Anorexia Nervosa: When Getting Thinner Becomes Dangerous

Anorexia nervosa is not “just dieting” or “being careful with food.”It is a serious, sometimes life-threatening eating disorder (American Psychiatric Association, 2013; National Institute of Mental Health [NIMH], 2024).

People with anorexia nervosa:

• Strongly fear gaining weight

• Severely limit how much they eat

• Often have a distorted body image – they may see themselves as “fat” even when they are dangerously underweight (American Psychiatric Association, 2013; NIMH, 2024)

  
  

What Is Anorexia Nervosa?

Anorexia nervosa is an illness where a person:

• Restricts food intake so much that their body weight becomes very low

• Is terrified of gaining weight, even when they are already too thin

• Bases their self-worth mostly on body weight or shape (American Psychiatric Association, 2013; Centre for Excellence in Eating Disorders [CEED], 2024)

  
  

This is not about vanity or willpower. It is a serious mental and physical health condition that can damage almost every organ in the body (NIMH, 2024; Mehler & Brown, 2015).

Types of Anorexia Nervosa

Experts describe two main types of anorexia (American Psychiatric Association, 2013; Eating Recovery Center, 2024):

1. Restricting Type

   
   

   • Weight loss happens mostly through:

     
     

     • Eating very little

     • Avoiding many foods

     • Fasting

     • Exercising too much

       
       

2. Binge-Eating / Purging Type

   
   

   • The person eats (sometimes small, sometimes large amounts) and then tries to “get rid of” the calories by:

     
     

     • Vomiting on purpose

     • Misusing laxatives, diuretics, or enemas

     • Exercising in extreme ways

       
       

Both types are dangerous and both need medical and mental health care (National Institute for Health and Care Excellence [NICE], 2017).

Signs Someone May Have Anorexia Nervosa

Not everyone looks the same, but some common signs include (NIMH, 2024; National Eating Disorders Association [NEDA], n.d.):

• Very low body weight for age and height

• Eating very small amounts or skipping meals

• Pretending to eat or hiding food

• Being obsessed with calories, the scale, or clothing sizes

• Wearing baggy clothes to hide weight loss

• Saying they feel “fat” even when others can see they are very thin

• Intense fear of gaining weight

• Exercising a lot, even when tired or sick

• Feeling guilty, anxious, or ashamed after eating

• Pulling away from friends and family, becoming more isolated

  
  

Anyone can have anorexia: kids, teens, adults, men, women, and people of every race and body type (NIMH, 2024; NICE, 2017).

How Anorexia Hurts the Body

Because the body is not getting enough nutrition, anorexia can cause serious, sometimes permanent damage (Mehler & Brown, 2015; NIMH, 2024).

Possible Complications

• Anemia (low red blood cells → tired, weak, dizzy)

• Heart problems, including slow heart rate and abnormal rhythms

• Low blood pressure and feeling faint

• Kidney problems

• Loss of menstrual periods in women

• Low testosterone in men

• Bone loss (osteopenia/osteoporosis), leading to fractures

• Dry skin, hair loss, feeling cold all the time

  
  

Anorexia has one of the highest death rates of any mental illness, from both medical complications and suicide (NIMH, 2024; Harris & Barraclough, 1998; Arcelus et al., 2011). Early help can save lives.

Treating Anorexia Nervosa

Both the restricting type and the binge-eating/purging type need treatment. It usually takes a team (NICE, 2017; Crone et al., 2023):

• Medical provider (doctor, NP, or PA)

• Mental health professional (therapist, psychologist, or psychiatrist)

• Dietitian experienced in eating disorders

• Family and support people when possible

  
  

1. Medical Care and Monitoring

Because anorexia affects the heart, blood pressure, kidneys, hormones, and bones, medical care is essential. This may include:

• Checking weight, heart rate, and blood pressure

• Blood tests and EKGs

• Sometimes hospital or day-program treatment if health is at risk (NICE, 2017; NIMH, 2024)

  
  

2. Therapy

Therapy helps people:

• Challenge harmful thoughts about food, weight, and self-worth

• Learn healthier coping skills

• Repair their relationship with food and their body

  
  

Guidelines recommend evidence-based therapies such as:

• Family-based treatment (FBT) for children and adolescents

• Cognitive-behavioral therapy for eating disorders (CBT-ED)

• Other structured approaches like MANTRA for adults (NICE, 2017; Crone et al., 2023)

  
  

3. Nutrition Support

Working with a dietitian or structured program helps people:

• Restore weight safely

• Learn regular meals and snacks

• Reduce fear foods and rigid food rules (NIMH, 2024; Crone et al., 2023)

  
  

4. Medication

Right now, there are no medications approved specifically for anorexia nervosa itself (NIMH, 2024). Medicines may still be used to:

• Treat depression, anxiety, or OCD that occur with anorexia

• Support sleep or other symptoms

  
  

Research suggests some medications can help with co-occurring conditions, but they do not replace nutrition and therapy (Mukai et al., 2023; Fornaro et al., 2023).

Medicine is usually added to therapy and nutrition work, not used alone.

Our Anorexia Nervosa Tee: Education You Can Wear

At NurseMob, we want information about anorexia to be visible, not hidden.

That’s why we created:

• An Anorexia awareness poster that clearly shows what this disorder is and lists key signs and complications in simple language

• An Anorexia awareness T-shirt that people can wear in schools, communities, and clinics

  
  

These tools:

• Help people see that extreme dieting, fear of weight gain, and self-starvation are serious medical issues, not “strong willpower” or “just being healthy” (American Psychiatric Association, 2013; NIMH, 2024)

• Can start conversations between friends, families, and health workers

• May be the first time someone recognizes their own behavior or a loved one’s as an eating disorder

  
  

The more posters on walls and shirts in the community, the more chances someone has to notice the signs early and seek help.

You can find the anorexia nervosa tee and poster in the NurseMob LLC store, created by a nurse to blend education, advocacy, and style.

Anorexia Nervosa

From$18.00

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How Do You Know If You Need Help?

You deserve help if:

• You are constantly thinking about food, weight, or getting thinner

• You are afraid to eat, or feel guilty and ashamed after eating

• You are losing weight from dieting, restriction, or over-exercise

• People around you say they are worried about how thin you look

  
  

You do not have to wait until you are “sick enough.”If you are struggling, that is enough to talk to someone (NIMH, 2024).

What You Can Do Right Now

If This Might Be You

Talk to:

• A doctor, nurse, or mental health professional

• A school counselor or trusted adult

  
  

You can say:

“I’m really worried about my eating and my weight. I’m afraid of gaining weight and I keep cutting back more and more. Can you help me get checked for an eating disorder like anorexia?”

If you feel faint, have chest pain, trouble breathing, or thoughts of hurting yourself:

• Call 911 (in the U.S.) or go to the nearest emergency room right away (NIMH, 2024).

  
  

If You’re Worried About Someone Else

Choose a calm time and say something like:

“I care about you. I’ve noticed you’re eating very little and you seem scared to gain weight. I’m worried this could be an eating disorder. Can we talk about it or ask someone for help together?”

Then you can:

• Help them make an appointment

• Go with them to the clinic or counselor

• Share reliable information from NIMH, NICE, or NEDA (NIMH, 2024; NEDA, n.d.; NICE, 2017)

  
  

Why Talking About Anorexia Matters

Anorexia nervosa is:

• Common enough that most schools and communities will see it

• Often hidden behind “healthy eating” or “fitness” language

• Treatable, especially when caught early (NIMH, 2024; NICE, 2017; Crone et al., 2023)

  
  

By learning the signs and speaking up with kindness, you might be the person who helps someone:

• Realize they are sick, not “just disciplined”

• Get real medical and psychological care

• Start moving toward recovery and a safer relationship with food and their body

  
  

Key References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Crone, C., Anzia, D. J., Fochtmann, L. J., & Dahl, D. (2023). APA Practice Guideline for the Treatment of Patients With Eating Disorders (4th ed.). American Psychiatric Association.

Eating Recovery Center. (2024). Understanding anorexia nervosa subtypes: Restricting and binge-eating/purging.

Harris, E. C., & Barraclough, B. (1998). Excess mortality of mental disorder. British Journal of Psychiatry, 173, 11–53.

Mehler, P. S., & Brown, C. (2015). Anorexia nervosa – medical complications. Journal of Eating Disorders, 3, 11.

Mukai, T., et al. (2023). Psychopharmacology of eating disorders: Systematic review and meta-analysis. Journal of Affective Disorders.

National Eating Disorders Association (NEDA). (n.d.). Anorexia nervosa.

National Institute for Health and Care Excellence (NICE). (2017). Eating disorders: Recognition and treatment (NICE guideline NG69).

National Institute of Mental Health (NIMH). (2024). Eating disorders: What you need to know (NIH Publication No. 24-MH-4901).

Fornaro, M., et al. (2023). Pharmacological management of eating disorders: An updated review. CNS Drugs.