Anorexia nervosa (AN) is most centrally characterized by an intense fear of gaining weight (or becoming fat) with a consequent failure to maintain an adequate body weight due to dietary restricting. It may also include body image disturbance. Additionally, AN may feature periodic binge eating and/or purging (e.g., self-induced vomiting, laxative or diuretic use), or compulsive exercise. Whilst males are generally less affected than women, emerging research shows that AN in males is increasing. However, it is important to note that alongside reporting a drive for thinness and a desire to be thin, males with AN may also report a desire to be ‘lean’ or ‘ripped’, with similar symptomatic features.
AN typically onsets during adolescence, and early warning signs may include rapid weight loss, extreme dieting and exercise, skipping meals, counting calories, increased anxiety around eating, increased shame around exposing one’s body, increased body checking behaviors, increased desire for label checking on foods, food rituals, increased anxiety if one’s eating or exercise plan is disrupted, hair loss, dry skin, brittle nails, and a flattening in mood. Medical warning signs include extremely low heart rate (often confused as a sign of good health, particularly if the person with anorexia nervosa compulsively exercises), loss of bone density, difficulty in regulating body temperatures, low blood pressure, blood electrolyte imbalances, and periods of lightheadedness and dizziness. Unfortunately, the risk of death in AN is significantly elevated due to risk of medical complications and suicide.
As such, AN is amongst the most dangerous of all psychiatric illnesses, and although the path to recovery is often long and challenging, recovery is entirely possible. Treatment is best undertaken as early as possible, and with specialized treatment providers.