Early symptoms of anorexia nervosa

Anorexia nervosa

The early symptoms of anorexia nervosa usually appear in pre-adolescence or young adulthood. The symptoms may be divided into physical and emotional and behavioral, but can be summed up as voluntarily keeping a body weight 15% or more below what is normal for the patient’s age and height.

Anorexia nervosa symptoms


Emotional and behavioral

  • Severe weight loss.
  • Loss of body fat.
  • Loss of muscle mass.
  • Thin appearance.
  • Irregular blood count.
  • Tiredness.
  • Insomnia.
  • Dizziness.
  • Fainting.
  • Bluish fingers.
  • Thinning hair.
  • Hair loss.
  • Soft, downy hair on the body.
  • Lack of menstruation.
  • Constipation.
  • Dry or blotchy yellowish skin.
  • Sensitivity to cold.
  • Abnormal heart rhythm.
  • Hypotension.
  • Dehydration.
  • Osteoporosis.
  • Arm or leg swelling.
  • Dry mouth.
  • Extreme dieting or fasting.
  • Excessive exercise.
  • Binging and purging.
  • Use of laxatives, enemas, diet aids, or herbal products to induce vomit or bowel movements, or reduce appetite.
  • Preoccupation with food.
  • Refusing to eat, especially around other people.
  • Denying hunger.
  • Fear of weight gain.
  • Lying about food intake.
  • Emotionlessness.
  • Social isolation.
  • Irritability.
  • Decreased sex drive.
  • Depression.
  • Confusion.
  • Suicidal ideation.
  • Distorted body image.
  • Playing with food.
  • Going to the toilet immediately after meals.


The specific cause of anorexia has not been determined, though genetic, psychological, and environmental factors are thought to be in play, as well as age, gender and even vocations. Thus, teen girls are more prone to developing anorexia nervosa (though it can occur in males too), as are athletes, actors, dancers, and models. Moreover, certain young women may be perfectionists – which in this case is a euphemism for having obsessive-compulsive traits – who are somehow genetically wired to adhere to draconian dietary regimes and therefore willing to starve themselves because they do not think they are ever thin enough. 

Other risk factors for anorexia nervosa include:

  • Worrying more about or paying more attention to weight and shape.
  • A childhood anxiety disorder.
  • A negative self-image.
  • Early childhood eating problems.
  • Predetermined social or cultural notions about health and beauty.

Additionally, life changes (new school or job, moving to a new place, relationship breakup, death of a loved one, etc.), positive or negative reinforcement from others after intended or unintended weight gain or loss, family history (a first degree relative with anorexia), and the media and society can all influence whether or not a person develops this condition.

As with the early symptoms of anorexia nervosa, the complications stemming from this disorder can also have a physical and an emotional nature:

Complications of anorexia nervosa



  • Anemia.
  • Low blood potassium levels.
  • Heart problems.
  • Bone loss.
  • Protein, vitamin, and mineral deficiency.
  • Thyroid gland issues.
  • Tooth decay.
  • Decreased testosterone in men.
  • Gastrointestinal issues.
  • Electrolyte anomalies.
  • Kidney issues.
  • Decreased white blood cells.
  • Increased risk of infection.
  • Suicide.
  • Anxiety.
  • Mood and personality disorders.
  • OCD.
  • Alcohol and substance abuse.



There are several tests that serve to confirm or discard possible causes of weight loss – and assess the extent of the damage –, as well as treatment alternatives to help patients regain and keep lost weight, as seen below:

Diagnosis and treatment of anorexia nervosa


Restoring normal body weight

  • Albumin.
  • Bone density test.
  • Complete blood count.
  • EKG.
  • Electrolytes.
  • Kidney function.
  • Liver function.
  • Total protein.
  • Thyroid function.
  • Urinalysis.
  • Increasing social activity.
  • Reducing physical activity.
  • Employing schedules for eating.
  • Hospitalization.



But in spite of the physical damage anorexia can cause, the root of the problem remains mental. In fact, in order to be diagnosed with this condition, the patient must first meet the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria:

  • Restricting food intake.
  • Fear of gaining weight.
  • Body image problems.

The biggest obstacle for the patient to be treated is for them to overcome the belief that they don’t need treatment to begin with. Fortunately, families of anorexic individuals can seek help from a variety of healthcare providers, including nurses, physicians, dietitians, and mental care providers. Likewise, there are several forms of psychotherapy available, such as:

  • Family-based therapy.
  • Individual therapy.
  • Cognitive behavioral therapy.
  • Group therapy.
  • Support groups.

Related Read:

- Weight loss in the Elderly: A sign of something more serious

- Anorexia nervosa

- Diseases and Conditions: Anorexia nervosa