Anorexia Nervosa
Anorexia nervosa is a serious eating disorder involving restriction of food intake leading to significantly low body weight, managed per the APA 2023 Practice Guideline for Eating Disorders.
Symptoms
Restriction of food intake leading to a significantly low body weight, an intense fear of gaining weight, and a distorted body image or denial of the seriousness of low weight.
Causes and risk
A combination of genetic vulnerability (high sensitivity to threat, difficulty delaying reward, cognitive rigidity) and social/psychological factors; per medical complications research, it carries some of the highest mortality of any psychiatric illness.
How it is evaluated
Diagnosis follows DSM-5 criteria; medical evaluation for complications (bradycardia, electrolyte abnormalities, bone density loss) is essential and guides urgency of treatment.
Treatment
A multidisciplinary team (medical, nutritional, and psychiatric) is standard per the APA guideline, which emphasizes weight restoration, psychotherapy, and treating at the least restrictive level of care that is safe.
When to seek care
Warning signs requiring urgent medical evaluation include a heart rate under 50 during the day (or under 45 at night), blood pressure under 90/45, a body temperature under 96°F, fainting, or a BMI at or below 15, per ACOG guidance -- these can signal a need for hospitalization.