Anorexia Nervosa Signs and Symptoms

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There are many signs and symptoms of anorexia nervosa, which can be classified as physical, emotional, or behavioral.

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The characteristic physical sign of the condition is significant weight loss that leads to the individual being underweight. The physical symptoms are closely linked to those observed in starvation when the body is unable to acquire the nutrients it needs to survive.

The emotional and behavioral effects, as well as the perception of body image, can be just as debilitating as the physical symptoms. Many patients report feeling flat, having a reduced desire to participate in social activities, and feeling isolated; thus, these patients are more likely to suffer from depression.

Physical changes

The physical appearance of an individual with anorexia nervosa is distinctively thin due to the extreme weight loss associated with the condition.

As a result of the changes in body composition, patients with anorexia often note significant changes in the way their body feels. These patients are likely to feel tired more easily, have difficulty sleeping at night, and/or be prone to dizziness or fainting. Those with anorexia may also suffer from constipation or headaches and have a reduced tolerance to cold temperatures.

Other physical signs include:

  • Amenorrhea
  • Abnormal blood test results
  • Dry or discoloration of the skin (bluish or yellowish)
  • Thin hair that easily breaks or falls out
  • Arrhythmia (abnormal heart rhythm)
  • Hypotension
  • Peripheral edema (swelling of arms or legs)
  • Reduced bone density
  • Dehydration
  • Brittle nails
Psychiatry – Anorexia Nervosa: By Megen Vo M.D. & Sara Buckelew M.D.

Emotional and behavioral changes

Emotional and behavioral changes related to anorexia nervosa include a preoccupation with food and body weight, leading to extreme weight loss techniques such as:

  • Restriction of food intake with strict dieting or fasting
  • Excessive exercise with weight loss goals
  • Self-induced vomiting or diarrhea to pass food more quickly

It is common for anorexic patients to deny hunger and refuse to eat for fear of gaining weight. Some patients may lie about the amount of food they have eaten to avoid suspicion or concern from family or friends.

The changes to and perception of the body can also cause patients to behave differently. These patients often have a strong preoccupation or obsession with their appearance and believe that weight loss will help them to feel better and happier with their bodies.

“Body checking” is a behavior commonly observed in people with anorexia and involves repeated activities such as weighing themselves, measuring the size of the waist, or checking their appearance in the mirror.

Patients with anorexia are more likely to feel flat and irritable and may withdraw from social activities. They are also prone to depressed feelings and are more likely to have thoughts of suicide. Additionally, the sexual drive of individuals with anorexia is also commonly affected, thus causing many patients to be less interested in sexual activities.

Warning signs

As individuals with anorexia nervosa have an overwhelming desire to remain thin, they often try to disguise the symptoms of the condition and avoid seeking medical help and treatment.

It is helpful for family and friends to be aware of warning signs so that they can recognize potential problems or harmful habits as they arise and encourage the affected individual to get help.

Red flag warning signs of anorexia nervosa may include:

  • Strict dieting
  • Skipping meals
  • Making excuses for not eating
  • Refusing to eat in public
  • Obsession with bodyweight
  • Repeated checking of appearance to notice flaws
  • Complaints of being fat
  • Dressing in layers to cover body appearance

If these signs are recognized in an individual, it is important that they are able to seek help and have access to a strong support network that can help them manage this condition appropriately.


Further Reading

Last Updated: Aug 24, 2023

Yolanda Smith

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.


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