What is anorexia like?

There are a number of features, that although not necessarily diagnostic of anorexia, have been found to be commonly (but not exclusively) present in those with this eating disorder.

Psychological

• Distorted body image
• Poor insight
• Self-evaluation largely, or even exclusively, in terms of their shape and weight
• Pre-occupation or obsessive thoughts about food and weight
• Perfectionism
• OCD (obsessive compulsive disorder)

Emotional

• Low self-esteem and self-efficacy
• Clinical depression or chronically low mood
• Intense fear about becoming overweight
• Moodiness or 'mood swings'

Interpersonal and social

• Poor or deteriorating school performance, however in some anorexics this is not present due to their perfectionistic tendencies
• Withdrawal from previous friendships and other peer-relationships
• Deterioration in relationships with the family

Physical

• Extreme weight loss
• Endocrine disorder, leading to cessation of periods in girls (amenorrhea)
• Starvation symptoms, such as reduced metabolism, slow heart rate (bradycardia), hypotension, hypothermia and anemia
• Growth of lanugo hair over the body
• Abnormalities of mineral and electrolyte levels in the body
• Zinc deficiency
• Often a reduction in white blood cell count
• Reduced immune system function
• Body mass index less than 17.5 in adults, or 85% of expected weight in children
• Possibly with pallid complexion and sunken eyes
• Creaking joints and bones
• Collection of fluid in ankles during the day and around eyes during the night
• Constipation
• Very dry/chapped lips due to malnutrition
• Poor circulation, resulting in common attacks of 'pins and needles' and purple extremities
• In cases of extreme weight loss, there can be nerve deterioration, leading to difficulty in moving the feet
• Headaches, due to malnutrition
• Thinning of the hair
• Nails become more brittle
• Constantly feeling "cold"
• Bruise easily
• Dry skin

Behavioral

• Excessive exercise, food restriction
• Fainting
• Secretive about eating or exercise behaviour
• Possible self-harm, substance abuse or suicide attempts
• Very sensitive to references about body weight
• Become very angry when forced to eat "forbidden" foods

Anorexia and Bulimia

The distinction between the diagnoses of anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified (EDNOS) is often difficult to make in practice and there is considerable overlap between patients diagnosed with these conditions. Furthermore, seemingly minor changes in a patient's overall behaviour or attitude (such as reported feeling of 'control' over any bingeing behaviour) can change a diagnosis from 'anorexia: binge-eating type' to bulimia nervosa.

It is not unusual for a person with an eating disorder to 'move through' various diagnoses as his or her behavior and beliefs change over time.

Additionally, it is important to note that an individual may still suffer from a health- or life-threatening eating disorder (e.g., subclinical anorexia nervosa or EDNOS: eating disorder, not otherwise specified) even if one diagnostic sign or symptom is still present. For example, a substantial number of patients diagnosed with EDNOS meet all criteria for diagnosis of anorexia nervosa, but lack the three consecutive missed menstrual cycles needed for a diagnosis of anorexia.

Feminist writers such as Susie Orbach and Naomi Wolf have criticised the medicalisation of extreme dieting and weight-loss as locating the problem within the affected women, rather than in a society that imposes concepts of unreasonable and unhealthy thinness as a measure of female beauty.