Some people worry too much about losing weight. However, sometimes, this worry becomes obsessive, leading to anorexia nervosa. It is an eating disorder that typically leads to severe weight loss. Individuals with anorexia nervosa typically exhibit an intense preoccupation with weight and calorie consumption, maintain an extremely low-calorie diet, and experience an overwhelming fear of weight gain. Such people feel good about themselves whenever they shed pounds and might also work out excessively.

Causes
Studies suggest that environmental factors, psychological traits, and genetic factors could be a few underlying causes. Some factors that result in anorexia nervosa are:

• Genetics – Studies suggest that the risk of developing any eating disorder is about 50-80 percent genetic. Individuals with first-degree relatives with an eating disorder are almost ten times more likely to have it. Further, the alterations in brain chemistry might be one of the causes. It involves changes to the neurotransmitters and brain reward system changes, directly influencing impulse regulation, mood, and appetite.
• Trauma – Some experts believe that trauma can also be one of the causes of eating disorders. People try to cope with overwhelming feelings or painful emotions by curtailing their food. Sexual or physical assault can also lead to people developing anorexia nervosa.
• Emotional health – Challenging relationships, impulsive behavior, and perfectionism can impact a person’s self-esteem and perceived self-worth, making them susceptible to anorexia.
• Peer pressure – Especially in adolescents and children, peer pressure can be one powerful force. Enduring bullying, teasing, or ridicule because of weight can also be responsible for a person developing anorexia.
• Culture and environment – Cultures that idealize a body type, typically thin bodies, also put unnecessary pressure on people to keep up with this unrealistic body standard. Some images in advertising or media and cultures associating thinness with success, popularity, happiness, and beauty may trigger anorexia in some people.

Symptoms
In anorexia nervosa, the physical symptoms are linked to starvation. But you may also have behavioral or emotional issues involving fear of becoming fat or gaining weight and distorted body weight perception. Sometimes, it is tricky to notice these symptoms because a low body weight for someone might not be so for others, and some people with the disorder might not look extremely thin. Further, people suffering from anorexia nervosa may disguise their physical problems, eating habits, or thinness.

Physical symptoms

• Significant weight loss or inadequate weight gain for age or developmental stage
• Thin physical appearance
• Abnormal blood cell counts
• Fatigue
• Sleep difficulties
• Dizziness or fainting spells
• Bluish coloration of the fingers
• Thinning, brittle, or falling hair
• Presence of fine body hair
• Absence of menstrual periods
• Constipation and stomach pain
• Intolerance to cold temperatures
• Dry or yellowed skin
• Irregular heart rhythms
• Low blood pressure
• Dehydration
• Swelling in the arms or legs
• Tooth erosion and knuckle calluses from self-induced vomiting

Behavioral and emotional symptoms
These may include constant attempts to shed weight by:

1. Engaging in severe food restriction by following strict diets or fasting
2. Excessive exercise
3. Engaging in episodes of binge eating followed by self-induced vomiting to eliminate food, which may involve the misuse of laxatives, enemas, diet aids, or herbal products

Some behavioral and emotional symptoms are:

• Constant preoccupation with food, sometimes demonstrated by preparing elaborate meals for others without consuming them
• Frequently skipping meals or refusing to eat
• Denial of hunger or offering excuses for not eating
• Restricting food intake to a few specific “safe” foods, typically low in fat and calories
• Establishing rigid mealtime rituals, such as spitting out chewed food
• Discomfort or reluctance to eat in public
• Dishonesty about the amount of food consumed
• Fear of weight gain, leading to frequent body weighing or measurement
• Regularly checking the mirror for perceived flaws
• Persistent complaints about being overweight or having fat body parts
• Wearing multiple layers of clothing to conceal body shape
• Lack of emotional expression (flat mood)
• Withdrawal from social activities
• Irritability
• Difficulty sleeping (insomnia)
• Decreased interest in sexual activity

Diagnosis
You will first undergo a physical examination to assess your heart rate and blood pressure. Diagnosis will also involve a reference to the mental health expert or a psychological exam, wherein you talk about your feelings and eating habits to find any criteria that possibly show that you are:

1. Engaging in food intake restriction
2. Experiencing fear associated with weight gain
3. Struggling with body image concerns

You will also undergo lab examinations, such as blood tests, to determine your liver and kidney function and electrolyte levels. Further, doctors may also evaluate heart irregularities and bone density.

Treatment options
Doctors with a multidisciplinary team of specialists will devise a comprehensive plan to address your specific needs. Some suggested strategies may be:

1. Individual and family counseling
2. Cognitive-behavioral Therapy to promote stress management and new thinking patterns
3. Supplements to address nutritional deficiencies
4. Treatment options for anxiety and depression
5. Nutritional Therapy for health promotion