Early Warning Signs of Anorexia

Anorexia nervosa is a serious eating disorder that can cause severe medical complications if left untreated. Understanding and recognizing the early warning signs can help with seeking professional advice and receiving an appropriate diagnosis and treatment.

Often people with an eating disorder will hide their behaviors from others, so it may be difficult to notice the signs. You may suspect a loved one has an eating disorder if they are beginning to make dramatic changes to their behaviors surrounding food and/or exercise, but there are other signs and symptoms that can indicate the development of anorexia.

Emotional and behavioral warning signs of anorexia

As anorexia symptoms begin to develop, there may be various emotional and behavioral warning signs that could indicate the occurrence of disordered eating, such as ^[1][2][3]:

• Regularly checking body weight, looking in the mirror, or measuring waist circumference
• Eating very small amounts of food
• Picking at food or moving food around the plate
• Avoiding certain types of food, such as carbohydrates
• Making comments about body weight, or other negative comments about appearance
• An intense fear of gaining weight
• Not wanting to eat in front of others
• Avoiding social events involving meals or food
• Engaging in excessive exercise
• Behaviors to prevent weight gain such as vomiting, using laxatives or diuretics, or taking appetite suppressants
• Obsessive or ritualistic behaviors around eating habits, calorie counting, and exercise
• Going to the bathroom immediately after eating
• Personality traits such as a need for control or inflexible thinking and behaviors
• Changes in mood, such as depression, anxiety, agitation, or social withdrawal

Physical warning signs of anorexia

As anorexia progresses, physical changes will become more apparent, although some physical signs may be present early in the condition, such as ^[1][2][3]:

• Feeling dizzy, lightheaded, or faint
• Feeling cold
• Feeling very tired and weak
• Trouble concentrating or ‘brain fog’
• Dry skin, nails, or hair
• Lowered immune system functioning, such as becoming unwell and not recovering as quickly as normal
• Wounds healing slowly
• Periods may become irregular or missed, or have not begun

When to seek professional help

If you think you may be experiencing symptoms or early warning signs of anorexia nervosa or another eating disorder, it is important to seek professional advice as soon as possible, to receive an appropriate diagnosis and support in managing your medical condition.

If you think a loved one is showing signs of anorexia, you may want to encourage them to seek help but this can cause distress and they may be reluctant to speak with you or a professional about their eating habits. You could offer to go to the doctor with them or try starting a conversation around this. You may wish to seek professional advice yourself on how best to manage this.

Early diagnosis can help to prevent serious medical complications from occurring and prevent symptoms from worsening, providing the best chance of recovery ^[4][5].

Physical complications of anorexia can include ^[5][6]:

• Hormonal deficiencies and infertility
• Muscle weakness and atrophy
• Osteoporosis, causing reduced bone density and potentially leading to fractures
• Vitamin and electrolyte deficiencies, which can lead to organ failure and death
• Severe dehydration and kidney problems
• Heart issues
• Seizures
• Weakened immune system

Anorexia can require long-term treatment and it may take several years of specialized treatment for a full recovery, especially if the condition has been present for a long period of time. As such, early intervention can greatly increase chances of recovery and reduce treatment time ^[4].

Treatment

Treatment for anorexia will usually involve a multidisciplinary approach, with input from various specialists, such as a dietician, therapist, and physician, who will work together to treat all aspects of the condition and help to improve and manage your physical and mental health ^[5].

You may be referred to a dietician or nutritionist, who can help advise and support you in managing your weight and nutritional intake safely. Nutritional rehabilitation can be distressing and challenging and typically requires specialized support to manage the psychological impact of this process ^[4][5].

Treatment for anorexia nervosa can also include specialized therapy to help you understand your condition and the emotions and behaviors you are experiencing, while developing techniques to manage and change unhealthy eating habits. This might include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), or interpersonal therapy ^[1][4].

Family therapy can be useful, particularly for adolescents, as it can help parents and other family members gain a better understanding of the condition and how best to support their loved one in overcoming anorexia ^[1][5].

You may also be referred to a doctor for medical monitoring. However, this doctor should have a background in eating disorders, because if they don’t understand these types of conditions then many symptoms of anorexia could be missed, overlooked, or invalidated.

Medication

Typically, medication is not prescribed in the treatment of anorexia, as research has shown little evidence of its effectiveness in managing eating habits or psychological aspects of the condition and the risk of side effects may be increased ^[4][5].

However, a doctor might decide that medication is appropriate in certain circumstances and may prescribe an antidepressant or antipsychotic medication if it is deemed necessary for treatment ^[4][5].

Medication is often used when the patient has a co-occurring mental health disorder, such as an anxiety disorder, OCD, or depression. Co-occurring disorders are common in people with anorexia.