What is anorexia nervosa?
Anorexia nervosa is a serious eating disorder characterized by intense restriction of food intake, an excessive fear of gaining weight and a significant distortion of body image. The person who experiences it perceives themselves as overweight despite being significantly below a healthy weight.
It is the mental disorder with the highest mortality rate: medical complications stemming from malnutrition and the risk of suicide mean that between 5% and 10% of people affected die as a direct or indirect consequence of the disorder. This figure underscores the importance of early diagnosis and specialized treatment.
Anorexia is not a matter of vanity or willpower. It is a complex mental illness with neurobiological, psychological and social roots that requires a professional approach. As a psychologist specialized in eating disorders, I offer integrative treatment that addresses every dimension of the disorder.
Types of anorexia nervosa
Restrictive anorexia
In this subtype, the person drastically reduces caloric intake without resorting to purging behaviors. Weight loss is achieved through extremely restrictive diets, prolonged fasting and, often, excessive physical exercise. It is the best-known subtype and the one most often associated with the classic image of anorexia.
Purging anorexia
In this case, the person combines food restriction with purging behaviors such as self-induced vomiting, the use of laxatives, diuretics or enemas. The presence of purging behaviors increases the risk of severe medical complications, such as electrolyte imbalances that can cause cardiac arrhythmias.
Symptoms of anorexia nervosa
Physical symptoms
- Significant and progressive weight loss
- Amenorrhea (loss of menstruation) in women
- Hair loss and the appearance of lanugo (fine body hair)
- Dry, cold skin with a yellowish or grayish appearance
- Extreme fatigue, dizziness and fainting
- Cold intolerance (always feeling cold)
- Gastrointestinal problems: constipation, bloating
- Bradycardia (abnormally slow heart rate)
- Bone fragility and brittle nails
Psychological and behavioral symptoms
- Intense fear of gaining weight or becoming fat
- Body image distortion (seeing oneself as fat despite being thin)
- Denial of the seriousness of low body weight
- Obsessive concern with calories, nutrients and weight
- Rigid rituals during meals: cutting food into very small pieces, separating foods, eating very slowly
- Avoidance of meals in public or social situations involving food
- Compulsive exercise, even when ill or injured
- Progressive social isolation
- Irritability, anxiety and depressive symptoms
Causes of anorexia nervosa
Anorexia does not have a single cause. It is the result of the interaction of multiple factors:
- Genetic: twin studies have shown that genetics accounts for between 50% and 80% of the risk of developing anorexia. Having a first-degree relative with an eating disorder multiplies the risk tenfold.
- Neurobiological: alterations in the serotonin and dopamine systems affect appetite regulation, mood and the sensation of reward.
- Psychological: perfectionism, low self-esteem, the need for control, cognitive rigidity, difficulty expressing emotions and traumatic experiences.
- Social: cultural pressure to be thin, restrictive diets, social media, bullying about physical appearance, sports that value low weight (dance, gymnastics, athletics).
In many cases, anorexia begins with a seemingly "innocent" diet that progressively becomes more restrictive. Unresolved traumatic experiences can also lie at the root of the disorder, and in such cases treatment with EMDR can be especially helpful.
Physical consequences of anorexia
The severe malnutrition associated with anorexia can damage virtually every system in the body:
- Cardiovascular: bradycardia, hypotension, cardiac arrhythmias, heart failure.
- Endocrine: amenorrhea, infertility, hypothyroidism, altered cortisol levels.
- Skeletal: premature osteopenia and osteoporosis, stress fractures.
- Neurological: brain atrophy (reversible with nutritional recovery), difficulties with concentration and memory.
- Gastrointestinal: gastroparesis, severe constipation, abdominal bloating.
Treatment of anorexia nervosa
Treating anorexia requires a multidisciplinary, individualized approach:
Psychological therapy
Cognitive-behavioral therapy (CBT-E, adapted for eating disorders) is the gold-standard treatment for anorexia in adults. It works on body image distortion, rigid thoughts about food and weight, and emotional regulation. In adolescents, family-based therapy (FBT) has proven the most effective.
Nutritional rehabilitation
Weight restoration is a central goal of treatment. A dietitian-nutritionist specialized in eating disorders sets a progressive, tailored eating plan. Nutritional recovery is not just about eating more: it involves relearning how to listen to the body's hunger and satiety cues.
EMDR for underlying trauma
When anorexia is linked to traumatic experiences — abuse, bullying, emotional neglect — EMDR helps process these memories to reduce their influence on eating behavior.
Asking for help is the first step
If you or someone close to you shows signs of anorexia nervosa, it is essential to act as soon as possible. Recovery is possible, but the longer treatment is delayed, the harder and longer the process can be. I offer a free informational session where we can assess the situation and chart the best path toward recovery.