In the case of anorexia nervosa, there is an overwhelming desire to be slim and a seriously altered body image, that is, sufferers see themselves as obese even though their weight is well below the norm for their age, sex and height.
People who suffer from anorexia nervosa show an intense fear of being obese, and have are overly concerned about food, their figure, and their weight. This fear leads them to follow a very strict diet (very low in calories and with an incorrect provision of nutrients) and to do what they can to “burn” the calories they have eaten (high level of physical activity, inducing vomiting, using medicines to reduce the appetite, abuse of laxatives and diuretics). This can lead to a severe state of malnutrition, which can prove fatal. Despite this, they are not usually aware of their illness and neither the risks that they are running because of their behaviour.
Generally, they are people who are perfectionist, competitive, introverted, with a tendency to be socially isolated but very responsible. The onset of anorexia nervosa often goes unnoticed, which is why it is important to recognise its initial signs, which may include:
- Cutting food into very small pieces and chewing them for a long time.
- Reducing the quantity of food and distributing it around the plate.
- Choosing fat-free and low-calorie foods (“avoiding fattening foods”).
- Secretly missing meals.
- Eating alone and lying about what was eaten.
- Going to the toilet to vomit immediately after eating.
- Doing excessive physical exercise, choosing what burns more calories.
- Taking physical exercise immediately after eating, usually alone.
- Depressed mood, irritable and anxious.
- Withdrawal from friends.
- Tendency towards perfectionism.
- Very critical and demanding of themselves.
- Always talking about food and their figure.
- Deny being hungry.
- Constantly worried about weight, shape and an exaggerated fear of being obese.
When the disorder is more advanced, other signs may appear, including:
- Interruption of the menstrual cycle (amenorrhea).
- Thin and sparse hair. Growth of very fine body hair (lanugo).
- Enlargement of the salivary glands.
- Changes in the teeth, caused by repeated vomiting.
- Frequent gastrointestinal problems.
- Yellowing of the palms of the hands and soles of the feet.
- Callouses on the backs of the fingers caused by repeated provocation of vomiting.
- Small haemorrhages in and around the eyes caused by the force of retching during vomiting.
- Cold and dry skin. Pallor. Brittle nails.
