen next.

It’s vital for a person who may have anorexia to get help as soon as possible. If you are concerned about your own eating habits, or think you may have signs of anorexia, you should see your GP. It is advisable to be completely honest about your concerns, weight loss and anorexia symptoms. Your GP may run some blood tests to check if you have any underlying medical conditions that could cause weight loss or any of your other symptoms. They may check your blood pressure and heart rate, and ascertain your BMI by measuring your height and weight. If they think you may be showing anorexia symptoms, your GP could refer you to a specialist team who deal with eating disorders.

It may help to prepare yourself before you visit your GP, by reading this leaflet from Beat about the process of diagnosis. GPs are not eating disorder experts, and so the knowledge and understanding shown by GPs will vary significantly. Beat advises that you should list your symptoms and concerns down so you remember everything you need to talk about, and consider taking somebody with you for support. You may also take a copy of Beat’s leaflet with you to the appointment, in case your GP is not fully aware of the official guidance on support for anorexia or other eating disorders.

It can be difficult to receive a diagnosis of anorexia and this is likely to cause a range of emotions and feelings. It is advisable to see this as a positive first step to recovering from anorexia. Many people report feeling relieved when they first speak about their condition and receive a diagnosis.

If you are concerned about someone you know or love, and think they may be displaying anorexia symptoms, you may find it difficult to talk to them, but it could be the best thing you can do to help them. Beat provides lots of advice about how to raise concerns with someone you know.

If you are worried that your child may be displaying signs of anorexia or an eating disorder, you may wish to read advice for parents from the NHS.

Many people with anorexia will be advised to participate in psychological therapy, usually a talking therapy such as:

• Cognitive behavioural therapy – challenges negative thought processes that may be causing issues with eating

• Counselling – talking about thoughts, feelings and problems with a trained counsellor in a safe, supportive, one-to-one environment to deal with emotional issues

• Focal psychodynamic therapy – explores events that may have happened in early life that have caused negative thoughts and feelings which may be causing anorexia

• Interpersonal therapy – this explores the relationships a person with anorexia has with other people and how this impacts upon their emotions and feelings

• Family therapy – often used for young people with anorexia and their families, to help both the young person and their loved ones understand the illness and its impact on one another

• Cognitive analytic therapy – explores things that may have happened in your past that may be the root cause of some of the thoughts you have, causing your anorexia

Your therapy is likely to involve working with a mental health practitioner, psychiatrist, psychotherapist or psychologist. Every individual will respond differently to different therapies, so you may start off with one type of therapy and then move on to something else if you and your therapist do not feel the therapy is helping your recovery.

Specialist treatment programmes

There are two treatment programmes which may be offered to you by the NHS:

• Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) – usually around 20 sessions long, this programme is specifically designed to help you recover from anorexia and understand why you are affected by it, as well as learning coping mechanisms to help you continue to deal with your eating disorder after the programme is finished

• Specialist supportive clinical management (SSCM) – usually taken alongside a talking therapy, this programme focusses on managing your anorexia with the support of a healthcare professional who gives you one-to-one, weekly support, encouragement and advice

Medication treatment for anorexia

There are no drugs that can treat anorexia, but you may be prescribed anti-depressant or anti-psychotic medication to help deal with related mental health problems you may have such as depression and anxiety.

Clinic/hospital admission

Some people with anorexia need to be cared for in a hospital or clinic. This may be important to their immediate health, i.e. if their weight is dangerously low, or it may be important to their recovery if the home environment may hinder their progress in some way. Some people agree to be admitted, and some may be ‘sectioned’, which means a group of medical professionals have agreed that the person needs to be cared for in a specialist hospital or clinic for a period of time, despite them not wanting to do this, for their own safety and wellbeing. This is a last resort and most people are able to recover from anorexia whilst living at home or perhaps attending a clinic as an outpatient.

Dietician support

Many people with anorexia will need to visit a dietician who will monitor their weight and food intake to ensure they are eating healthily whilst also gaining weight.

Children and young people with anorexia

Treatment for young people with anorexia is likely to be similar to that for adults. If you are concerned that your child has an eating disorder, the NHS offers advice and information to help you.

Anorexia treatment can be a challenging time, but many people find a way through their illness and are able to recover completely. If you are worried about seeking help for anorexia, it may help you to read real-life stories from people who have experienced anorexia diagnosis and anorexia treatment.

You may wish to learn more about the various treatments for anorexia.

If you know someone who has (or may have) anorexia, this section of the guide may help you understand more about how the condition affects a person’s life. If you have anorexia, this section may help you realise that you have a problem and hopefully encourage you to seek support for anorexia.

Impact on daily living

Everyone with anorexia will have different thoughts, feelings, backgrounds, and will experience their condition in various ways. Living with anorexia or any eating disorder is tough. We all need food to give us energy in order to make our bodies function. A person who has anorexia may find daily life difficult due to the symptoms of anorexia which may make them physically tired with lower immunity. They may become ill often, have issues with anxiety or depression, and find their food-related activities take up much of their energy, time and thoughts.

The way a person feels about themselves and their role in the world is really important to their wellbeing, and a person with anorexia may have psychological problems which cause their condition, for example, low self-esteem and a negative self-image. These problems may affect many of the experiences they have in life.

Anorexia can put a great strain on relationships. A person with anorexia may become withdrawn or their personality may change as a result of their eating disorder. If a person’s family, partner or friends become aware of their condition, this can cause difficulties in communication – their loved ones may try to broach the subject and how this is done can further affect the relationship. If you are concerned about someone you are close to, read more about how to talk about anorexia.

Even if a person has accepted that they have an eating disorder, or has been given an anorexia diagnosis, the symptoms of anorexia are likely to continue for some time, even during anorexia treatment programmes. Recovery from anorexia takes time and this process can also make relationships difficult. Family, partners, friends and colleagues should learn more about ways to support a person with anorexia.

A person with a diagnosis of anorexia, who is trying to recover and going through anorexia treatment, may still feel as though anorexia is taking over their life. They are likely to spend much time focussed on food and trying to change their eating habits and thought processes. They may be spending time in therapy or hospital. Recovery from anorexia will be different for every individual with the illness, and some people will continue to live with anorexia, or recover from anorexia, for large portions of their life.

Diet is obviously a huge issue for a person with anorexia. Here, we talk briefly about what an anorexia diet is like both before a diagnosis and also during anorexia treatment.

Many people with anorexia have anxiety about eating and develop obsessive behaviour around food and mealtimes. It’s a common misconception that people with anorexia do not eat at all – many do eat food and still have meals. However, psychologically they are likely to have issues with food and the process of eating it, i.e. they may fear becoming fat, they may obsessively count calories or nutritional values, they may try to avoid eating or eat small amounts, they may only eat certain types of food, and they may make themselves sick or use laxatives to remove food from their stomach. It can be very difficult to spot symptoms of anorexia, as the condition can make some people secretive about food and some people may eat to prove to others that they do not have a problem.

A diet for anorexia during recovery is likely to be focussed on encouraging the person with an anorexia diagnosis to put on weight and understand the importance of food and nutrition. This can be a delicate process and may be very challenging for the person with anorexia. They are likely to be supported by a dietician who will help them construct meal plans and develop a healthier relationship with food. A dietician is likely to advise about portion sizes needed, the importance of eating regularly through the day, and is likely to set target weights for the person to achieve each week. A diet for anorexia is likely to consist of meals and snacks that are balanced in terms of nutrients and the right amount of fats, fruits/vegetables, dairy, protein and carbohydrates. The Eatwell Guide is the approved, official guide to a balanced diet, and a diet for anorexia is likely to be based upon achieving this.

You may also be advised to take certain vitamin and mineral supplements for anorexia to replenish your body’s resources and make your body healthier again.

One of the symptoms of anorexia may be over-exercising or a pre-occupation with exercise and burning calories. Some people obsessively count steps or do hard gym workouts and runs to lose weight. During treatments for anorexia, a person may be advised to stop exercising altogether, and to gradually reintroduce exercise to an appropriate amount. They are likely to be educated about the importance of exercise and calorie intake, and eventually encouraged to adopt fitness activities like walking, yoga, and other exercises that can benefit the body without being focussed on weight loss or fat burning.

Anorexia and employment

Many people who are anorexic are able to work both during their illness and their recovery. If you are concerned that a colleague at work may have anorexia, Beat offers advice on how to deal with this.

If you believe yourself to be anorexic or have received an anorexia diagnosis, you may wish to tell your employer. During anorexia treatment, you may need to take time off work for medical appointments. They are required to make reasonable adjustments in the workplace to enable you to do your job whilst you are dealing with your mental health condition.

Beat Chat Rooms – online groups to discuss a variety of issues related to anorexia and other eating disorders, whether you are affected yourself or know someone who is

Anorexia, Bulimia and EDNOS Recovery Support Group – a Facebook support group for people affected by eating disorders to share stories, advice and information

Anorexia and Bulimia Care – a charity supporting people with anorexia and other eating disorders, offering online information and advice, regional support groups, nutritional guidance, befriending services, helpline and training services

Beat Eating Disorders – a charity supporting people with anorexia and other eating disorders, offering a huge amount of information and advice as well as a helpline and email support

Childline – a charity supporting young people, offering advice and support for those with anorexia or other eating disorders, as well as any other health, wellbeing or family problems, providing the well-known telephone helpline

Family Lives – advice if you are concerned your child may have anorexia, real life stories about this situation and a helpline for both parents and young people

Mind – a charity supporting people with mental health problems and their families, including those experiencing an eating disorder, such as anorexia, as well as related conditions, with lots of advice about coping, treatments and a helpline

National Centre for Eating Disorders – a charity providing information about eating disorders, including anorexia, as well as a directory of counsellors and professionals trained in eating disorder recovery

NHS – source of official medical advice and information about anorexia including anorexia symptoms, anorexia treatments and living with the condition

Rethink – a mental illness charity with information about eating disorders, local services and support groups and a helpline

Student Minds – a charity supporting students with mental health problems, providing information about eating disorders and peer support programmes

Young Minds – a charity supporting young people and their families with a range of mental health conditions, including eating disorders like anorexia, providing advice and information online as well as a 24/7 text support line

Anti-depressant

– medication used to treat depression and mood-related disorders

Anti-psychotic

– medication for people who experience psychotic episodes, as in schizophrenia or bipolar

Blood pressure

– the rate at which the heart pumps blood around the body through blood vessels

BMI

– a measurement of body mass, which relates a person’s weight to their height to establish if they are underweight, overweight or average weight

Body image

– a person’s perception of how they look to other people

Eating disorder

– a psychological disorder involving issues with eating and an altered relationship with food

Genetics

– a person’s DNA inherited from their parents

Heart failure

– severe heart malfunction that means the heart no longer works properly, which can cause death

Laxatives

– substances (herbal or drug-based) designed to help remove waste from the stomach and bowel

Infertility

– inability to conceive naturally (make a baby)

Mental health practitioner

– someone trained to support people with mental health problems in therapy or treatment programmes

Psychotherapist

– a person who helps someone with mental health problems to work on the issues causing their condition

Psychologist

– a professional in psychology, who may be a mental health practitioner and carry out psychotherapy or other talking therapies

Psychological therapy

– otherwise known as ‘talking therapies’, psychological therapy is a process of working through mental health problems, feelings or life experiences with the support of a trained practitioner

Talking therapy

– otherwise known as ‘psychological therapy’, this treatment involves opening up about feelings, thoughts and behaviours with the goal of rectifying current life difficulties