Anorexia nervosa is a psychological illness that has serious physical, emotional and social consequences. It is characterised by body image distortion with an obsessive fear of gaining weight, which manifests itself through depriving the body of food. It often coincides with increased levels of exercise.

There are two main sub-types of anorexia:

Restricting type — this is the most commonly known type of anorexia nervosa, whereby a person severely restricts their food intake. Restriction may take many forms (e.g. maintaining very low calorie count, restricting types of food eaten, eating only one meal a day) and may follow obsessive and rigid rules (e.g. only eating food of one colour).

Binge-eating or purging type — this type of anorexia nervosa forms when a person restricts their intake as above, but also has regularly engaged in binge-eating or purging behaviour (e.g. self-induced vomiting, over-exercise, misuse of laxatives, diuretics or enemas).

There is no single cause of anorexia but there are risk factors that increase the likelihood of anorexia developing. These can be biological, psychological and social.

Anorexia nervosa usually develops during adolescence and generally has an earlier age of onset than bulimia nervosa and binge eating disorder (the latter are often developed during late adolescence or early adulthood). However, like all eating disorders, anorexia can develop at any age or stage of life for people of any gender, including males. It is a myth that only adolescent girls experience anorexia.

Evidence tells us that anorexia nervosa has a moderate-high genetic heritability. Ongoing research into this field is analyzing hundreds of genes that may influence the chance of developing an eating disorder with the hope of improving treatment and even preventing illness. You can learn more about the Eating Disorders Genetic Initiative (EDGI), the world’s largest ever genetic investigation of eating disorders, here. 

Other research also shows that women with autism may have a higher chance of developing anorexia nervosa. It appears that up to 20-35% of women with anorexia meet the diagnostic criteria for autism. Symptoms and treatment for people with autism and anorexia nervosa may differ from other populations, with research into this field still ongoing. You can learn more about eating disorders and autism here.

You can learn about risk factors for all eating disorders here.

Some of the more common signs and symptoms of anorexia nervosa are:

• Preoccupation with body shape, weight and/or appearance
• Intense fear of gaining weight
• Preoccupation with food or food related activities
• Negative or distorted body image, perceiving self to be fat when at a healthy weight or underweight
• Low self-esteem (e.g. guilt, self-criticism, worthlessness)
• Rigid thinking (‘black and white’, ‘good and bad’ foods)
• Feeling out of control
• Mood swings
• Anxiety or depression
• Heightened anxiety around meal times
• Heightened sensitivity to comments or criticism about body shape, weight, appearance, eating or exercise habits
• Suicidal or self-harm thoughts or behaviours
• Constant or repetitive dieting, restrictive or rigid eating patterns
• Excessive or compulsive exercise
• Changes in clothing style
• Impaired school or work performance
• Obsessive rituals around food
• Changes in food preferences
• Frequent avoidance of eating meals, making excuses not to eat
• Social withdrawal or avoidance of social situations involving food
• Repetitive or obsessive body-checking behaviours
• Deceptive or secretive behaviour around food

Anorexia nervosa can affect the mind and body in a multitude of ways:

Brain – preoccupation with food/calories, fear of gaining weight, headaches, fainting, dizziness, mood swings, anxiety, depression

Hair and skin – dry skin, brittle nails, thin hair, bruises easily, yellow complexion, growth of thin white hair all over body (called lanugo), intolerance to cold

Heart and blood – poor circulation, irregular or slow heartbeat, very low blood pressure, cardiac arrest, heart failure, low iron levels (anaemia)

Intestines – constipated, diarrhoea, bloating, abdominal pain

Hormones – irregular or absent periods, loss of libido, infertility

Kidneys – dehydration, kidney failure

Bones and muscles – loss of bone calcium (osteopenia), osteoporosis, muscle loss, weakness, fatigue

‘Atypical’ anorexia nervosa refers to people who meet the standard diagnostic criteria for anorexia nervosa, except for the weight component.

Individuals with atypical anorexia nervosa may still experience weight loss, however their weight will not fall into a low category.

Many clinicians believe that the term ‘atypical’ is unhelpful, as atypical anorexia nervosa is actually found to be more prevalent than ‘typical’ anorexia nervosa. People with atypical anorexia nervosa are just as likely to display worrying symptoms, such as low heart rate and for females, loss of menses. Due to the stigma around weight gain and larger bodies, many people with atypical anorexia nervosa as not supported or encouraged to weight restore. This can lead to higher rates of relapse or partial recovery. Weight restoration, no matter the starting point, is the single biggest predictor of long term recovery in anorexia nervosa.

If you think that you or someone you care about may be experiencing ‘atypical’ anorexia nervosa, it’s important to seek help as soon as possible. The EDV Hub is a great place to start, or see our full range of support services below.

It is possible to recover from anorexia, even if you have been living with the illness for many years. The first step towards recovery is to ask for help. With the right team supporting you and a high level of commitment, you can recover from anorexia.

Anorexia is an incredibly serious mental illness and has the highest mortality rate of any psychiatric illness. Extreme food restriction can lead to starvation, malnutrition, severe mental distress and suicidality. However, complete recovery from anorexia is possible.

Treatment can include working with a range of health professionals, such as a psychologist and dietitian. You can learn more about evidence-based treatment approaches here.

Don’t forget that recovery also involves ongoing learning, self-help and peer support.

Lived experience perspective

“There is no magic word, prescription or motivational speech that will force recovery upon you. Only you can make that choice. That choice will dissipate the loneliness and isolation that your eating disorder compels you to feel.  I took small steps, which turned into bigger leaps towards health and happiness. 

Everyone will tell you that recovery is worth it. You will roll your eyes, as I did every time someone said the same to me. Then one day, I realised I wanted to be able to go outside, go to the beach, play with my dog and spend time with those I loved without the eating disorder cloud hanging above my head. So, channel that strong willed attitude that resides within all survivors of this illness into something productive. Take small steps in a journey that will make you, and everyone surrounding you, incredibly proud of the battle you have won.”

• EDV Hub – helpline service providing information, navigation and general support. Open Mon – Fri, 9.30am – 4.30pm.
• Telehealth Counselling –  up to five, free 30-45 minute sessions with a trained counsellor to help you take the next step in your recovery. Whether you are just starting to seek help, are on a waitlist for treatment or are wanting to re-engage with support after relapse, EDV’s understanding Counselling team are here to support you. Carers and families are also encouraged to speak to EDV Telehealth Counsellors. 
• Telehealth Nurse – free and expert guidance with registered nurses who specialise in eating disorders. Nurses listen to your unique circumstance and help you navigate and access specialised eating disorder services. Nurses can also support clients and health professionals around medical management for eating disorders.
• Online Support Groups – peer-led groups that provide an open space to discuss what you are struggling with, reflect on current challenges and discuss coping tools. Different groups are available depending on your needs. You are welcome to attend multiple groups. 
• Peer Mentoring Program – 1:1 recovery support with an EDV mentor who has experienced and recovered from an eating disorder. The program allows for 13 mentoring sessions over a six month period.
• Carer and Family Support – carer specific services including Carer Coaching and online courses.
• LearnED eLearning platform – for self-paced education and online courses
• EDV Podcast – for lived experience perspectives and professional insights
• EDV Newsletters – for recovery support delivered directly to your inbox each mont