Usually the first signs of anorexia nervosa are healthier eating habits and exercising more than before. It is common that at the beginning stages of anorexia other people give positive feedback to the person with the disorder due to his or her weight loss. The person battling with the eating disorder usually also seems more energetic and self-confident. Anorexic people consider it a success when they deny themselves food and lose weight; they feel a sense of control over themselves and their lives by losing "just a little bit more" weight. In their mind, a healthy diet means few calories and they see exercising as a way of losing weight.
Eating, and particularly eating forbidden foods, feels like failing to an anorexic person and leads to anxiety and self-blame. Contrary to common belief, anorexic people do not usually suffer from loss of appetite. They think about food almost constantly, and they fear gaining weight and see themselves as fat, even when they are seriously underweight. Starvation caused by weight loss worsens disturbed behavior and psychological symptoms (including hostility, insomnia, and depression).
Most anorexics exercise a lot, strenuously and obsessively. Some may also vomit or use diuretics or laxatives, and sometimes ‘cutting’ and other kinds of self-destructive behavior may occur.
Typical symptoms and effects of anorexia nervosa:
- weight loss, underweight
- limiting what one eats (possibly also interfering with other family members' eating habits)
- categorizing food into what is allowed and what is forbidden
- showing extreme interest in food and cooking
- fear of gaining weight, feeling fat and perceiving oneself to be fat
- absence of menstrual cycles (can cause osteoporosis or infertility if prolonged)
- irritable, defiant, fits of bad temper
- hyperactivity, restlessness, obsessive exercising, insomnia
- rules and rituals (especially about food, eating and exercise)
- solitude, becoming withdrawn
- hair loss or thinning
- losing muscular strength
- feeling cold, lowered body temperature, slow pulse, low blood pressure
- lanugo: soft, white hair growing on the face and/or elsewhere on the body