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What are the signs & symptoms of anorexia nervosa?

At Priory, we understand that anorexia nervosa can be a severe and debilitating mental illness, which can be extremely difficult to cope with. In addition, anorexia can also be a very secretive disorder, with individuals going to extreme lengths to conceal their weight loss or eating habits, which means that often, expert help and treatment is not sought in a timely manner.

The signs and symptoms of anorexia can vary from person to person, and can be categorised into psychological, physical and behavioural/social symptoms.

Psychological symptoms of anorexia

  • Having an overwhelming and irrational fear of putting on weight, and an unwillingness to put on weight
  • Feeling as though you are fat, when other people say that you are thin. For example, thinking that certain parts of your body are too ‘fat’, even though you are underweight – this could also be a sign of body dysmorphic disorder (BDD)
  • Having an obsession with looking a certain way and striving for a certain body shape
  • Spending a lot of time thinking about food, and feeling as though this has taken over your life
  • Experiencing guilt and shame when you eat
  • Depression
  • Anxiety
  • Stress
  • Self-harm
  • Panic attacks
  • Anxiety attacks
  • Suicidal thoughts
  • Anger, irritability and impatience – finding that you get angry for no reason and taking this out on those who are closest to you
  • Mood swings
  • Feeling tearful and emotionally tired – finding that you are crying more than usual and become emotional for no apparent reason
  • Difficulty concentrating due a lack of energy
  • Low self-esteem and a reduction in confidence
  • Inability to make rational decisions
  • Exacerbation of any existing mental health problems such as anxiety, depression or obsessive compulsive disorder (OCD)

Physical symptoms of anorexia

  • Severe or significant weight loss over a short period of time
  • Extreme tiredness and exhaustion due to starvation
  • Sleep disturbances, including insomnia
  • Dizziness
  • Dry/yellowish skin
  • Always feeling cold
  • Heart palpitations and bradycardia (abnormally low heart rate)
  • Dehydration
  • Headaches
  • Tooth decay, bad breath and scars on the knuckles as a result of induced vomiting
  • Low blood pressure
  • Constipation
  • Abdominal pain
  • Loss of sexual urges - this could be due to a lack of body confidence

This page was clinically reviewed by Dr Pippa Hugo (MBChB, MRCPsych) in July 2018, and is scheduled to be reviewed again in July 2020. To view all Priory anorexia specialists, please click here.

Behavioural/social symptoms of anorexia
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What are the long-term effects of anorexia nervosa?
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Self-help tips for dealing with the early signs of anorexia
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