Anorexia Nervosa

DSM Definition of Anorexia Nervosa:

According to the DSM (the diagnosis manual) Anorexia Nervosa is an eating disorder characterized by an intense fear of gaining weight and the refusal to maintain a minimally normal body weight. Individuals with anorexia also exhibit a misperception of body shape and/or size.

What are the Signs?

Restriction of food intake, weight loss, preoccupation with food, difficulty with variety, rules around meals, and obsessions body shape and weight. Behaviorally it looks like obsessive actions that are on continual repeat that include the restriction of food, glorification of thinness, body checking, and exercising excessively just to name a few. Fueled by what the DSM states above: the intense fear of gaining weight, Anorexia Nervosa can be diagnosed with care and it can be course corrected. Treatment can be mindful and full of heart, with everyone in mind. People report going from a place of severely struggling to feeling like themselves, full recovery.

In terms of interpersonal attachment, low self esteem often is connected to a negative body image. Other’s may have to go to the gym as they are exercising excessively. For both Men and Women, control is as much a core function as it is a virtue.

What does an Immediate Family Member Experience?

A sense of being lost, confused and frustrated. Holding on to hope, caregivers of find themselves searching for a way to convince their loved one its okay. If it feels as though there’s nothing you can do to convince someone otherwise you may be looking at eating disorder symptoms.

If you feel ignored or seemingly unable to ‘get through.’

When normal body weight isn’t accepted and the achievement of holding below a specific ideal weight is the primary force behind someone’s behavior, how can you even get through? This is the point where many people start to feel hopeless and confused. There is a way, its completely possible and depending on age and situation and you always want to include a component of family therapy. There’s so much to say and so much to learn, a sense of strength always finds itself in connection.

A Disorder of Social and Attachment Dysfunction

Eating disorders like Anorexia Nervosa are completely treatable and family therapy studies show quicker recovery and better remission rates. For adults, including loved ones is recommended but not required. For Adolescents the family system is key to feeling better.

Struggles to connect often show as isolation, anger, irritability and avoidance. Experiences of being alone often maintain the mechanisms of the struggle to begin with and often people just think they are going to be able to get through. If the struggle gets worse, it may be time. We want to make sure that no one ever falls to a place where a significantly low body weight creates a significant loss of hope.

How Do You Recognize the Signs and Symptoms?

Old school ideas of what living with anorexia looks like is not always the case. More times than not, it’s quite different, sophisticated and surprisingly hidden.

People at any weight can struggle. Please know it’s no one’s fault. This is a biological, genetic compilation of neurological susceptibility, environmental triggers, and a sophisticated response exhibiting resilience. Often misunderstood, what typically happens is a person experiences environmental factors that are difficult. The body becomes flooded with a response often anxiety, eating habits change, calorie intake decreases, psychological distress manifests, excessive exercise (even sports) may become a fixation to feel better, body image and body shape become a focus of feeling safe in the world, and it only gets further complicated from there.

When does Anorexia Begin?

Transitions in life. When changes are out of our control, we seek to cope in sophisiticated ways. Some time frames include:

  • Puberty
  • Changes in environment such as school or location
  • College
  • Entering the working world
  • ADHD Diagnosis and use of stimulants for focus
  • Sensory Integration Struggles
  • Trauma both big and small
  • Internalizing diet mindset from social media and influential sources.
  • If you can catch this early, the long term effects don’t have to remain. Recovery is very possible.

If you can catch any signs early during these experience, the long term effects are easier to avoid and do not have to take affect. Recovery is very possible. You may want to seek answer from a certified eating disorder therapist who specifically diagnose anorexia to help clear up any confusion or concerns.

Anorexia Symptoms

  • Weight loss
  • Thin appearance
  • Abnormal blood counts
  • Elevated liver enzymes
  • Fatigue
  • Dizziness or fainting
  • Seizure
  • Brittle nails
  • Hair that thins, breaks or falls out
  • Absence of menstruation (amenorrhea)
  • Development of fine hair on the extremities (lanugo)
  • Constipation
  • Dry skin
  • Intolerance of cold
  • Irregular heart rhythms
  • Low blood pressure
  • Dehydration
  • Osteoporosis, the loss of bone calcium, which may result in broken bones
Aside from these CONTROL is one of the main identifiers of anorexia.

For Kids

  • looks like arguments are home, defiance, refusal to eat, avoidance of birthday parties, rigid choice in eating foods that are ‘junk’ or ‘bad.’ Risk factors include but are not secluded to the overuse of social media, lack of social interactions, stimulant medication (at times), or a history of mental disorders that cause isolation.

In Adults:

  • looks like emaciation, loss of weight too quickly, yo-yo dieting, focus regression, struggles with relationships, and avoidance.
  • Cognitive Symptoms of Anorexia include feeling as though one can’t stop following rigid food rules, how one views their body as quite negative or needing to be maintained vigorously, and even compulsions to exercise daily.
  • For both Men and Women, control is as much a core function as it is a virtue.

For All:

  • One tell tale sign is the fixation and obsession towards being perfect; gaining weight is the fear and perfect food intake equals a healthy weight, reducing body fat and creating a sense of being okay in the world.

Thoughts about food, body, and exercise can dominate and challenge their life. Nothing is good enough. They may control food by avoiding social events or refusing meals. If this sounds familiar, it may be time to seek help. There are ways to prevent this disorder from getting worse.

Other common characteristics of someone with anorexia include:

Difficulties with communication.

The more one is restricting food intake, the more communication is limited too. Individuals may even have difficulty asserting themself and their needs. Causing confusion and misunderstanding in relationships. Someone struggling to explain or access emotions is common in individuals with anorexia nervosa.

Commonly hides oneself and isolates

This is often how it starts in the first place. There is an intense desire to not be seen until one feels better.

Relating to difficulty in social executive functioning, this particular sign may not be so obvious. We often may just brush it off but if one is consider asking yourself, “What is the relationship with food?”

What is a relationship with food?

This gets to the core of identifying signs and symptoms. A simple question, yet so complex it makes other mental disorders feel simple. Food shouldn’t be causing the problem. Food shouldn’t be the reason for how we feel in our body. This one question helps look beneath the surface of every eating disorder to understand what is going on. The complexity, even small signs have to be supported and yet it’s so frustrating for so many. Treatment is the first line defense. Stabilizing behavior is not easy. Reversing behavior is complex and doing it in a way that promotes courage and connection is the trick.

We Know How to Help.

Seeing the whole picture is not often easy and yet has to be one of the first steps. A person struggling with Anorexia Nervosa may not see whats going on. We work to build awareness where there is none. Supporting the needs of a person who can’t seem to connect while also maintaining a psychological, physical, and emotional equilibrium helping you find balance is what we do. A certified eating disorder specialist connects the dots between all of the food restriction, exercise, isolation, perfectionism, emotional avoidance, relationships, school, and work.

When a Person is Scared and Doesn’t Know What to do.

The surrounding pain of a serious eating disorder is one of the hardest things to recognize. Others may see it, but the person struggling with the complexities of a mental health difficulty may not. From a non-judgmental stance, learning to own even just an ounce of the experience without guilt and blame is hard but it’s also where change happens. It’s incredible to see. Our professionals get to see this every day, they are trained in frontline evidence based treatments that have proven to help rid a person of the intense struggle of anorexia. We are also certified in many common co-occurring challenges, such as anxiety, family issues, depression, codependency, school problems, bipolar disorder, self-harm, and other mood and behavioral problems.

Why should I seek an eating disorder specialist?

Treatment requires its own language and boundaries. One miscalculated pressure about food can trigger a negative moment. There are medical standards that must be upheld to properly treat restriction. Don’t let anyone tell you otherwise.

How Severe of a Presentation Can you Help?

Eating Disorders often cause people to have unwanted hospital stays. It’s our job to support those who struggle and work diligently to avoid that from happening. We do everything we can to stabilize an actively regressing situation and our aim is always to ‘safety-net’ experiences from the onset. We want you to avoid as much pain as possible and sometimes we can’t always ‘safety net’ the situation. We will fight to make it happen though. When we have to send someone to hospital… those moments break our hearts. The sooner one comes in for support, the more accessible recovery is.

Can you offer skills and insight?

That’s what we do.

We will help you to develop more tolerance and then build awareness as to why your eating disorder began in the first place. If a person doesn’t want to know, that’s okay too. We just want to make sure the physical symptoms and eating disorder psychopathology never come back.

What Treatment Interventions Are Best?

Specialized interventions such as cognitive behavioral therapy for eating disorders (CBT-E), Adolescent & Family Based Treatment for Eating Disorders (FBT), CBT-AR for selective eating (ARFID), CPT (Cognitive Processing Therapy) for trauma, Safe and Sound Interventions (SSP), Somatic Resilience Therapy and other Trauma based certifications are all here at Hilltop.

We also offer free group therapy for anyone who works with our therapists.

Integrate psychodynamic approaches will help build a roadmap to recovery.

You then will have the power to challenge.

We have many articles throughout our website some are highlighted below for further learning.

Radio & TV


Print & Media:

You are not alone. There is hope.

Contact Us for a no charge, no judgment, no commitment