About anorexia nervosa
Anorexia nervosa is an eating disorder and a serious mental health condition.
If someone has anorexia nervosa, they:
- have an intense fear of gaining weight or becoming overweight
- limit the amount of food they eat to avoid gaining weight
- might do other things to avoid gaining weight, like vomiting, using laxatives or diuretics, or over-exercising
- often have a distorted body image and think they’re overweight when they’re not.
Pre-teens, teenagers and all people with anorexia nervosa need a lot of support from family and health care professionals.
Types of anorexia nervosa
There are 2 main types of anorexia nervosa.
This is the most common type of anorexia nervosa. If someone has restricting anorexia nervosa, they limit their food intake by:
- limiting the number of meals they eat
- reducing the number of calories (kilojoules) they eat
- cutting out certain foods.
Sometimes they might also have obsessive rules about food, like eating only at specific times, not eating some types of food, eating from particular plates and bowls, or recording details of everything they eat.
If someone has restricting anorexia nervosa, they might also over-exercise to control their weight and might ‘strive to be thin’.
If someone has binge eating/purging anorexia nervosa, they limit the amount of food they eat and then binge-eat or purge, or both:
- Binge-eating is when you eat more food than most people would eat over a similar period of time.
- Purging can include vomiting up food or misusing laxatives, diuretics or enemas.
If someone has binge-eating/purging anorexia nervosa, they might purge after eating only a small amount of food.
Signs and symptoms of anorexia nervosa
Anorexia nervosa is a serious medical condition. It can have physical, psychological and behavioural signs and symptoms.
- low body weight
- abdominal pain
- fine downy body hair
- tiredness, weakness and muscle aches
- loss of or irregular menstrual periods
- failure to start puberty
- dizzy spells
- shortness of breath
- heart palpitations
- feelings of cold
- hair loss and thinning.
- distorted body image – a person might think they’re overweight when they’re not
- obsessive thoughts about food, weight and body shape
- intense desire for weight loss
- low self-esteem
- mood swings
- depression or anxiety
- suicidal thoughts
- refusal to accept that weight is dangerously low.
- over-exercising and/or limiting food all the time
- behaving secretly about eating or exercise
- avoiding social situations that involve food
- weighing yourself all the time
- often wearing baggy or oversized clothes
- behaving aggressively if forced to eat ‘forbidden foods’
- being obsessive about planning and preparing food, but having no interest in eating
- withdrawing from family, friends and other social relationships
The long-term complications of anorexia nervosa can be severe. They include:
- osteoporosis and risk of increased bone fractures
- problems with the heart and kidneys
- a higher risk of suicide.
You don’t have to be underweight to have anorexia nervosa. Rapid weight loss in overweight pre-teens and teenagers can be a sign of an eating disorder called atypical anorexia nervosa. Pre-teens and teenagers with atypical anorexia nervosa can also have many of the symptoms described above. And they can be just as unwell as pre-teens and teenagers with typical anorexia nervosa and be even more distressed.
Medical help: when to get it for pre-teens and teenagers with anorexia nervosa
If you notice that your child‘s eating habits have changed, or you see a change in their mood and behaviour in relation to food, you need to talk with your child and your GP as soon as you can.
It might be a difficult conversation. Try to stay calm and non-judgmental. Focus on your child’s health and wellbeing, not your child’s weight and appearance.
If you’re not sure how to talk with your child about these issues, you could ask your GP or a mental health professional for help. You can also contact the Butterfly Foundation by calling the free national helpline on 1800 334 673, or using the Butterfly Foundation webchat.
Early assessment and help from a health professional can stop problem eating turning into an eating disorder. It might be easier to get your child to see a health professional now. If you step in early, you might be able save your child from intensive treatment and a very long recovery time.
Diagnosing anorexia nervosa in pre-teens and teenagers
There’s no single test to diagnose anorexia nervosa.
If your GP thinks your child might have anorexia nervosa, the GP will talk with your child about eating behaviour, habits and thoughts. The GP will also do a full physical examination and tests including a blood test, a urine test or an ECG. They might order a scan to check your child’s bone health.
The GP might then refer your child to a specialist service to confirm the anorexia nervosa and recommend appropriate treatment.
Treatments, therapies and supports for pre-teens and teenagers with anorexia nervosa
There’s no single treatment for anorexia nervosa.
Treatment involves a team of health professionals with expertise in different areas. They’ll prescribe or suggest a treatment plan that’s specific to your child’s needs. The plan will depend on things like:
- your child’s age
- the type of anorexia nervosa your child has
- the causes, severity and stage of your child’s anorexia nervosa.
The plan will include regular visits to your child’s GP and a dietitian who specialises in eating disorders. It’s also likely to include some or all of the following.
This is a common way to treat anorexia nervosa. It can include family sessions, one-on-one sessions with your child, or group-based sessions. This treatment aims to help you and your child understand anorexia and how it affects your lives. It also aims to help your child:
- manage their emotions
- get back to normal eating
- work on things like over-exercising and laxative misuse
- build self-esteem
- re-engage with family, friends and social activities.
There are no medicines for anorexia nervosa. But if your child has depression or anxiety as well as anorexia nervosa, there are some medicines that might help with these other conditions.
Your child might need to go to hospital to be treated for the physical effects of anorexia nervosa. This will depend on your child’s weight, symptoms and other health issues.
Hospital treatment usually focuses on supporting people to eat at regular mealtimes and gain weight.
With early intervention and treatment, pre-teens and teenagers have a better chance of recovery from anorexia nervosa, but it’s also possible for them to get sick again. If you notice that your child is showing the symptoms of anorexia nervosa again, see your doctor as soon as possible.
Causes of anorexia nervosa
We don’t know what causes anorexia nervosa. But there are some factors that can put pre-teens and teenagers at higher risk for anorexia nervosa.
These risk factors include:
- being a girl, although boys can get anorexia too
- being a perfectionist or high achiever
- thinking in an obsessive way
- experiencing a stressful life event
- dieting in strict ways
- being in settings where thinness is valued
- having a family history of anorexia nervosa.
Although anorexia has no known cause, we do know that it isn’t your fault as a parent. If your child has anorexia, your love and support will be very important in helping your child get better.