The physical signs and symptoms of anorexia nervosa are related to starvation, but the disorder also includes emotional and behavior issues related to an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.

Physical symptoms

Physical signs and symptoms of anorexia may include:

  • Extreme weight loss
  • Thin appearance
  • Abnormal blood counts
  • Fatigue
  • Insomnia
  • Dizziness or fainting
  • Bluish discoloration of the fingers
  • Hair that thins, breaks or falls out
  • Soft, downy hair covering the body
  • Absence of menstruation
  • Constipation
  • Dry or yellowish skin
  • Intolerance of cold
  • Irregular heart rhythms
  • Low blood pressure
  • Dehydration
  • Osteoporosis
  • Swelling of arms or legs

Emotional and behavioral symptoms

Behavioral symptoms of anorexia may include attempts to lose weight by either:

  • Severely restricting food intake through dieting or fasting and may include excessive exercise
  • Bingeing and self-induced vomiting to get rid of the food and may include use of laxatives, enemas, diet aids or herbal products

Other emotional and behavioral signs and symptoms related to anorexia may include:

  • Preoccupation with food
  • Refusal to eat
  • Denial of hunger
  • Fear of gaining weight
  • Lying about how much food has been eaten
  • Flat mood (lack of emotion)
  • Social withdrawal
  • Irritability
  • Reduced interest in sex
  • Depressed mood
  • Thoughts of suicide

When to see a doctor

Anorexia, like other eating disorders, can take over your life. Unfortunately, many people with anorexia don't want treatment, at least initially. Their desire to remain thin overrides concerns about their health. If you have a loved one you're worried about, urge her or him to talk to a doctor.

If you're experiencing any of the problems listed above, or if you think you may have an eating disorder, get help. If you're hiding your anorexia from loved ones, try to find a confidant you can talk to about what's going on.

Red flags to watch for

It may be hard to notice signs and symptoms of anorexia because people with anorexia often disguise their thinness, eating habits or physical problems.

If you're concerned that a loved one may have anorexia, watch for these possible red flags:

  • Skipping meals
  • Making excuses for not eating
  • Eating only a few certain "safe" foods, usually those low in fat and calories
  • Adopting rigid meal or eating rituals, such as spitting food out after chewing
  • Cooking elaborate meals for others but refusing to eat
  • Repeated weighing or measuring of themselves
  • Frequent checking in the mirror for perceived flaws
  • Complaining about being fat
  • Not wanting to eat in public
  • Calluses on the knuckles and eroded teeth if inducing vomiting
  • Covering up in layers of clothing
Dec. 30, 2014