Healthdirect Free Australian health advice you can count on.

Medical problem? Call 1800 022 222. If you need urgent medical help, call triple zero immediately

healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do.

beginning of content

Anorexia nervosa

6-minute read

What is anorexia nervosa?

Anorexia nervosa is an eating disorder. The symptoms include very low weight, a distorted body image and an intense fear of gaining weight.

This serious mental illness is most common in women and usually starts in adolescence. It is the third most common chronic illness in girls and young women and affects up to 1 in 200 girls. One in 11 people who develop anorexia after puberty are male.

People with anorexia nervosa may see themselves as being heavy or large when they are actually severely underweight. They follow restrictive diets and harsh, punishing exercise routines. They control food as a way of controlling areas of their lives or dealing with negative emotions.

Anorexia falls into 2 general types:

1. Restricting type

People with this type of anorexia nervosa place severe restrictions on the quantity and type of food they consume.

This could include counting calories, skipping meals, restricting certain foods (such as carbohydrates) and following obsessive rules, such as only eating foods of a certain colour.

These behaviours may be accompanied by excessive exercise.

2. Binge eating/purging type

People with this type of anorexia also place restrictions on the food they eat. But this is accompanied by binge eating and then purging.

Binge eating means someone eats a large amount of food to cope with feelings of being out of control. The person then 'compensates' for this eating by purging the food through vomiting or misusing laxatives, diuretics or enemas.

What are the symptoms of anorexia nervosa?

The most obvious sign that someone has anorexia nervosa is that they are severely underweight, they have lost weight very quickly, or their weight fluctuates dramatically.

A BMI of less than 18.5 is considered underweight. But being very thin is not the only sign of anorexia. There are also other signs that a person may have anorexia nervosa.

Physical signs

  • loss of menstruation in women, decreased libido (sex drive) in men
  • fainting or dizziness
  • always feeling cold
  • bloating, constipation or developing food intolerances
  • poor sleep
  • lethargy and tiredness
  • looking pale
  • dry, yellow skin
  • sunken eyes
  • fine hair on the face and body

Psychological signs

  • being preoccupied with eating, food, body shape and weight
  • being extremely dissatisfied with their body, or having a distorted body image
  • being anxious and/or irritable at meal times
  • depression and anxiety
  • difficulty concentrating
  • having rigid thoughts about food
  • low self-esteem and perfectionism

Behavioural signs

  • intense dieting (counting calories, avoiding foods)
  • deliberately misusing laxatives, appetite suppressants, enemas and diuretics
  • obsessive behaviour around body weight or shape (weighing themselves obsessively, pinching waist or wrists)
  • binge eating
  • avoiding eating with other people and secrecy around food
  • wanting to be alone
  • excessive exercising
  • obsessive rituals around food
  • preoccupation with cooking, recipes and nutrition
  • self-harm, substance abuse or suicide attempts

What causes anorexia nervosa?

The causes of anorexia nervosa are not fully understood.

There may be genetic risk factors and a combination of environmental, social and cultural factors. It's likely that some people are more vulnerable to anorexia because of particular personality traits.

The causes that may contribute to a person developing anorexia nervosa include:

Psychological factors, such as a high level of perfectionism or obsessive-compulsive personality traits, feeling limited control in life and low self-esteem, a tendency towards depression and anxiety and a poor reaction to stress.

Environmental factors, including the onset of puberty, stressful life events and relationship problems.

Cultural pressures to be thin stemming from media and pop culture such as magazines, TV shows and movies.

Occupations that demand a thin physique may increase the risk of anorexia nervosa, such as certain sports, ballet, or the television and fashion industries.

Brain chemistry, because extreme dieting can affect the balance of hormones in the body, affecting how the brain functions.

Genetic predisposition, which arises from the genes inherited from parents. Anorexia nervosa often runs in families, suggesting there may be a genetic cause.

When should I see my doctor?

Many people with anorexia nervosa think they’re not sick enough or thin enough to need treatment. But seriously restricting calorie intake is dangerous and can have a serious impact on health. If you have anorexia nervosa, the earlier you seek help, the better your chances of recovery.

If you are worried about your eating, it’s important to speak someone. Your doctor is a good place to start, or you could talk to someone you trust like a friend, family member or teacher. They will help you take the first steps towards treatment and recovery.

FIND A HEALTH SERVICE — Our Service Finder can help you find doctors, pharmacies, hospitals and other health services.

ASK YOUR DOCTOR — Preparing for an appointment? Use our Question Builder for general tips on what to ask your GP or specialist.

How is anorexia nervosa diagnosed?

After ruling out that weight loss is caused by another condition, your doctor may refer you to a mental health professional. This health professional will diagnose anorexia nervosa based on your thoughts, feelings and eating behaviours. They will also check for any other mental or physical complications.

How is anorexia nervosa treated?

The first step to recovery is restoring good nutrition and a healthy weight. This allows treatments to work effectively. If the person has life threatening medical complications or is extremely low weight, they may need to spend time in hospital.

A psychologist can help a person with anorexia nervosa learn behaviours that will help them to return to and maintain a healthy weight. Someone with anorexia nervosa may also see a dietitian, family therapist, psychiatrist or other members of a healthcare team.

Antidepressants and other medicines are sometimes used to treat anorexia nervosa along with psychological therapy.

On average, people have anorexia nervosa for 5 to 7 years. It's common for people with the condition to relapse, so follow-up and treatment for anorexia nervosa is important.

Complications of anorexia nervosa

When people with anorexia nervosa enter a state of starvation, their brain stops functioning properly. They are at risk of self-harm, substance abuse, suicide attempts, depression and anxiety.

Anorexia nervosa can also cause physical complications including:

Unfortunately, around 1 in 5 people eventually die of the consequences of anorexia nervosa, and one in 5 will attempt suicide.

Resources and support

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2020


Back To Top

Need more information?

These trusted information partners have more on this topic.

Top results

Anorexia nervosa and osteoporosis

Osteoporosis is a condition in which the bones become fragile, leading to a higher risk of breaks or fractures. A minor bump or fall can be enough to cause a break in someone with osteoporosis. People with anorexia nervosa are at increased risk of developing osteoporosis. This factsheet explains how anorexia nervosa can affect your bones, how to find out if you are at risk of osteoporosis, and what you can do to help protect your bone health

Read more on Osteoporosis Australia website

Anorexia nervosa

Anorexia nervosa (AN) is defined by the persistent restriction of energy intake, intense fear of gaining weight and disturbance in self-perceived weight or shape

Read more on NEDC - National Eating Disorders Collaboration website

Anorexia Nervosa - Butterfly Foundation

The Butterfly Foundation represents all people affected by eating disorders and negative body image issues. Butterfly National Helpline 1800 ED HOPE provides free phone, email and web support and referral for individuals experiencing an eating disorder, carers and professionals.

Read more on Butterfly Foundation website

Anorexia nervosa in children and young people | Sydney Children's Hospitals Network

What is anorexia nervosa? Anorexia nervosa is a mental illness in which there is a disturbance in the way a person experiences their body shape or weight as well as unhappiness with their body

Read more on Sydney Children's Hospitals Network website

What Is Anorexia Nervosa? | Eating Disorders Victoria

Eating Disorders Victoria provides information on what is anorexia nervosa, warning signs, the physical effects, and treatment and recovery options.

Read more on Eating Disorders Victoria website

Anorexia nervosa in children & teenagers | Raising Children Network

Anorexia nervosa is a mental and eating disorder that makes people lose too much weight. Read about signs of anorexia and how to get help for your child.

Read more on raisingchildren.net.au website

What is anorexia nervosa? | Eating disorders | ReachOut Australia

Anorexia nervosa is a type of eating disorder with some unique characteristics, such as an obsessive fear of gaining weight, distorted body image and low body weight.

Read more on ReachOut.com website

Anorexia nervosa | Garvan Institute of Medical Research

Eating disorders share symptoms such as a distorted view of body shape and weight, and extreme disturbances in eating behaviour. Read about Garvan's research and understanding of these disorders.

Read more on Garvan Institute of Medical Research website

Eating disorders - myDr.com.au

Anorexia nervosa, bulimia nervosa and binge eating disorder are the main eating disorders. Abnormal eating patterns are one symptom.

Read more on myDr website

Learn About Anorexia Nervosa | How Far Is Too Far?

Anorexia is a serious mental illness, not a lifestyle choice or dietPeople with anorexia restrict both how much and what is eatenAnorexia has the highest mortality rate of any mental illnessAnyone can be affected by anorexia, regardless of gender, age or ethnicityAnorexia has serious physical and mental health complicationsRecovery is possible; early treatment leads to the best results

Read more on Eating Disorders Victoria website

Healthdirect 24hr 7 days a week hotline

24 hour health advice you can count on

1800 022 222

Government Accredited with over 140 information partners

We are a government-funded service, providing quality, approved health information and advice

Australian Government, health department logo ACT Government logo New South Wales government, health department logo Northen Territory Government logo Government of South Australia, health department logo Tasmanian government logo Government of Western Australia, health department logo