Anorexia Nervosa

Key Takeaways

• Anorexia is characterized by a restriction of caloric intake and, in some cases, binge eating and purging that leads to a body weight substantially below average
• Symptoms can manifest as an intense fear of weight gain, an inaccurate perception of one’s body, obsessive calorie counting, excessive exercise, social withdrawal, and more
• Treatment for anorexia nervosa may involve hospitalization (for severe cases), nutritional rehabilitation and counseling, various forms of therapy, and in some cases, medication

Understanding Anorexia Nervosa

Unlike many other mental health conditions, historical accounts of eating disorders are limited, and their clinical presentations have evolved considerably over time. The earliest known medical documentation of self-starvation due to psychiatric reasons dates back to 1689, with the term anorexia nervosa introduced nearly two centuries later in 1874. ^[1]

However, although the disorder had officially been named, anorexia remained rare and largely uninvestigated. By the 1960s, a pathological fear of gaining weight was identified as a key characteristic of the condition, which was then considered a culture-specific disorder primarily affecting young women from upper social classes in Western societies. ^[1]

Anorexia tends to begin with a diet before evolving into an obsession that can lead to potentially life-threatening physical health complications. Losing weight can be “addictive,” and many individuals with anorexia experience a sense of control from developing a rigid relationship with food and exercise. ^{[1] [2]}

People with anorexia are preoccupied with body weight and food, fear weight gain, and have a distorted body image that causes them to believe they are overweight, when in reality, their body mass index (BMI) is dangerously low. BMI is a number calculated from a person's weight and height that is used to estimate whether they have a healthy body weight for their height. ^[1]

While some individuals with anorexia nervosa may perceive themselves as thin, they often fail to grasp the serious medical risks associated with their malnourished condition. Anorexia typically presents as abnormal eating habits and rituals that can take the form of repetitive weighing, measuring, and mirror-checking, as well as collecting recipes or hoarding food. ^[3]

Types of Anorexia Nervosa

There are two types of anorexia - the more commonly known restricting type, where a person excessively limits their food intake, and the bingeing/purging type, where an individual eats large quantities of food after restricting and then either vomits or uses laxatives to eliminate calories after eating (purges). ^[1]

It is important to note that some people with the purging subtype of anorexia do not engage in binge eating but frequently purge after eating even small amounts of food. Additionally, individuals with the purging type tend to be more impulsive and have higher rates of substance abuse, with both types having the potential to engage in excessive exercise. ^[3]

The Rise of Anorexia and Emerging Connections to Social Media

According to a 2024 study, eating disorders (including anorexia) are increasing, and the improper use of social media platforms is likely a major contributing factor. The trend is particularly evident among adolescents, who are using social media more frequently for communication, learning, relationship building, and entertainment. ^[4]

The unregulated sharing of content on social media can severely affect the physical and mental health of young people, often through exposure to “thinspiration” or “fitspiration.” These terms refer to content commonly shared on social media that aims to inspire individuals to attain thin or fit bodies. ^[4]

While content promoting unrealistically thin or fit physiques may serve this purpose in healthy individuals, in those prone to anorexia, it can lead to obsession. Additionally, this type of content can promote unhealthy body image standards and exacerbate or encourage the development of disordered eating habits in susceptible individuals, including children. ^[4]

These platforms also contribute to issues with self-esteem and feelings of self-loathing. A study examining TikTok usage among children and adolescents diagnosed with eating disorders revealed that participants often encountered content related to anorexia (referred to as Pro-Ana) and bulimia nervosa (referred to as Pro-Mia) without intentionally seeking it. ^[4]

The influence of online social connections is strong, as virtual communities can shape individual behaviors and beliefs through peer influence and perceived social norms. Influencers who appeal to adolescent audiences can further shape eating behaviors through the content they share, often being viewed as role models in terms of food choices and body image. ^[4]

How Common Is It?

Anorexia nervosa can impact individuals of any body size, age, race, ethnicity, or gender; however, the disorder is more commonly seen in women than in men. In fact, since 1930, the prevalence of anorexia among young women aged 15 to 19 has risen with each passing decade. ^[1]

Anorexia can begin at any stage of life, most often during adolescence, but also in childhood or later adulthood, including after age 40. Lifetime prevalence ranges from 0.3% to 1%, though European studies have reported higher rates of between 2% and 4%, regardless of culture, ethnicity, or race. ^{[1] [5]}

Symptoms

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anorexia nervosa is characterized by a restriction of caloric intake that leads to significantly low body weight relative to age, gender, development, and health. People with anorexia also have a distorted perception of their body and think it is larger than it actually is. ^[3]

Anorexia nervosa symptoms include an intense fear of putting on weight and engaging in behaviors that prevent weight gain, even when already underweight. Additionally, individuals with the disorder place excessive importance on shape and believe that their physical form is the only way to attain self-worth, often failing to recognize the seriousness of their low weight. ^[3]

These underlying thought patterns may manifest as behavioral, emotional, or physical symptoms: ^[1]

Behavioral Symptoms

• Intense fear of weight gain or becoming “fat”
• Distorted body image and self-perception
• Restricting food intake or skipping meals
• Obsessively counting calories or weighing food
• Rigid, ritualistic, or abnormal eating habits (such as cutting food into very small pieces, rearranging food, or eating very slowly)
• Hiding or disposing of food secretly
• Disappearing to the restroom after meals
• Wearing baggy clothing to hide body shape or weight loss
• Obsessive focus on food preparation or cooking without eating
• Gathering recipes or hoarding food
• Frequent checking of body weight or appearance in the mirror
• Excessive or compulsive exercise

Emotional Symptoms

• Dismissal of hunger or refusal to eat
• Social withdrawal and isolation
• Difficulty with spontaneous social interactions
• Diminished sexual drive
• Irritability and mood swings
• Persistent sadness or depression
• Anxiety or discomfort around eating in public
• Feelings of inadequacy or low self-worth
• Intense need to maintain control over surroundings
• Emotionally reserved or overly controlled expression
• Rigid or black-and-white thinking patterns

Physical Symptoms

• Significantly underweight
• Inadequate nutritional intake or poor nutrient status
• Dehydration or loss of body fluids
• Persistent fatigue or lack of energy
• Constipation or digestive discomfort
• Abdominal bloating or stomach pain
• Increased sensitivity to cold temperatures
• Growth of fine, soft body hair (lanugo)
• Dry or yellow-toned skin
• Thinning hair or hair loss
• Fragile nails that break easily
• Difficulty conceiving or infertility

Causes

Studies indicate that multiple factors can raise the risk of developing anorexia, particularly when combined. These include genetic (family history of co-occurring physical and mental health issues), social, and environmental influences, as well as metabolic dysfunction, comorbid psychiatric conditions, and altered brain function that mirrors addiction. ^[1]

Genetics and a Family History of Co-Occurring Conditions

Evidence for the genetic component of anorexia comes from studies of families and twins, showing the condition tends to run in families. The latest large genetic study on anorexia included nearly 17,000 people with the condition and found eight key genetic regions linked to it. ^{[6] [7]}

Additionally, Individuals with anorexia are more likely to have family members who have experienced certain health issues, including weight difficulties, physical illnesses, and mental health conditions, such as: ^{[1] [6]}

• Depression
• Substance abuse
• Anxiety disorders
• Obsessive-compulsive disorder
• Bulimia nervosa

Social Influences

A 2021 review identified four main factors linked to social media that contribute to disordered eating, including eye-catching visuals, how content spreads, social connections online, and adolescent influencers. Eye-catching visuals involve attractive pictures and videos of products offered by food companies, which can encourage dysfunctional eating. ^[4]

The algorithm also affects the type of content seen by users, and is likely to promote “thinspiration” and “fitspiration” to vulnerable individuals who have previously shown interest in this type of content. Social media also makes it easy to share recipes and food experiences that showcase unhealthy eating behaviors, especially among adolescents with eating disorders. ^[4]

Environmental Factors

Environmental factors that may contribute to anorexia include familial pressures, such as a family history of restrictive eating and weight control behaviors. Childhood abuse and family dysfunction may also play a role in the development of anorexia nervosa. ^{[6] [8]}

Additionally, influences known to increase the risk of anorexia nervosa include societal pressure to be thin, which are often encouraged in elite sports that focus on body size and dieting such as: ^{[1] [6]}

• Ballet
• Cheerleading
• Figure skating
• Gymnastics
• Modeling
• Bodybuilding
• Wrestling
• Jockeying

Metabolic Dysfunction

Emerging research suggests that metabolism may play a role in the development of anorexia, with two large studies finding that people with anorexia exhibit differences in cholesterol levels and how the body processes insulin and fat. ^[9]

Additionally, these studies found that the genes linked to body weight and blood sugar levels in those with anorexia are often the opposite of individuals with a higher weight, suggesting that biological factors, not just mental health, may play a role in the disorder. ^[9]

Comorbid Psychiatric Disorders

Research shows a strong link between depression, anxiety, and eating disorders in both men and women. Most studies found that feeling depressed or having negative emotions is closely tied to developing eating disorder symptoms. Depression can also make people more likely to adopt unrealistic beauty ideals and engage in harmful eating habits. ^[8]

People with eating disorders like anorexia additionally experience other mood disorders, trauma-related issues, OCD, substance use, personality disorders, and neurodevelopmental disorders. Self-harm and suicidal thoughts are also frequent and can be worsened when more than one mental health issue is present. ^[10]

Altered Brain Function

Studies show that people with active anorexia have the largest reductions in brain thickness compared to other mental health conditions studied so far. The findings show that when people with anorexia are underweight, their brain’s outer layer and some deeper brain areas are much smaller than normal. ^[11]

Additionally, an emerging theory is that issues with how the brain processes rewards might cause restrictive anorexia in a similar way to addictive behaviors. People with eating disorders showed clear differences in how the putamen (a part of the brain linked to learning, movement, and processes like reward, thinking, and addiction) is connected to other areas. ^{[2] [12]}

When Does it Develop?

A 2024 review states that anorexia mostly affects adolescents, but rare cases are documented in younger children too. When anorexia develops before the age of puberty, it is referred to as early-onset (or prepubertal) anorexia nervosa. ^[13]

While the disorder typically develops during adolescence and young adulthood (with the average peak of onset being 15.5 years of age), anorexia can also emerge later in life. However, this is unusual and often indicates that the condition was missed at an earlier stage. ^[14]

Psychiatric Conditions Associated with Anorexia

Anorexia often co-occurs with other mental health conditions, with studies showing that between 55% and 95% of people diagnosed with an eating disorder are also diagnosed with at least one other mental health condition. The most commonly co-occurring psychiatric disorders include: ^[10]

• Anxiety disorders: 74% of people with eating disorders also struggle with anxiety, particularly surrounding food intake and weight gain
• Mood disorders: 54% of individuals with eating disorders have mood disorders such as depression, with overlapping symptoms including low self-worth, body dissatisfaction, loneliness, isolation, and feelings of being out of control, angry, or irritable
• Trauma and stress-related disorders: At least 52% of those with an eating disorder have a history of trauma, often preceding the eating disorder's onset
• Obsessive-compulsive and related disorders: Obsessive symptomology is frequently seen in eating disorders, such as preoccupations with weight loss, and repetitive compulsions like measuring, weighing, body checking, and food-related rituals.
• Substance use disorders: Anorexia and substance use are related as they are both unhealthy coping mechanisms. Substance abuse is more common in individuals who purge, although some individuals may use drugs to suppress their appetite
• Personality disorders: Various personality disorders frequently co-occur alongside eating disorders, including obsessive-compulsive personality disorder and borderline personality disorder
• Neurodevelopmental disorders: Neurodevelopmental disorders, such as ADHD or autism spectrum conditions, commonly co-exist with anorexia nervosa and share overlapping symptoms
• Non-suicidal self-harm and suicidality: Self-harm is also common in people with anorexia, and can become more severe with multiple coexisting psychiatric conditions

Suicide Hotline

If you or someone with anorexia that you know is struggling with thoughts of suicide, it is crucial to get help right away. In the United States, you can call the Suicide and Crisis Lifeline at 988. For international suicide hotlines, you can find a comprehensive list here.

If your country is not listed, simply search for “suicide hotline” \+ “your country’s name” to find emergency contact details for immediate assistance. Remember, people with anorexia who are suicidal need urgent care, and in some cases, hospitalization.

Risks and Complications

In addition to the increased risk of developing a comorbid psychiatric disorder, the extreme malnutrition associated with anorexia can lead to critical health issues. The more severe the disorder is, the more life-threatening the health complications can become. Anorexia often causes: ^[15]

• Cardiac issues: Anorexia leads to a decreased heart rate, low blood pressure, and potential valve problems due to the heart shrinking from insufficient food intake. While the heart's pumping function is often maintained, there is a significant, unexplained increased risk of sudden cardiac death
• Gastrointestinal problems: Restrictive eating causes the digestive system to slow down, causing constipation, liver problems, issues with the stomach emptying, and at times, blocked digestion
• Pulmonary issues: Lung function can be affected by anorexia nervosa, with anorexic individuals at a higher risk of collapsed lungs, lung infection, and abnormal breathing patterns
• Blood cell abnormalities: Malnutrition impacts bone marrow and leads to a low white blood cell count, anemia, and low platelet counts (all of which typically resolve with refeeding)
• Endocrine imbalances: Hormones are severely disrupted by anorexia, causing menstruation to cease in females, low testosterone in males, growth hormone resistance, high cortisol, and in some cases, dangerously low blood sugar
• Muscle and bone loss: Significant muscle wasting (muscle atrophy) and severe, potentially irreversible bone density loss occur with excessive food restriction, increasing the risk of fractures
• Brain atrophy: Anorexia can cause the brain to shrink in size, which often reverses with weight restoration, but may lead to lasting cognitive issues
• Dermatological complications: Without adequate nutrition, an individual’s skin becomes dry, bluish, and may develop fine, downy hair. Hair and nails become brittle, and the skin can turn yellowish

Severe anorexia (especially the purging subtype) is associated with life-threatening physical complications, including: ^[16]

• Critically low BMI
• Multiple bone fractures and osteoporosis
• Chronic low potassium
• Dangerous irregular heartbeats, increasing risk of sudden cardiac death
• Anemia requiring blood transfusions
• Respiratory complications and hospital-acquired infections

Prevention

Experts are inconclusive in regards to anorexia prevention, but certain positive habits may reduce the risk. Studies suggest that family interventions, such as supporting healthy attitudes about food, body image, exercise, and weight, may help. Additionally, encouraging activities that engage skills and interests (eg. hobbies or helping others) can shift the focus from appearance. ^[1]

Furthermore, programs that promote body positivity (such as journaling, support groups, affirmations, and guided reflections) are being used more frequently to help people build a healthier body image and lower the risk of developing anorexia. Additionally, reducing or avoiding social media use may help prevent these problems from arising. ^{[17] [18]}

Alternatively, having a solid understanding of how social media can be misleading (social media literacy) and developing a positive view of one's body can help to protect against its negative effects. Social media literacy is often taught as part of body-positive programs and is being increasingly implemented by professionals in an effort to prevent eating disorders. ^{[17] [18]}

Finally, starting treatment for eating disorders early has shown good results and is generally well-received by individuals in the early stages of anorexia. To help overcome challenges such as denial or a lack of motivation to recover, research shows that support and encouragement from friends and family play an important role in early intervention. ^[19]

Diagnosis Tests and Assessments

Individuals with anorexia frequently attempt to hide their condition from others. However, over time, those close to them may become concerned about noticeable changes in weight or behavior. Encouraging early diagnosis is important and can help prevent serious health complications. ^[1]

When diagnosing anorexia, healthcare providers typically review the affected individual’s medical and weight history, conduct a physical examination (including weight criterion), and may recommend psychological evaluations. The professional will also investigate nutritional behavior and physical activity levels. ^{[1] [16]}

Weight Criterion

Doctors typically use a severity scale from the DSM-5 to determine the severity of the anorexia and whether the individual requires hospitalization. This scale is based on body mass index (BMI), which is calculated by dividing a person’s weight in kilograms by their height in meters squared, and the severity scale is as follows: ^[6]

• Mild: BMI is between 17 and 18.5 (A little below normal weight)
• Moderate: BMI is between 16 and 16.99 (More underweight than mild)
• Severe: BMI is between 15 and 15.99 (Seriously underweight)
• Extreme: BMI is less than 15 (Dangerously low and very serious)

Laboratory Diagnostic Testing

When an individual is diagnosed with anorexia, doctors often run blood tests to check overall health and monitor changes over time. One key test looks at leptin, a hormone that helps regulate body fat and hunger signals. Very low leptin levels can show how much body fat has been lost and how severe the starvation is, even if the person does not acknowledge the issue.

Psychiatric Evaluations

The Eating Disorder Examination (EDE) interview and Eating Disorder Examination Questionnaire (EDE-Q) are the most commonly used tools for evaluating whether a person meets the diagnostic criteria for anorexia. These assessments have been carefully studied for accuracy and are considered the gold standard for evaluating eating disorder pathology. ^[20]

The EDE interview is the most commonly used tool for diagnostic assessment, while the EDE-Q is favored for its practicality in large-scale and clinical settings. Both are good at measuring anorexia, with the EDE found to be more reliable for identifying specific behaviors such as binge eating (a criterion for the binging and purging subtype of anorexia). ^[21]

Eating Disorder Examination (EDE)

The Eating Disorder Examination is an interview used to assess a wide range of eating disorder symptoms, including those presenting in people with anorexia. The interview was initially designed to evaluate anorexia and bulimia, and consists of four subscales, which focus on key areas related to eating disorders: ^[22]

• Dietary restraint
• Eating concern
• Weight concern
• Shape concern

Eating Disorder Examination Questionnaire (EDE-Q)

While the Eating Disorder Examination-Questionnaire is highly effective at identifying anorexia diagnoses and providing a detailed understanding of symptoms, it requires significant time and training to administer. For this reason, many researchers and clinicians choose to use the EDE-Q, which is the self-report version of the EDE. ^[23]

The EDE-Q consists of 28 questions adapted from the Eating Disorder Examination, based on the same four subscales, and is intended for individuals aged 14 and older. The questionnaire is designed to measure the frequency, range, and severity of behaviors linked to anorexia nervosa. ^[24]

The EDE-Q can be completed either in person or online and is available in many languages. There are also several versions of the EDE-Q tailored for different groups, including the EDE for Adolescents (EDE-A), the Youth Eating Disorder Examination Questionnaire (YEDE-Q), and the EDE-Q Parent Version (EDE-Q-PV). ^[24]

Nutritional Behavior Assessment

A thorough nutrition assessment involves collecting information about current and past eating habits and the duration of these patterns. It also includes detailed information about the types, amounts, and timing of foods or beverages consumed, eating environments, as well as food preparation methods. ^[25]

Additionally, nutritional evaluations investigate patterns around the source of meals (eg. restaurants, brands, or meals prepared by particular individuals). Many people with anorexia prefer to make their own meals, so it is common for them to be the only ones preparing their food. ^[25]

A nutritional review also looks at behaviors such as: ^[25]

• Counting calories
• Fasting
• Measuring or weighing food
• Chewing and spitting
• Binge eating
• Purging
• Using large amounts of condiments or spices (to make food taste inedible)
• Drinking excessive amounts of water
• Avoiding certain foods or entire food groups

Physical Activity Assessment

The individual’s activity level is evaluated both on its own and in connection with their eating habits. Additionally, the use of dietary supplements and medications (whether prescribed or over-the-counter) is also reviewed to determine if they are being misused. Information is gathered directly from the person, as well as from family members who may be present. ^[25]

Treatment Options

Anorexia is a serious condition, but recovery is possible with support from healthcare providers and a recommended treatment plan. Anorexia nervosa treatments vary based on the severity of the disorder, ranging from hospitalization and inpatient treatment to therapy and nutritional counselling. In certain cases, medication may be prescribed. ^{[1] [5] [26]}

Hospitalization and Inpatient Treatment

People with anorexia who are not physically stable should be hospitalized right away, as their condition can be life-threatening due to both medical and mental health complications. Hospitalization is also necessary when there is a lack of social support or persistent behaviors such as purging, refusal to eat, or compulsive exercise. ^{[5] [6]}

Reintroducing Food and Restoring Nutrition (Realimentation)

All major treatment guidelines highlight that quickly regaining weight is a key part of recovering from an eating disorder. Gaining weight is essential for both mental and physical healing - and for improving overall quality of life. In order to achieve this, healthcare professionals reintroduce food to restore nutrition (a process referred to as realimentation). ^[26]

Research suggests that weight gain targets are often 200 to 500 grams per week, and 500 to 1000 grams for hospitalized patients. Severely underweight individuals can safely start to reintroduce food at around 2000 calories daily while their blood minerals are closely monitored to prevent refeeding syndrome, a serious risk marked by low phosphate levels. ^{[5] [26]}

To gain around 700 grams weekly, patients may need to consume over 3000 calories daily, often in the form of high-calorie foods. Digestive issues are common early on but usually improve with weight gain, while mental recovery from starvation can take several weeks despite steady physical progress. ^[26]

Therapy

In addition to restoring nutrition through realimentation, therapy forms a key part of treatment for anorexia. During the early stages of starvation, psychotherapy primarily helps to boost motivation and address common fears (such as unrealistic worries about gaining too much weight). ^[26]

As treatment progresses, therapy shifts toward exploring personal challenges and developing healthy coping techniques. In the final stages, the main goal becomes preventing relapse and maintaining recovery. A 2024 review recognizes the following forms of therapy as beneficial in the treatment and ongoing management of anorexia nervosa: ^[26]

• Cognitive-behavioral therapy for eating disorders (CBT-ED): Helps individuals with anorexia recognize and challenge dysfunctional thoughts and behaviors related to food, body image, and self-worth
• Family therapy: Involves the whole family in treatment, which is especially helpful for children and adolescents. This form of therapy supports healthy communication and recovery at home
• Behavioral therapy: Focuses on changing harmful eating-related behaviors through habit-building strategies. Behavioral therapy aims to assist with trigger tracking, developing healthy coping strategies, and setting achievable goals
• Interpersonal psychotherapy: Targets relationship issues and life transitions that may trigger disordered eating in the form of excessive restriction
• Maudsley model for adults with anorexia nervosa (MANTRA): A structured therapy that focuses on motivation to change, building self-compassion, and strengthening interpersonal relationships that support recovery
• Mixed or non-specific psychotherapy: Combines elements from various therapy approaches or uses general supportive counseling techniques
• Psychodynamic-oriented psychotherapy: Focuses on unconscious patterns and past experiences that may influence current eating behaviors
• Psychoeducation: Provides information about eating disorders, nutrition, and coping strategies to empower and inform the patient and their support system
• Sports therapy: Uses supervised physical activity to rebuild a healthy relationship with movement and body awareness

Nutrition Counseling

Nutritional counselling is a form of psychoeducation that helps individuals with anorexia understand the importance of balanced eating for physical and mental recovery. It provides guidance on meal planning, nutrient needs, and the effects of starvation on the body. Nutritional counselling also addresses fears around food, works to rebuild trust in eating, and helps patients move toward a healthier relationship with food. ^[1]

Medication

Pharmacotherapy is not the first step in treating anorexia, but it may be used when patients do not respond to initial care or have other mental health conditions. There is no officially approved anorexia nervosa medication, and evidence for effectiveness is limited. However, some drugs may be used in certain cases: ^[5]

• Selective serotonin reuptake inhibitors (SSRIs): Antidepressants that help regulate mood and anxiety, though the drugs show minimal impact in undernourished patients
• Tricyclic antidepressants (TCAs): TCAs are older antidepressants that are less commonly used due to their potential to cause heart problems
• Olanzapine: An atypical antipsychotic that may help with weight gain, anxiety, and obsessive thoughts in severely anorexic individuals
• Other antipsychotics: Less effective than olanzapine for weight gain, but sometimes used to reduce agitation and disordered thinking

Experimental Medications

In addition to the above-mentioned medications, researchers are investigating the following pharmaceuticals: ^[26]

• Cannabinoids: Investigated in small studies for their potential to increase appetite
• Ghrelin agonists: Experimental drugs that mimic a natural hunger hormone and may help stimulate appetite
• Psilocybin: Colloquially termed “magic mushroom,” psilocybin is being studied for its possible effects on mood and rigid thinking present in people with anorexia nervosa
• Metreleptin (recombinant leptin): An experimental hormone treatment thought to address mental symptoms caused by starvation-related leptin deficiency

Home Management and Self-Care

Anorexia nervosa is a serious condition that requires professional treatment. That said, the following self-care tips may help to manage recovery in combination with therapy, nutritional counseling, and potentially medication.

Avoid Triggers

Social media and certain online content promote unhealthy body images and eating habits that trigger anorexia. It is important to limit exposure to these sources and focus on positive, supportive content in the form of books, films, or podcasts. Finding healthy activities and people who encourage recovery can also help reduce the influence of harmful triggers.

Avoid Counting Calories or Weighing Yourself

Due to the fact that weighing yourself and counting calories can lead to obsession and compulsive restricting, it is best to avoid these behaviors entirely. Unfortunately, most people who struggle with anorexia are already aware of the calorie content of most foods, so it can be helpful to use cognitive-behavioral therapy techniques to shift your thoughts or distract yourself if you are tempted to mentally count. ^[1]

Focus on the Benefits of Nutrition

Nutritional counselling can help those with anorexia to become aware of the health and beauty benefits of nutritious food. When thoughts of restriction arise, it can be helpful to remind yourself that nutrient dense foods have a strong link to good mental health and brain function. Additionally, eating a variety of nutrients is the key to glowing skin and voluminous hair.

Embrace a Balanced Lifestyle

In order to reap the full rewards of nutrition, it is necessary to not only eat regularly but also to eat a wide variety of vitamins and minerals. This means embracing all food groups, including carbs, fats, and protein. If you are battling to motivate yourself to eat, try to reframe planning, shopping, and cooking as a game where the goal is to get the most nutrients possible.

Listen to Affirmations While You Eat

Anorexia often comes with feelings of unworthiness and beliefs that you do not deserve to eat. To combat this, it is a good idea to listen to some affirmations while you eat to encourage and support yourself. Look for affirmations that are focused on health, self-love, and personal growth, particularly on the more difficult days.

Reframe Food as a Celebration

Experiment with new recipes or buy foods you have not tried before, just because you want to see how they taste. Endeavour to be open-minded and curious about food, and remind yourself that you are allowed to treat yourself, for the sake of your mental and physical health. By adopting a creative and experimental attitude, food can ultimately become a celebration of life.

Support Groups

Research has revealed that support groups can be of benefit to individuals with anorexia. Eat Breathe Thrive offers a variety of programs to maintain eating disorder recovery, including free online yoga courses, support groups, and professional training for those seeking to help others. ^[1]

Eating Disorders Anonymous is a free platform that encourages finding a sponsor (mentor) who can guide you through challenges around anorexia and supervise self-reflection through the completion of the 12 steps (a series of questions designed to challenge dysfunctional thoughts).

Final Thoughts

Anorexia nervosa is a severe and potentially life-threatening mental health condition characterized by an intense fear of weight gain and restricted food intake. Early identification and comprehensive treatment are crucial for recovery and preventing long-term physical and mental health complications.

Treatment involves a multidisciplinary approach, including hospitalization for severe cases, nutritional rehabilitation and counselling, psychotherapy, and potentially medication. Recovery is possible, and these treatments aim to restore healthy eating habits, address underlying psychological issues, and help individuals with anorexia lead a fulfilling, healthy life.

Author

Star Gorven

Star Gorven is a wellness and mental health writer with a talent for crafting evocative and evidence-based content across a wide range of topics. Her work blends analytical research with imagination and personality, offering thoughtful insights drawn from her exploration of subjects such as psychology, philosophy, spirituality, and holistic wellbeing.

Activity History - Last updated: March 19, 2026, Published date: March 19, 2026

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Reviewer

Jennifer Brown

Dr. Jennifer Brown is dual board-certified in family medicine and obesity medicine. She currently works for Amwell Medical Group, providing virtual primary care services, including mental health treatment.

Activity History - Medically reviewed on April 6, 2026 and last checked on March 19, 2026