Some people with anorexia lose weight mainly through severely restricting the amount of food they eat. They may also try to lose weight by exercising excessively. Others with anorexia binge and purge, similar to bulimia. They control calorie intake by vomiting after eating or by misusing laxatives, diuretics or enemas.

No matter how weight loss is achieved, anorexia has a number of physical, emotional and behavioral signs and symptoms.

Physical anorexia symptoms

Physical signs and symptoms of anorexia include:

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

Emotional and behavioral anorexia symptoms

Emotional and behavioral characteristics associated with anorexia include:

  • Refusal to eat
  • Denial of hunger
  • Afraid of gaining weight
  • Lying about how much food has been eaten
  • Excessive exercise
  • Flat mood (lack of emotion)
  • Social withdrawal
  • Irritability
  • Preoccupation with food
  • Reduced interest in sex
  • Depressed mood
  • Possible use of laxatives, diet aids or herbal products

When to see doctor

Anorexia, like other eating disorders, can take over your life. You may think about food all the time, spend hours agonizing over options in the grocery store and exercise to exhaustion. You also may have a host of physical problems that make you feel generally miserable, such as dizziness, constipation, fatigue and frequently feeling cold. You may feel irritable, angry, moody, sad, anxious and hopeless. You might visit pro-anorexia websites, refer to the disease as your "friend," cover up in layers of heavy clothing, and try to get by on a menu of lettuce, carrots, popcorn and diet soda.

If you're experiencing any of these problems, 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.

Anorexia red flags to watch for

It may be hard to notice signs and symptoms of anorexia because people with anorexia often go to great lengths to 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 cutting food into tiny pieces or spitting food out after chewing
  • Cooking elaborate meals for others but refusing to eat
  • Repeated weighing of themselves
  • Frequent checking in the mirror for perceived flaws
  • Complaining about being fat
  • Not wanting to eat in public

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.

Jan. 05, 2012

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