anorexia nervosa with hair loss

  • FUE Hair Transplant
  • FUT Hair Transplant
  • Beard Transplant
  • Eyebrow Transplant
  • Female Hair Transplant
  • Crown Hair Transplant
  • Afro Hair Transplant
  • Forehead Reduction Surgery
  • How Many Grafts Do I Need
  • Hair Transplant Recovery
  • Hair Transplant Growth Chart
  • Consultation Questions To Ask
  • Hair Transplant Costs UK
  • Low Level Laser Therapy
  • Female Hair Loss Treatment
  • Before & After
  • Hair Loss Facts & Statistics
  • Female Pattern Baldness
  • Male Pattern Baldness
  • Ludwig Scale
  • Norwood Scale
  • Minoxidil For Beard
  • Finasteride
  • Dutasteride
  • London Harley St

anorexia nervosa with hair loss

Wimpole Hair Transplant Clinic UK Logo

Anorexia And Hair Loss: What You Need To Know

anorexia nervosa with hair loss

  • Share on Twitter
  • Share on Facebook
  • Share on LinkedIn

Anorexia nervosa is a mental health disorder characterised by an obsession over weight, restricted eating, and a distorted body image. Sufferers often lose weight rapidly, becoming malnourished. The health risks of eating disorders like anorexia are well-known — but did you know anorexia can also cause hair loss [1]?

Find out how and why anorexia affects hair loss, and how you can begin to recover from an eating disorder to restore both your physical health and hair health.

Why do people with anorexia lose hair?

What are the symptoms of anorexia hair loss, abi’s story, hair loss as a sign of anorexia, body hair growth and anorexia, bulimia and hair loss, recovery from anorexia hair loss, what to do if you’re experiencing hair loss and anorexia.

People with anorexia nervosa typically eat an extremely low-calorie diet. As food is increasingly restricted, the body ceases to send nutrients to body parts that aren’t essential for survival. That means nail beds and hair follicles stop receiving nutrients, leading to weak, brittle hair and nails, and ultimately hair loss and hair thinning.

Restricted diets can also shock the hair into falling out. This process is called telogen effluvium and usually occurs as a result of emotional difficulty or trauma .

People suffering from anorexia nervosa may experience a receding hairline, hair loss, and thinning hair. They can also undergo loss of vitality, due to vitamin deficiencies caused by their disordered eating. As a result, sufferers in some cases lose their eyelashes and experience receding cuticles and gums as well.

thinning hair in anorexia patient

Abi Jones* shared her experience of anorexia nervosa with The Wimpole Clinic:

“I was eight when it started. A girl at school called me a ‘fat b****’ and I went quickly from 10 stone to a dangerously underweight 5.5 in a number of months. When I was at my worst my hairline receded and gums receded too.

“I also lost my eyelashes and it slowed my pubic development, so I didn’t grow hair elsewhere for a number of years, despite [having started] monthly cycles. It had a huge impact on my hormones and I still struggle with that now.”

Low self-esteem

Changes to your hair due to an eating disorder are distressing and unwanted, but sufferers are not alone. Ms Jones says she never felt happy with her appearance, which triggered her eating disorder.

When she lost her hair and eyelashes, it fed into her low self-esteem. She says,

“I just felt like I was being punished for being fat… I was being punished for my hair being horrid, nowhere to put mascara.”

Hair loss can be a clear sign that someone you know is suffering from an eating disorder, especially if they’re young [2].

If you notice someone has thin or patchy hair and is displaying disrupted eating patterns, it’s important to raise the issue with them in a sensitive way. Find out how to talk to someone about an eating disorder .

Conversely, some people with anorexia see more hair growth on their body. Increased body hair can occur as a result of hormone imbalances caused by anorexia.

More commonly, body hair growth in anorexic people is often in the form of a soft, downy hair called lanugo.

More commonly seen in newborn babies, this condition rarely occurs in adults. Lanugo develops when the body is trying to conserve heat, and is a symptom of severe anorexia.

which vitamin deficiency causes hair loss - featured image by freepic.diller on Freepik

Bulimia nervosa is another common eating disorder, and can also cause hair loss. This eating disorder is characterised by excessive eating in a short space of time, followed by immediate removal of food from the body either by vomiting or taking laxatives.

Like anorexia, bulimia disrupts the hair’s growth cycle, causing temporary hair loss as a result of shock.

Hair loss stemming from anorexia is usually temporary. That means when you begin to eat more, healthy hair growth will usually return.

It isn’t easy to overcome an eating disorder. However, with proper psychological treatment, it is possible to return to a healthy body weight and restore strong hair after anorexia nervosa.

With treatment and good nutrition, hair can regain strength and vitality, allowing those recovering from eating disorders to benefit from higher self-esteem, and feel better about their appearance.

Ms. Jones, who suffered a receding hairline but has now recovered, comments,

“My hair is a huge part of my identity now… I wonder if that’s why? I won’t cut it short. My hair and nails, I really look after them. It’s a really valuable thing to me now.”

To reverse the effects of anorexia hair loss, you should speak to your GP or a mental health professional. They can refer you to a specialist who can help you overcome your eating disorder.

If you’re suffering from hair loss due to an eating disorder, a hair loss specialist such as the Wimpole Clinic may be able to help you manage your symptoms and find a treatment for female hair loss . 

Book a consultation with an experienced trichologist to discuss any concerns you have about your hair loss.

Addressing the cause of your hair loss is the best way to restore it. Anorexia nervosa is a serious mental health condition which requires specialist treatment. For information and support regarding mental health issues, visit https://www.mind.org.uk/.

For more information regarding eating disorders visit the National Eating Disorders Association (NEDA) website.  

*names have been changed to protect confidentiality

  • Anorexia nervosa – medical complications
  • General Characteristics of Hair in Eating Disorders

Blog search

anorexia nervosa with hair loss

Book a consultation

Simply fill in your details in the form below and we'll get in touch with you shortly.

  • Clinic * Choose Clinic Location* London, Harley Street Birmingham Brighton Bristol Leicester Manchester Newcastle Nottingham Oxford Mayfair Hair (VIP)
  • I consent to my information being used to contact me regarding my enquiry in accordance with our Privacy Policy
  • I would like to receive information, promotions and offers via email
  • Eating Recovery Center
  • Mood & Anxiety Center

Suggestions

Common searches.

  • Eating Disorders
  • Family Programming

Anorexia Hair Loss Explained

By Delia Aldridge

Table of Contents

Anorexia and hair loss

What is anorexia, what causes hair loss with anorexia, what does anorexia hair loss look like.

  • Complications and signs of anorexia

How to stop hair loss from anorexia

Find help for hair loss and anorexia.

Hair loss is one of many side effects of anorexia nervosa, a restrictive eating disorder. With anorexia nervosa (here referred to as anorexia), hair loss occurs after one restricts their food or engages in other eating disorder behaviors ( purging , excessive exercise ). Over time, as the eating disorder behaviors continue, an individual with anorexia becomes malnourished, causing hair loss and numerous other serious health risks.

Anorexia is an eating disorder that affects people of all genders, races, ethnicities and ages. People with anorexia experience some or all the following symptoms:

  • Intense fear of weight gain
  • Body image issues
  • Restricted eating
  • Binge eating and purging

One of the hallmark signs of anorexia is the denial that anything is wrong. People with eating disorders often do not see their symptoms as others see them. They may not think they have a problem at all. This can make it hard for people with anorexia to reach out for help or to seek eating disorder treatment.

When a person restricts the food they eat by eating less or engaging in other eating disorder behaviors, the body becomes depleted of nutrients. Without enough nutrients, the body cannot function normally.

When food is restricted over a period, malnourishment can occur. A malnourished body will try to redistribute any remaining nutrients/energy to keep the body’s organs and systems functioning as well as possible. This can lead to hair loss. Here’s an example of how it happens.

  • The body continues to send nutrients to the most essential body functions (cardiovascular, respiratory, etc.).
  • The body stops sending nutrients to nonessential body functions.
  • Hair loss occurs as the body stops sending nutrients to the hair follicles.

Along with the process mentioned above, there are other potential causes of hair loss in individuals with anorexia, such as:

  • Hormonal changes
  • Medications
  • Vitamin or nutrient deficiencies
  • Hypothyroidism

When hair loss occurs with anorexia, one’s hair can become brittle and break easily. The fingernails may also become brittle and break easily. Additional signs of anorexia include:

  • Receding hairline
  • Thinning of the scalp hair
  • Clumps of hair falling out
  • Bald spots on the head
  • Eyelash thinning

These symptoms can occur in people of all genders and all ages. When hair loss occurs with anorexia, it is a sign that other health complications may already be taking place.

If you know someone that has been losing hair and they also are showing signs of an eating disorder , they may be experiencing multiple other health problems, as well. Hair loss with anorexia is serious, but it can be treated.

How long does it take for the hair to grow back?

Once an individual has recovered from their eating disorder and has taken in enough nutrients to resolve any medical complications, it may take a few months for hair growth to re-occur. Some individuals may continue to shed hair before the hair growth resumes [1] .

What about anorexia and body hair?

Interestingly, anorexia is associated with new hair growth on the body -- even while scalp hair is lost. Fine, downy hair can grow on certain places on the body, including the face, arms and back. This new hair growth is called lanugo . Lanugo develops to keep the body warm as body fat percentage drops in people with anorexia [2] .

Learn more about lanugo and anorexia here.

Complications of anorexia

Hair loss is just one of the many medical complications related to anorexia. After restricting food for some time, all the body’s systems can potentially be affected, including:

  • Skeletal (loss of bone density)
  • Muscular (loss of muscle mass)
  • Cardiovascular (bradycardia and hypotension)
  • Respiratory
  • Digestive (constipation)
  • Reproductive (missed or absent periods)

Notably, anorexia can cause functional changes of the heart that may show up as dizziness, headache, exercise intolerance or fatigue. The eating disorder can also cause permanent loss of bone density and irreversible changes to the brain. When anorexia occurs in early adolescence, growth can be stunted. The individual may not achieve their full adult growth potential [2] .

Signs of anorexia

Food restriction, starvation, weight loss and malnutrition can impact nearly every organ system in the body and dramatically affect one’s thoughts and behaviors [3] . And, unfortunately, diagnosing anorexia is not always straightforward.

Even when a person is seriously ill from anorexia, their lab work may come back normal. Therefore, it is important to know the signs of anorexia to watch for. Here are some of the physical and mental signs of anorexia:

  • Reduced strength
  • Reduced libido
  • Hormone imbalances 
  • Preoccupation or obsession with food
  • Irritability
  • Social isolation
  • Self-harm (cutting)
  • Sleep problems
  • Constipation

Thankfully, most of the complications associated with anorexia can be reversed with treatment. However, if the eating disorder is left untreated, an individual may experience many chronic health issues, including hair loss, throughout their lifespan.

The best way to stop hair loss from anorexia is to recover from the eating disorder. A three-pronged approach to treatment is recommended, including:

  • Evidence-based therapies for eating disorders
  • Nutritional counseling
  • Medical management

The most effective eating disorder treatment is found by working with a multidisciplinary team that includes a psychiatrist, primary care physician, therapist and registered dietitian.

Learn more about eating disorder treatment here .

Every day, my team provides support to individuals experiencing hair loss related to anorexia, helping people of all ages and genders recover from their eating disorders.

If you would like to learn more about anorexia treatment at Eating Recovery Center, we invite you to call us at 866-622-5914 . Please know that help is available and recovery is possible.

Read more articles on this topic:

  • Anorexia vs. Bulimia: What’s the Difference?
  • Anorexia Subtypes: Understanding Restricting Type and Binge-Purge Type
  • Lanugo: Anorexia Hair Growth Explained
  • Male Anorexia: A Comprehensive Overview
  • Anorexia in Teens: The Growing Risk of Eating Disorders
  • Hughes, E.C., & Saleh, D. (2023). Telogen effluvium . StatPearls Publishing. Accessed November 21, 2023.
  • Mehler, P.S., & Andersen, A.E. (2022). E ating disorders: A comprehensive guide to medical care and complications (4th ed.) . Johns Hopkins University Press.
  • Sidiropoulos, M. (2007). Anorexia nervosa: The physiological consequences of starvation and the need for primary prevention efforts . McGill Journal of Medicine, 10(1), 20-25.

Struggling with an eating disorder?

One conversation can make all the difference. Connect with us today.

Connect With Us

Delia Aldridge, MD, FAPA, CEDS-S

Delia Aldridge, MD, FAPA, CEDS-S

Related Resources

anorexia nervosa with hair loss

Struggling With Food? When & How to Ask for Help

Blog | Signs and Symptoms

anorexia nervosa with hair loss

Warning Signs of Bulimia: Recognizing Hidden Clues

anorexia nervosa with hair loss

Binge Eating Disorder Screening Tool

Download | Signs and Symptoms

anorexia nervosa with hair loss

Clean Eating Red Flags: 5 Orthorexia Warning Signs

Eating Recovery Center is accredited through the Joint Commission. This organization seeks to enhance the lives of the persons served in healthcare settings through a consultative accreditation process emphasizing quality, value and optimal outcomes of services.

Organizations that earn the Gold Seal of Approval™ have met or exceeded The Joint Commission’s rigorous performance standards to obtain this distinctive and internationally recognized accreditation. Learn more about this accreditation here .

Joint Commission Seal

1-877-825-8584

eatingdisordersonline.com

  • Eating Disorders

Anorexia Hair Growth: The Causes of Hair Loss and Treatment for Hair Re-Growth

By: alexander burns | january 20, 2020.

anorexia nervosa with hair loss

Hair loss, hair thinning, brittle fingernails, and flaky skin are all common side effects of anorexia nervosa and bulimia nervosa. Even though hair loss is not the most dangerous side effect of anorexia, the subsequent change in appearance and body image is often one of the most distressing outcomes for people with an eating disorder.

What Causes Hair Loss?

People with anorexia nervosa typically experience an obsessive desire to become thinner and lose weight. This preoccupation with extreme weight loss often leads to the development of one or more eating disorders, including severe caloric restriction, binge-eating and purging, excessive fasting, and acute over-exercising. In addition to physical side effects, people with anorexia can also experience debilitating emotional and cognitive side effects, including distorted body image, obsessive-compulsive behavior, and depression.

Unsurprisingly, living with an eating disorder can seriously disrupt your body’s essential and non-essential functions. In this case, people who’ve had anorexia for a long time will often show signs of general malnourishment, severe weight loss, and dangerous nutrient deficiencies. While in a state of depleted protein and nutrient conservation, your body will automatically neglect a wide range of non-essential bodily functions, including nail growth, skin repair, and hair growth, in order to maintain your body’s essential organ and tissue functions.

Hair loss due to anorexia first starts when your body is no longer able to efficiently produce keratin, a fibrous structural protein found in hair follicles. The rate of hair loss and hair regrowth in people with anorexia will depend on several different factors, including their level of malnourishment, age, gender, and genetic makeup. As a general rule of thumb, people who’ve suffered from anorexia usually experience a return to regular hair growth after six months of nutritional stabilization.

Treating Hair Loss for People with Anorexia

Hair loss among people with anorexia rarely occurs independently of other symptoms. Light-headedness, dehydration, chronic fatigue, and intolerance to cold are some of the more serious side effects of anorexia nervosa. If you know a family member or friend who is experiencing these symptoms in addition to hair loss, we implore you to reach out and express loving concern and non-judgemental support.

For more information about professional eating disorder treatment, we recommend getting in touch with the National Eating Disorder Association (NEDA), a non-profit organization dedicated to eating disorder prevention, treatment, and awareness. For urgent assistance, contact the emergency services or call the NEDA Helpline.

Sources: ED Catalogue, Psychology Today, The Guardian

Photo: Pexels

More Articles

November 11, 2023.

anorexia nervosa with hair loss

There is currently no approved drug for anorexia nervosa, a common and occasionally fatal eating disorder. Research showed that low doses of a...

In the past, eating disorders were primarily considered to be behavior. This overly-simplistic misunderstanding of the issue only created more...

Sudden light-headedness can be a frightening experience for anyone, particularly if you are unsure of the cause. For many, experiencing occasional...

anorexia nervosa with hair loss

Maintaining a balanced diet not only keeps our body functioning at its best, it also keeps our skin, hair, and nails looking bright and healthy....

anorexia nervosa with hair loss

Researchers are closer to finding the genetic cause for binge eating and might be getting closer to an effective treatment. “Based upon our...

anorexia nervosa with hair loss

When a person begins recovery treatment for anorexia nervosa, they may need to initiate a process known as refeeding. The refeeding process is a...

anorexia nervosa with hair loss

When a baby is in utero, they develop fine white hairs all over their body. These are known as lanugo hairs and they protect the baby’s skin from...

anorexia nervosa with hair loss

A new study published in the journal Pediatrics found more than 90 percent of patients with eating disorders not specifically defined (EDNOS) in...

anorexia nervosa with hair loss

Eating disorders might be hard to talk about, or even to admit to yourself. If you know, or if you even suspect, you have an eating disorder,...

anorexia nervosa with hair loss

If you suspect your child has an eating disorder, you may feel overwhelmed. There are a few things you should know upfront.

First and...

anorexia nervosa with hair loss

Eating disorders don't discriminate. They don't care if you're rich or poor, they don't care about your color or gender, and they don't care if...

anorexia nervosa with hair loss

In the U.S., an estimated one in 200 people develop an eating disorder. That is a startling number, but another number is even more alarming: one...

anorexia nervosa with hair loss

A lot of what people know about eating disorders comes from "common knowledge." Unfortunately, common knowledge isn't always correct, or it may...

anorexia nervosa with hair loss

Anorexia is a serious eating disorder that is characterized by an intense fear of gaining weight. In many cases, people suffering from this...

anorexia nervosa with hair loss

Most people find holidays stressful, but the thought of facing holidays can be overwhelming for a person with an eating disorder. If a special day...

anorexia nervosa with hair loss

  • Patient Care & Health Information
  • Diseases & Conditions
  • Anorexia nervosa

If your doctor suspects that you have anorexia nervosa, he or she will typically do several tests and exams to help pinpoint a diagnosis, rule out medical causes for the weight loss, and check for any related complications.

These exams and tests generally include:

  • Physical exam. This may include measuring your height and weight; checking your vital signs, such as heart rate, blood pressure and temperature; checking your skin and nails for problems; listening to your heart and lungs; and examining your abdomen.
  • Lab tests. These may include a complete blood count (CBC) and more-specialized blood tests to check electrolytes and protein as well as functioning of your liver, kidney and thyroid. A urinalysis also may be done.
  • Psychological evaluation. A doctor or mental health professional will likely ask about your thoughts, feelings and eating habits. You may also be asked to complete psychological self-assessment questionnaires.
  • Other studies. X-rays may be taken to check your bone density, check for stress fractures or broken bones, or check for pneumonia or heart problems. Electrocardiograms may be done to look for heart irregularities.

Your mental health professional also may use the diagnostic criteria for anorexia in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

More Information

  • Bone density test
  • Complete blood count (CBC)
  • Electrocardiogram (ECG or EKG)
  • Liver function tests

Treatment for anorexia is generally done using a team approach, which includes doctors, mental health professionals and dietitians, all with experience in eating disorders. Ongoing therapy and nutrition education are highly important to continued recovery.

Here's a look at what's commonly involved in treating people with anorexia.

Hospitalization and other programs

If your life is in immediate danger, you may need treatment in a hospital emergency room for such issues as a heart rhythm disturbance, dehydration, electrolyte imbalances or a psychiatric emergency. Hospitalization may be required for medical complications, severe psychiatric problems, severe malnutrition or continued refusal to eat.

Some clinics specialize in treating people with eating disorders. They may offer day programs or residential programs rather than full hospitalization. Specialized eating disorder programs may offer more-intensive treatment over longer periods of time.

Medical care

Because of the host of complications anorexia causes, you may need frequent monitoring of vital signs, hydration level and electrolytes, as well as related physical conditions. In severe cases, people with anorexia may initially require feeding through a tube that's placed in their nose and goes to the stomach (nasogastric tube).

Care is usually coordinated by a primary care doctor or a mental health professional, with other professionals involved.

Restoring a healthy weight

The first goal of treatment is getting back to a healthy weight. You can't recover from anorexia without returning to a healthy weight and learning proper nutrition. Those involved in this process may include:

  • Your primary care doctor, who can provide medical care and supervise your calorie needs and weight gain
  • A psychologist or other mental health professional, who can work with you to develop behavioral strategies to help you return to a healthy weight
  • A dietitian, who can offer guidance getting back to regular patterns of eating, including providing specific meal plans and calorie requirements that help you meet your weight goals
  • Your family, who will likely be involved in helping you maintain normal eating habits
  • Psychotherapy

These types of therapy may be beneficial for anorexia:

  • Family-based therapy. This is the only evidence-based treatment for teenagers with anorexia. Because the teenager with anorexia is unable to make good choices about eating and health while in the grips of this serious condition, this therapy mobilizes parents to help their child with re-feeding and weight restoration until the child can make good choices about health.
  • Individual therapy. For adults, cognitive behavioral therapy — specifically enhanced cognitive behavioral therapy — has been shown to help. The main goal is to normalize eating patterns and behaviors to support weight gain. The second goal is to help change distorted beliefs and thoughts that maintain restrictive eating.

Medications

No medications are approved to treat anorexia because none has been found to work very well. However, antidepressants or other psychiatric medications can help treat other mental health disorders you may also have, such as depression or anxiety.

Treatment challenges in anorexia

One of the biggest challenges in treating anorexia is that people may not want treatment. Barriers to treatment may include:

  • Thinking you don't need treatment
  • Fearing weight gain
  • Not seeing anorexia as an illness but rather a lifestyle choice

People with anorexia can recover. However, they're at increased risk of relapse during periods of high stress or during triggering situations. Ongoing therapy or periodic appointments during times of stress may help you stay healthy.

  • Acupuncture

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

When you have anorexia, it can be difficult to take care of yourself properly. In addition to professional treatment, follow these steps:

  • Stick to your treatment plan. Don't skip therapy sessions and try not to stray from meal plans, even if they make you uncomfortable.
  • Talk to your doctor about appropriate vitamin and mineral supplements. If you're not eating well, chances are your body isn't getting all of the nutrients it needs, such as Vitamin D or iron. However, getting most of your vitamins and minerals from food is typically recommended.
  • Don't isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart.
  • Resist urges to weigh yourself or check yourself in the mirror frequently. These may do nothing but fuel your drive to maintain unhealthy habits.

Alternative medicine

Dietary supplements and herbal products designed to suppress the appetite or aid in weight loss may be abused by people with anorexia. Weight-loss supplements or herbs can have serious side effects and dangerously interact with other medications. These products do not go through a rigorous review process and may have ingredients that are not posted on the bottle.

Keep in mind that natural doesn't always mean safe. If you use dietary supplements or herbs, discuss the potential risks with your doctor.

Anxiety-reducing approaches that complement anorexia treatment may increase the sense of well-being and promote relaxation. Examples of these approaches include massage, yoga and meditation.

Coping and support

You may find it difficult to cope with anorexia when you're hit with mixed messages by the media, culture, and perhaps your own family or friends. You may even have heard people joke that they wish they could have anorexia for a while so that they could lose weight.

Whether you have anorexia or your loved one has anorexia, ask your doctor or mental health professional for advice on coping strategies and emotional support. Learning effective coping strategies and getting the support you need from family and friends are vital to successful treatment.

Preparing for your appointment

Here's some information to help you get ready for your appointment and know what to expect from your doctor or mental health professional.

You may want to ask a family member or friend to go with you. Someone who accompanies you may remember something that you missed or forgot. A family member may also be able to give your doctor a fuller picture of your home life.

What you can do

Before your appointment, make a list of:

  • Any symptoms you're experiencing, including any that may seem unrelated to the reason for the appointment. Try to recall when your symptoms began.
  • Key personal information, including any major stresses or recent life changes.
  • All medications, vitamins, herbal products, over-the-counter medications and other supplements that you're taking, and their dosages.
  • Questions to ask your doctor so that you'll remember to cover everything you wanted to.

Some questions you might want to ask your doctor or mental health professional include:

  • What kinds of tests do I need? Do these tests require any special preparation?
  • Is this condition temporary or long lasting?
  • What treatments are available, and which do you recommend?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor or mental health professional is likely to ask you a number of questions, including:

  • How long have you been worried about your weight?
  • Do you exercise? How often?
  • What ways have you used to lose weight?
  • Are you having any physical symptoms?
  • Have you ever vomited because you were uncomfortably full?
  • Have others expressed concern that you're too thin?
  • Do you think about food often?
  • Do you ever eat in secret?
  • Have any of your family members ever had symptoms of an eating disorder or been diagnosed with an eating disorder?

Be ready to answer these questions to reserve time to go over any points you want to focus on.

  • Sim LA (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2018.
  • Anorexia nervosa. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Nov. 13, 2017.
  • Hales RE, et al. Anorexia nervosa. In: The American Psychiatric Publishing Textbook of Psychiatry. 6th ed. Washington, D.C.: American Psychiatric Publishing; 2014. http://psychiatryonline.org. Accessed Nov. 13, 2017.
  • Klein D, et al. Anorexia nervosa in adults: Clinical features, course of illness, assessment, and diagnosis. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
  • Mehler P. Anorexia nervosa in adults and adolescents: Medical complications and their management. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
  • Mehler P. Anorexia nervosa in adults: Evaluation for medical complications and criteria for hospitalization to manage these complications. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
  • Pike K. Anorexia nervosa in adults: Cognitive behavioral therapy (CBT). https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
  • Walsh BT. Anorexia nervosa in adults: Pharmacotherapy. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2017.
  • Anorexia nervosa. Merck Manual Professional Version. http://www.merckmanuals.com/professional/psychiatric-disorders/eating-disorders/anorexia-nervosa. Accessed Nov. 13, 2017.
  • Harrington BC, et al. Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa. American Family Physician. 2015;91:46.
  • Brockmeyer T, et al. Advances in the treatment of anorexia nervosa: A review of established and emerging interventions. Psychological Medicine. In press. Accessed Nov. 13, 2017.
  • Davis H, et al. Pharmacotherapy of eating disorders. Current Opinion in Psychiatry. 2017;30:452.
  • Herpertz-Dahlmann B. Treatment of eating disorders in child and adolescent psychiatry. Current Opinion in Psychiatry. 2017;30:438.
  • Fogarty S, et al. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review. Eating Behaviors. 2016;21:179.
  • Eating disorders. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Eating-Disorders/Overview. Accessed Nov. 13, 2017.
  • Lebow J, et al. Is there clinical consensus in defining weight restoration for adolescents with anorexia nervosa? Eating Disorders. In press. Accessed Dec. 4, 2017.
  • Lebow J, et al. The effect of atypical antipsychotic medications in individuals with anorexia nervosa: A systematic review and meta-analysis. International Journal of Eating Disorders. 2013;46:332.
  • Five things to know about safety of dietary supplements for children and teens. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/tips/child-supplements. Accessed Feb. 9, 2018.

Associated Procedures

Products & services.

  • A Book: Mayo Clinic Family Health Book, 5th Edition
  • Newsletter: Mayo Clinic Health Letter — Digital Edition

Mayo Clinic in Rochester, Minnesota, has been recognized as one of the top Psychiatry hospitals in the nation for 2023-2024 by U.S. News & World Report.

  • Symptoms & causes
  • Diagnosis & treatment
  • Doctors & departments

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

  • Opportunities

Mayo Clinic Press

Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press .

  • Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence
  • The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book
  • Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance
  • FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment
  • Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book

Show the heart some love!

Help us advance cardiovascular medicine.

Eating Disorder Resources

Will your hair grow back after anorexia?

As long as you keep doing what you’re doing and making progress in your recovery, your hair will grow back.

Can you reverse hair loss from anorexia?

No. Not from anorexia-related hair loss. While the hair loss can be pronounced, it is diffused all over the scalp for most people rather than centered in a single spot. What’s more, the hair loss is temporary and often reverses once a person returns to normal eating habits and a healthy diet.

Why does my hair fall out anorexia?

Anorexia can cause hair loss through the loss of vital nutrients to the scalp. The growth phase of hair growth can be disrupted by a direct lack of nutrients, organ under-performance, or gastric issues. The healthy hair growth cycle is disrupted and ceases to grow effectively.

Does hair always fall out with anorexia?

Hair loss stemming from anorexia is usually temporary. That means when you begin to eat more, your hair will usually return. It isn’t easy to overcome an eating disorder. But with proper psychological treatment, it is possible to return to a healthy body weight and restore strong hair after anorexia nervosa.

How long does it take hair to regrow after anorexia?

For the vast majority patients 16-25 years of age, it’s a complete improvement. It does, however, take up to 15-18 months to see the maximum improvements although hair shedding slows down considerably and hair starts sprouting as BMI climbs over 18 and especially as BMI moves above 19.

Does Undereating cause hair loss?

Hair loss Undereating can cause hair loss if nutritional intake is not sufficient. In a 2013 review , experts suggested that deficiencies in proteins, minerals, essential fatty acids, and vitamins can cause hair loss or other abnormalities, such as changes in hair color or structure.

Can starving yourself cause hair loss?

Hair loss- lack of nutrition in the body leads to loosening the hair roots. We tend to lose more hair if we try to lose weight by starving ourselves. It also leads to hair thinning and poor hair growth.

Can anorexia be fully cured?

Many Patients with Anorexia Nervosa Get Better, But Complete Recovery Elusive to Most. Three in four patients with anorexia nervosa – including many with challenging illness – make a partial recovery. But just 21 percent make a full recovery, a milestone that is most likely to signal permanent remission.

What are the best foods for hair growth?

  • Eggs. Eggs are a great source of protein and biotin, two nutrients that are essential for hair growth.
  • Berries. Berries are loaded with beneficial compounds and vitamins that may support hair growth.
  • Fatty fish.
  • Sweet potatoes.

Can anorexics grow hair?

Lanugo is one of the side effects of anorexia nervosa, bulimia nervosa and other eating disorders in adults. It can indicate poor nutrition and malnourishment. Healthcare providers believe lanugo grows when a person doesn’t have enough body fat to keep them warm.

What is bulimia face?

When a person has been engaging in self-induced vomiting regularly and they suddenly stop engaging in the behaviour, their salivary glands in front of their ears (cheeks) may begin to swell. This makes their cheeks look swollen.

Can a history of anorexia cause infertility?

Having an eating disorder, such as anorexia or bulimia, can make it more difficult to conceive. Unfortunately, patients can still experience fertility issues, even after receiving treatment for an eating disorder.

What is the refeeding syndrome?

Refeeding syndrome can be defined as the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally5). These shifts result from hormonal and metabolic changes and may cause serious clinical complications.

Does anorexia cause starvation?

The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioral issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.

What does hair falling out mean?

Hair loss (alopecia) can affect just your scalp or your entire body, and it can be temporary or permanent. It can be the result of heredity, hormonal changes, medical conditions or a normal part of aging. Anyone can lose hair on their head, but it’s more common in men.

What is female baldness called?

The main type of hair loss in women is the same as it is men. It’s called androgenetic alopecia, or female (or male) pattern hair loss.

Does hair grow back after bulimia?

The good news is that hair loss is temporary, but the bad news is that it can take awhile (as you may have been noticing) for hair to return to its previous state. It generally takes 6 to 12 months before hair growth starts to resume normally.

Do I have lanugo?

One way to tell whether someone is developing adult lanugo as a symptom of a health condition is to check for the growth of fine hairs in places where they did not grow before, such as on the face or hands.

Can a 1200 calorie diet cause hair loss?

Anytime a person consumes less than 1300 calories per day the chances of telogen effluvium increase. Telogen effluvium (TE) Is a hair shedding disorder whereby the patient experiences more daily hair loss than they may have in the past.

What should we drink to stop hair fall?

  • Kiwi juice. Rich in vitamin E, kiwi juice will stimulate hair growth.
  • Lettuce, cucumber, honey and lemon.
  • Walnut, raisin, dried parsley leaves, ginger and honey.
  • Beetroot, carrot, apple, cucumber and ginger.
  • Banana, spinach and lemon.

Which vitamin is good for stop hair fall?

Vitamin B is one of the best-known vitamins to prevent hair loss and promote hair growth. It helps create red blood cells which carry oxygen and nutrients to the scalp and hair follicles. This creates a healthy hair growth atmosphere. The most famous and commonly heard B-vitamin is Biotin.

What are the 3 stages of starvation?

  • Withdrawal.
  • Listlessness.
  • Increased susceptibility to disease.

How long does it take to lose hair from not eating?

Some people who go on crash diets that exclude protein or who have abnormal eating habits may develop protein malnutrition. When this happens, the body will help save protein by shifting growing hairs into the resting phase. Increased hair shedding can occur 2 to 3 months later.

How can I prevent hair loss while dieting?

  • Avoid diets that restrict calories too severely.
  • Add a variety of healthy proteins to your diet to help improve the production of amino acids needed to produce keratin.
  • Eat plenty of whole grains, fruits and vegetables.
  • Get adequate sleep (about 7 to 8 hours a night)

When does anorexia become serious?

The disorder is diagnosed when a person weighs at least 15% less than their normal/ideal body weight. Extreme weight loss in people with anorexia nervosa can lead to dangerous health problems and even death.

Privacy Overview

Learn more about the results we get at Within

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

What causes lanugo hair in anorexia?

anorexia nervosa with hair loss

The disordered eating patterns involved with anorexia nervosa (AN) can impact nearly every function of the body, including the way hair is grown.

While many people who struggle with AN experience hair loss as part of the condition, others experience new or changed hair growth — specifically, the appearance of soft, fine hair all over the body and face.

Called lanugo, it's a common symptom of both anorexia nervosa and malnutrition, often appearing as body fat levels drop. 1 But as AN is treated and healthy weight gain is sustained, the hairs often fall out on their own.

anorexia nervosa with hair loss

What is lanugo?

Lanugo hair is fine, soft hair, sometimes referred to as downy hair or peach fuzz. It usually grows in utero, while a fetus is still developing. 2

Most of the time, the hair will fall out before birth, but it's possible for a newborn baby to have lanugo, especially in the case of premature babies. In these cases, the hair stops growing and typically falls out on its own, after a couple of weeks. 2

Lanugo can grow anywhere on the body, except those areas that don't have hair follicles, including the lips, nails, palms, and the soles of the feet. 2 The purpose of this downy hair is to help keep a fetus warm, though lanugo hair sometimes appears on adults, including those with AN or severe malnutrition, and people who have certain cancers or tumors. 2

Lanugo hair is one of the most common dermatological signs of anorexia nervosa . 3 People struggling with the eating disorder generally experience this symptom when they lose significant weight, and with it, body fat. 1

As body fat diminishes, there are less layers to help keep the internal organs warm. To make up for this loss, blood is often redirected away from the extremities and focused centrally. This can lead to other skin signs of AN, including dry or flaky skin and bluish lips, fingers, ears, and nose, as well as a sensitivity to cold. 1

Lanugo hair often grows in response, as well, in an attempt to regulate body temperature. 1 It can grow anywhere, but often appears along the spine, as facial hair or on the sides of the face, on the shoulders, or along the forearms. 4

  • What does anorexia nervosa mean?
  • Treatment of anorexia nervosa
  • Anorexia causes
  • Acute anorexia definition
  • Anorexia nervosa restricting type
  • Anorexia long-term effects

When does lanugo go away?

The good news about AN is that many symptoms are not permanent. As the condition is treated, and steps are taken to build a healthier diet and lifestyle, many symptoms will recede. The same is true with lanugo.

The feathery hair is not considered a medical complication, and therefore, there is no "treatment" specifically for the issue. Directly addressing anorexia nervosa—or the source of malnutrition—is the only way to get rid of lanugo.

Generally, once someone regains enough body fat, lanugo hair will fall out on its own. 4 The process usually happens slowly, and people with anorexia nervosa may notice lanugo hair falling out as their recovery journey goes on.

Other ways anorexia impacts hair growth

The impact of malnutrition should not be understated. It can manifest throughout the body and have any number of physical effects. And when it comes to hair growth, the malnutrition developed through AN can just as easily lead to hair loss , or overly brittle and dry hair. 3

In these cases, specific nutritional deficiencies brought on by the limited food intake involved with AN often drive the issue. Some vitamins and minerals most important for hair growth and hair health include: 5

  • Some polyunsaturated essential fatty acids

Maintaining healthy and sustained weight gain is a crucial aspect of reversing these effects on hair. But it's important that a diet include these essential nutrients to best promote healthy hair regrowth.

Finding help for anorexia nervosa

As an eating disorder, anorexia nervosa can cause a number of mental, physical, and emotional health concerns. And medical complications occurring with this illness won't go away on their own, and tend to only get worse with time. 

If you or a loved one fear weight gain, limit food intake, struggle with body image issues, or experience other symptoms of AN or other eating disorders, it's time to seek out help.

Your primary care physician, therapist, or another trusted medical professional can be a great place to start. These experts can help you receive an official diagnosis and may be able to recommend you to successful treatment programs.

At Within, our diverse team comes from multidisciplinary backgrounds, able to help address the mental, physical, and emotional needs of recovery. And our unique program allows you to access this personal support and complete your recovery program from the comfort of your own home. Regardless of where you look for it, it's important to remember that help is always available, and it can help lead you to a healthier and happier future.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

  • Mehler, P. S., & Brown, C. (2015). Anorexia nervosa - medical complications . Journal of Eating Disorders, 3 , 11.
  • Lanugo . Cleveland Clinic. Accessed August 2023. 
  • Strumia R. (2009). Skin signs in anorexia nervosa . Dermato-endocrinology, 1 (5), 268–270.
  • I am now in recovery for anorexia nervosa, but before that, I developed lanugo. Once I have recovered from anorexia, will the lanugo disappear? (2021, August 9). Center for Young Women’s Health. Accessed August 2023. 
  • Guo, E. L., & Katta, R. (2017). Diet and hair loss: effects of nutrient deficiency and supplement use . Dermatology Practical & Conceptual, 7 (1), 1–10.

Further reading

anorexia nervosa with hair loss

Exercise bulimia vs. anorexia athletica

anorexia nervosa with hair loss

Do I have anorexia nervosa?

anorexia nervosa with hair loss

What is weight restoration?

anorexia nervosa with hair loss

Does anorexia cause dehydration?

anorexia nervosa with hair loss

Does anorexia face swelling occur?

anorexia nervosa with hair loss

Signs and symptoms of starvation

anorexia nervosa with hair loss

Anorexia health risks and dangers

anorexia nervosa with hair loss

Anorexia's effect on your organs

anorexia nervosa with hair loss

Why does anorexia bloating occur?

anorexia nervosa with hair loss

Anorexia and bruising: Signs, causes, and healing

anorexia nervosa with hair loss

What happens to hair growth when you have anorexia?

anorexia nervosa with hair loss

What are the effects of anorexia on teeth and oral health?

anorexia nervosa with hair loss

Mental health and physical medical complications of anorexia nervosa

anorexia nervosa with hair loss

Yellow skin in anorexia nervosa: Jaundice symptoms

anorexia nervosa with hair loss

Edema in anorexia recovery: causes, symptoms and treatment

anorexia nervosa with hair loss

Refeeding syndrome and anorexia

anorexia nervosa with hair loss

How does anorexia affect the brain?

anorexia nervosa with hair loss

How does anorexia affect eyesight?

anorexia nervosa with hair loss

Can anorexia cause heart problems?

anorexia nervosa with hair loss

How anorexia affects hands: cold, shaking, tingling and discolored fingernails

anorexia nervosa with hair loss

Does anorexia cause parotid gland swelling?

anorexia nervosa with hair loss

The occurrence of anorexia and mood swings

anorexia nervosa with hair loss

Does anorexia cause diabetes?

anorexia nervosa with hair loss

Can eating disorders cause anemia?

anorexia nervosa with hair loss

Anorexia nervosa and brain fog: What is it?

anorexia nervosa with hair loss

Anorexia nervosa ketoacidosis symptoms

anorexia nervosa with hair loss

Anorexia and your digestive system

anorexia nervosa with hair loss

Anorexia and the kidneys

anorexia nervosa with hair loss

Anorexia joint pain, muscle, bone and body aches

anorexia nervosa with hair loss

Can anorexia cause IBS (irritable bowel syndrome)?

anorexia nervosa with hair loss

Anorexia and hypermetabolism

anorexia nervosa with hair loss

Anorexia and lower back pain

anorexia nervosa with hair loss

Anorexia and gastroparesis

anorexia nervosa with hair loss

Anorexia and cachexia

anorexia nervosa with hair loss

Anorexia and constipation

Symptoms - Anorexia nervosa

The main symptom of anorexia nervosa (often called anorexia) is deliberately losing a lot of weight or keeping your body weight much lower than is healthy for your age and height.

Signs and symptoms include:

  • missing meals, eating very little or avoiding eating any foods you see as fattening
  • lying about what and when you've eaten, and avoiding eating with others
  • wearing baggy clothes to hide your body shape and lying about how much you weigh
  • taking medicines to reduce your hunger (appetite suppressants), or to help you poo (laxatives) or to make you pee (diuretics)
  • exercising excessively or making yourself sick to try to avoid putting on weight
  • an overwhelming fear of gaining weight
  • strict rituals around eating and thinking about food a lot
  • weighing yourself frequently and seeing losing a lot of weight as a positive thing
  • believing you're fat when you're a healthy weight or underweight
  • not admitting your weight loss is serious

You may also notice physical signs and symptoms such as:

  • if you're under 18, your weight and height being lower than the minimum expected for your age
  • if you're an adult, having an unusually low body mass index (BMI)
  • your periods stopping (in women who have not reached menopause) or not starting (in younger women and girls)
  • bloating, constipation and abdominal pain
  • headaches or problems sleeping
  • feeling cold, dizzy or very tired
  • poor circulation in hands and feet
  • dry skin, hair loss from the scalp, or fine downy hair growing on the body
  • reduced sex drive

People with anorexia often have other mental health problems, such as depression or anxiety .

Warning signs of anorexia in someone else

The following warning signs could indicate that someone you care about has an eating disorder:

  • dramatic weight loss
  • lying about how much and when they've eaten, or how much they weigh
  • avoiding eating with others
  • cutting their food into small pieces or eating very slowly to disguise how little they're eating
  • trying to hide how thin they are by wearing loose or baggy clothes

In children with anorexia, puberty and the associated growth spurt may be delayed. Young people with anorexia may gain less weight than expected and may be smaller than children of the same age.

Getting help

Getting help and support as soon as possible gives you the best chance of recovering from anorexia.

If you think you may have anorexia, even if you're not sure, see a GP as soon as you can.

If you're concerned that a family member or friend may have anorexia, let them know you're worried about them and encourage them to see a GP. You could offer to go along with them.

You can also talk in confidence to an adviser from eating disorders charity Beat by calling its helpline on 0808 801 0677.

If someone needs urgent medical help, go to  111.nhs.uk  or call 111 for advice.

Page last reviewed: 18 January 2024 Next review due: 18 January 2027

banyan logo

  • Intensive Outpatient Program
  • Partial Hospitalization Program
  • Outpatient Program
  • 12 Step Program
  • Eating Disorder Program
  • Faith in Recovery
  • Family Program
  • LGBTQ Addiction Treatment
  • Mature Track Program
  • Military and Veterans Program
  • SMART Recovery Program
  • Stabilization Program
  • Telehealth Services
  • Biofeedback
  • Holistic Treatment
  • Psychoeducational Groups
  • Trauma Treatment
  • Vivitrol Treatment
  • Prescription Drugs
  • Drug Addiction FAQs
  • ADA Compliance
  • Drug Addiction Glossary
  • Slang Glossary
  • What to Bring Lists
  • Baldwinville, MA
  • Naperville, IL
  • Langhorne, PA
  • Boca Raton, FL
  • Pompano Beach, FL
  • Cathedral City, CA
  • Waelder, TX
  • Wilmington, MA
  • Laurel Run, PA
  • Sebring, FL
  • Lake Worth, FL
  • Palm Beach Shores, FL
  • Milford, DE
  • Wasilla, AK

banyan-locations

  • Verify Insurance

Do Eating Disorders Cause Hair Loss?

Do Eating Disorders Cause Hair Loss?

When we hear someone mention hair loss, we usually think of aging or chemotherapy. What most people don’t associate with hair loss is eating disorders like anorexia and bulimia nervosa . In reality, many people experience hair loss due to eating disorders, including hair thinning and areas of balding. But why do eating disorders cause hair loss? Today our center for eating disorders is sharing the science behind this physical change.

Why Do Eating Disorders Cause Hair Loss?

There are various types of eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, and more. Many people with eating disorders are malnourished, meaning they lack the proper nourishment needed for the cells in their body to work properly. The main reason eating disorders cause hair loss is because of keratin depletion.

Our hair is made up of the protein keratin, and without it, hair begins to thin, shed, and fall out altogether. Malnourishment, which is common among people with eating disorders, is often marked by protein depletion, including proteins like keratin. The result, of course, is hair loss.

Hair loss is a symptom of an eating disorder that’s reached a severe stage. The medical term for eating disorder-related hair loss is telogen effluvium. This is a reversible condition marked by the excessive shedding of resting or telogen hair after the body goes through a sudden change or shock.

When the body goes through an immense amount of stress, such as severe changes in eating, stress pushes large numbers of hair follicles into a resting phase, eventually causing them to fall out. Hair loss caused by eating disorders can range from mild shedding and thinning to losing clumps of hair at a time.

When a person’s eating disorder gets to a severe point, the body may become so determined to save itself that it concentrates its efforts towards organ function and cuts hair out of its energy budget.

What Eating Disorder Causes Hair Loss?

Eating disorders like anorexia nervosa and bulimia nervosa are most often linked to hair loss, thinning, and shedding. This is mainly due to the eating-related behaviors practiced by individuals with these conditions, including starvation, self-induced vomiting, reduced food intake, and over-exercising.

Eating disorders are usually linked to distorted body image, fear of weight gain, and an obsession with body shape and weight. Considering this, not only can eating disorders cause hair loss, but other side effects of eating disorders include:

  • Heart problems
  • Malnutrition
  • Dehydration
  • Slowed brain function
  • Gastroparesis
  • Stomach problems
  • Decreased hormone levels
  • Hypothermia
  • Dental problems (common among people who vomit after binge eating)

Anorexia nervosa has the highest mortality rate of any psychiatric disorder. Considering its impact on the body, this isn’t a surprise. But it is a tragedy. So many have lost their lives to eating disorders like anorexia and bulimia, which is why finding eating disorder support is so important.

Our Eating Disorder Treatment in Philadelphia

Banyan Treatment Center offers various levels of eating disorder treatment at our Philadelphia rehab center. Our counselors, therapists, and nutritionists work with patients through every step of their recovery to ensure they achieve sustainable physical and mental health.

We understand that eating disorders are often linked to underlying issues with mental health, which is why we also offer body dysmorphic disorder treatment at our facility. In addition to disorder-specific programs, our team administers various therapy programs in singular and group settings to promote personal growth and peer support.

Not only do eating disorders cause hair loss, but they deteriorate a person’s physical and mental health as well as their relationships with friends and family. Don’t let an eating disorder rule your life any longer.

Call Banyan Treatment Center Philadelphia today at 888-280-4763 to learn how our eating disorder treatment can help.

Alyssa, Director of Digital Marketing

Alyssa, Director of Digital Marketing

Related posts.

anorexia end stages

Embracing Hope: A Compassionate Look at End-Stage Anorexia

depression

What Is Emotional Eating Disorder?

Re-establishing a Normal Sleep Schedule after Getting Sober

The Effects of Focalin Withdrawal and How to Address Them

Don’t go we can help., we have beds available. call for same day admission..

Call Now     Verify Insurance

anorexia nervosa with hair loss

  • Open access
  • Published: 31 March 2015

Anorexia nervosa – medical complications

  • Philip S Mehler 1 &
  • Carrie Brown 2  

Journal of Eating Disorders volume  3 , Article number:  11 ( 2015 ) Cite this article

105k Accesses

121 Citations

29 Altmetric

Metrics details

In contrast to other mental health disorders, eating disorders have a high prevalence of concomitant medical complications. Specifically, patients suffering from anorexia nervosa (AN) have a litany of medical complications which are commonly present as part of their eating disorders. Almost every body system can be adversely, affected by this state of progressive malnutrition. Moreover, some of the complications can have permanent adverse effects even after there is a successful program of nutritional rehabilitation and weight restoration. Within this article we will review all body systems affected by AN. There is also salient information about both, how to diagnose these medical complications and which are the likely ones to result in permanent sequelae if not diagnosed and addressed early in the course of AN. In a subsequent article, the definitive medical treatment for these complications will be presented in a clinically practical manner.

Anorexia nervosa and bulimia are both inherently associated with many different medical complications. This review article is part one of a planned three part series of articles in this regard. We will focus solely on the medical complications associated with restricting anorexia nervosa. Part two of this series will be devoted to the medical complications associated with bulimia nervosa and, the third paper will discuss the treatments currently available for the medical complications of both anorexia nervosa and bulimia. Some of this information is based on experienced clinical opinion.

Anorexia nervosa is associated with numerous general medical complications [ 1 ]. The complications affect almost all major organ systems and often also include physiologic disturbances such as hypotension, bradycardia and hypothermia. Medical complications account for more than half of all deaths in patents with anorexia nervosa [ 2 ]. Standardized mortality ratios show that the rate of death in anorexia nervosa is 10 to 12 times greater than the rate in the general population [ 3 , 4 ]. Indeed, anorexia nervosa has the highest mortality rate of any psychiatric disorder, likely due to these medical complications.

In general, medical complications of anorexia nervosa are a direct result of weight loss and malnutrition. Starvation induces protein and fat catabolism that leads to loss of cellular volume and function, resulting in adverse effects on, and atrophy of, the heart, brain, liver, intestines, kidneys, and muscles [Table  1 ].

The reported incidence of these medical complications varies, depending upon the individual patient and also on the severity of the episode of anorexia nervosa. The primary risk factors for developing medical complications in anorexia nervosa are the degree of weight loss and the chronicity of the illness [ 5 ]. There are no known sociodemographic risk factors for developing complications.

Dermatological

As weight loss worsens due to the nutritional deprivation, it is common for the patient with anorexia nervosa to have dry skin which can fissure and bleed especially in the fingers and toes [ 6 ]. Also it is common for these patients to have cold intolerance and a bluish discoloration to the distal tips of their fingers as well as their nose and ears. This is referred to as acrocyanosis, and may be due to the shunting of blood flow centrally in response to the hypothermia seen with anorexia nervosa. Lanugo hair growth, which is fine downy hair on the sides of the face and along the spine, is regularly noted with anorexia nervosa and may represent an attempt by the body to conserve heat. Decubitus ulcers over boney prominences may develop due to loss of supporting subcutaneous tissue and needs to be looked for at the time of physical examination because delayed wound healing is also part of the cutaneous manifestations of starvation. Easy bruisabilty is likewise related to the relative absence of subcutaneous tissue due to weight loss.

  • Gastrointestinal

With pure food restriction, once weight loss below approximately 15–20 percent of ideal body weight occurs, there is often the development of gastroparesis [ 7 ]. Gastroparesis refers to delayed emptying of the stomach. Bloating, upper quadrant pain and early satiety are the main symptoms, and may be severe. Acute gastric dilation, which should be screened for with an abdominal X-ray if the patient complains of severe left upper quadrant pain or has significant vomiting, is an extreme and rare result of delayed gastric emptying. If this diagnosis is missed, the massive dilatation of the stomach can result in gastric necrosis, perforation and death [ 8 , 9 ]. Bloating can be worsened by a high-fiber diet that these patients may resort to in an attempt to treat their slowed gastrointestinal transit. In rare cases it may be necessary to obtain a nuclear medicine gastric emptying study to investigate prolonged symptomatology.

Similarly, constipation commonly accompanies the weight loss of anorexia nervosa. Patients may complain of bowel movements that are infrequent or small. It is helpful from the start to reassure these patients that bowel patterns in healthy patients may normally vary anywhere from two times per day to just a few times per week, and that persons with anorexia nervosa issues are expected to indeed have even fewer bowel movements. Constipation in these patients is due either to drastically reduced caloric intake, which results in reflex hypofunctioning of the colon, or to slow colonic transit.

An upright abdominal X-ray may be useful to exclude abnormal bowel distention when symptoms of constipation persist after an adequate trial of interventions aimed at alleviating constipation. The absence of excessive stool on these radiographic studies provides the clinicians caring for these patients and the patients with proof that bowel function is normal and no longer deserves ongoing concern. This is especially helpful because the interplay of functional gastrointestinal disorders is significantly prevalent in patients with anorexia nervosa [ 10 ], in the form of the irritable bowel syndrome.

Liver transaminases (AST & ALT) are often abnormal in anorexia nervosa, occurring in almost half of all patients with anorexia nervosa [ 11 ]. Weight loss and fasting can produce mild elevation (2-3x normal) of transaminases (AST/ALT). Mild transaminase elevation can also occur early in the course of refeeding if dextrose calories are excessive, and is referred to as steatosis. These elevations usually resolve and normalize if the daily caloric intake and the amount of dextrose calories are temporarily decreased. A higher level of calorie intake can then be reintroduced at a later date once the liver tests have normalized. The transaminase may also be markedly elevated (4-30x normal) with severe anorexia nervosa, even before refeeding has started, and may be a sign of serous multiorgan failure [ 12 ]. Nutritional support will usually result in improvement. If the liver function tests are elevated during the early phases of refeeding, a liver ultrasound can help distinguish starvation-induced enzyme elevations from refeeding-induced elevations. During starvation, the ultrasound typically reveals that the liver is small in size whereas the ultrasound in refeeding hepatitis the ultrasound may show an enlarged fatty liver [ 13 ]. The starvation-induced elevations are more likely to occur in patients with a body mass index (BMI) less than 12/kg/m 2 [ 14 ]. The exact cause of this phenomenon is not known. Putative causes include autophagy or organ hypoperfusion due to the myocardial dysfunction seen in anorexia nervosa.

Another gastrointestinal complication to be aware of in patients with anorexia nervosa is the superior mesenteric artery syndrome (SMA). It results from compression of the duodenum between the aorta and spine posteriorly and the SMA anteriorly as a result of loss of the adipose tissue fat pad that normally surrounds the SMA, as a direct result of weight loss. This narrows the angle between the two blood vessels and entraps the duodenum. The SMA syndrome manifests with upper quadrant abdominal pain soon after eating along with early satiety, nausea and vomiting. Abdominal CT scan or an upper GI series are diagnostic and reveal an abrupt cut-off of the third portion of the duodenum as it passes between the SMA and aorta [ 15 ].

Aspiration of oral calories into the airways, both liquids and solids, may also occur in more severe cases of anorexia nervosa due to dysphagia that is caused by pharyngeal muscle weakness resulting from protein-calorie malnutrition [ 16 ]. Difficulty swallowing and uncoordinated transfer of the food bolus from the mouth to the stomach may lead to aspiration and even result in aspiration pneumonia. A bedside swallow evaluation by a speech therapist and/or a video fluoroscopic swallow study can confirm the diagnosis. If dysphagia and aspiration are confirmed, modifying the consistency of foods or inserting a temporary feeding tube may be required until sufficient weight gain restores normal swallow function.

Acute pancreatitis in patients with anorexia nervosa is rare, but has been described during refeeding [ 17 ]. The presumptive etiology is that malnutrition activates proteases such as trypsin which injures pancreatic cells. Its presentation, during the early phases of refeeding, is typical for pancreatitis and is characterized by epigastric pain which radiates posteriorly, accompanied by nausea and vomiting and associated with elevations of the pancreatic enzymes amylase and lipase.

Patients with anorexia nervosa have a number of abnormalities in endocrine function. Secretion rates of cortisol are generally elevated [ 18 ], and metabolic clearance rates are decreased, with the result that the half-life of cortisol may be prolonged in malnourished individuals. The clinical significance of this elevated cortisol level is unknown, but it may be involved with loss of bone density in anorexia nervosa.

Alterations in growth hormone are also present in anorexia nervosa. Levels are more often elevated, but levels of insulin like growth factor (IGF-1) are decreased, indicative of growth hormone resistance [ 19 ]. The clinical significance of this finding is not clear. Antidiuretic hormone levels may also be low in anorexia nervosa which may rarely result in central diabetes insipidus manifested by hpernatremia.

The thyroid abnormalities in individuals with anorexia nervosa resemble those of the euthyroid sick syndrome, in which total thyroxine (T 4 ) and triiodothyronine (T 3 ) levels are low. The key, however, is that thyroid stimulating hormone (TSH) usually remains in the normal range [ 20 ]. Levels of T 3 usually decrease in proportion to the degree of weight loss. Total T 4 levels are low because T 4 is preferentially converted to a biologically inactive reverse T 3 . It is important to avoid unnecessary and potentially dangerous thyroid hormone replacement therapy for low-weight anorexic patients with the aforementioned thyroid function test findings because these alterations in thyroid function tests, normalize with nutritional rehabilitation. The risks of unnecessary thyroid hormone are especially prominent both because of its deleterious effect on bone mineral density, in a population of patients who are already at risk for severe osteoporosis, and because of its effect to increase metabolic rate and frustrate weight gain.

Dietary restriction accompanied by weight loss and excessive exercise lead to depletion of hepatic glycogen stores and disruption of hepatic gluconeogenesis, resulting in abnormalities of glucose metabolism and hypoglycemia. In milder cases of anorexia, hypoglycemia is not generally present. In contrast, individuals with advanced anorexia nervosa develop hypoglycemia [ 21 ]. Severe hypoglycemia has been associated with sudden death because it indicates liver failure and a depletion of substrate to maintain safe blood glucose levels [ 22 ]. In the presence of hypoglycemia, insulin levels are appropriately decreased in anorexia nervosa. Recent studies indicate that individuals who are older have a higher risk of hypoglycaemia [ 23 ]. Rare reports of reactive hypoglycemia during early refeeding have also been reported in anorexia nervosa [ 24 ].

Anorexia nervosa is occasionally complicated by comorbid Type 1 Diabetes Mellitus. While the exact casual association between type 1 diabetes mellitus and anorexia nervosa has not been fully elucidated, these two disorders do sometimes coexist in the same patient. This in turn creates treatment challenges, especially during the early phases of refeeding and is associated with an increased mortality risk [ 25 ].

It is irrefutably clear that excessive hyperglycemia and poor glucose control, in all diabetic patients, are associated with premature microvascular complications such as diabetic retinopathy and nephropathy [ 26 ]. One can however logically posit that this concern is only relevant over the course of the lifetime of a patient with type 1 diabetes mellitus. It is not likely to be of clinical significance if present for a period of just a few weeks during a structured refeeding program for the diabetic patient with severe anorexia nervosa, as long as his or her level of hyperglycemia is not excessive (i.e., glucose level less than 250 mg/dL). Thus, an allowance for “permissive hyperglycemia,” is certainly more conducive to building the requisite therapeutic trust which is so critical in the refeeding program of a patient with anorexia nervosa. This approach should be followed during the early stages of refeeding as opposed to a weight-restored state where tight glucose control is again sought [ 27 ].

Sex hormones are affected in both male and female patients with anorexia nervosa. These patients have low levels of hypothalamic gonadotropin releasing hormone (GnRH) and low levels of pituitary luteinizing (LH) and follicle stimulating hormone (FSH), estrogen and testosterone. These abnormalities affect potency, fertility and bone density. The neuroendocrine regulation of normal female reproductive functions depends on a rhythm of nerve impulses generated within the medial basal hypothalamus, which governs the pulsatile release of GnRH from nerve terminals. Pulsatile GnRH release is the central controller of pituitary LH and FSH secretion, which determine the time onset of normal menstrual function [ 28 ]. Patients with anorexia nervosa reproducibly have a characteristic “hypothalamic amenorrhea syndrome” with a variable reduction in pulsatile hypothalamic GnRH gonadostat signalling to the pituitary gland, resulting in a failure of ovulation. The degree of impairment varies among patients with anorexia nervosa, but in general, the frequency and amplitude of the LH-FSH pulses are diminished, with a reversion to a prepubertal pattern and the development of the commonly found amenorrheic state. Thus, this functional amenorrhea seen in anorexia nervosa reflects a temporary, reversible disturbance of hypothalamic-pituitary function. Most amenorrhea seen with anorexia nervosa is of the secondary type, meaning the patient previously had normal menstrual periods.

Of patients with anorexia nervosa, 20–25 percent may experience amenorrhea before the onset of significant weight loss, and 50–75 percent will experience amenorrhea during the course of dieting and its weight loss [ 29 ]. In some patients with anorexia nervosa, amenorrhea occurs only after more marked weight loss [ 30 ]. Overall, the development of amenorrhea is most strongly correlated to loss of body weight. As a result of the aforementioned changes in reproductive hormones, patients with anorexia nervosa have difficulty conceiving, but, importantly, patients with anorexia nervosa may ovulate and become pregnant despite their amenorrhea. Unplanned pregnancy is a risk in anorexia nervosa [ 31 ]. Overall, the incidence of infertility is increased in anorexia nervosa due to the commonly found amenorrhea and decreased libido. If pregnancy does occur, there is also a higher rate of pregnancy complications as well as neonatal complications [ 32 ]. Increased numbers of miscarriages have also been reported in anorexia nervosa [ 33 ].

Hematologic

The bone marrow is adversely affected by anorexia nervosa. All three cell lines, namely red blood cells, white blood cells and platelets, may be affected by anorexia nervosa. Specifically, anemia and leukopenia occur in approximately one-third of the patients and thrombocytopenia occurs in ten percent [ 34 ]. The basic pathology of the affected marrow demonstrates a hypoplastic marrow with gelatinous deposition and serous fat atrophy [ 35 ]. As disease severity worsens and BMI falls, the frequency of these abnormalities is greater with upwards of seventy-five percent of patients demonstrating cytopenias [ 36 ]. However, there is no characteristic change in red cell size with most patients having normal indices. Similarly, all white cell types are proportionately reduced to cause neutropenia and lymphopenia, but no consistent pattern emerges for anorexia nervosa. The serum international normalized ratio (INR) level may be mildly elevated, due to liver damage and impaired synthesis of coagulation factors; patients may thus present with petechiae and purpura [ 37 ].

Interestingly, patients with anorexia nervosa do not seem to be predisposed to more frequent infectious diseases, notwithstanding their malnourished states. However, because the usual signs of infection (fever and elevated white blood cell count) may not be present in anorexia nervosa, increased vigilance and a lower threshold to evaluate for an infection should be followed [ 38 ].

Recent studies have demonstrated that anorexia nervosa is associated with variable, but usually significant, brain atrophy [ 39 ]. Severe cases of anorexia nervosa may appear, on magnetic resonance imaging (MRI), to be indistinguishable from the brain of a person with Alzheimer’s disease; ventricles are enlarged and cortical substance is decreased [ 40 ]. While anorexic patients often have a surprising degree of accomplishment in school, as weight erodes they become increasingly unable to attend to, and concentrate on, written materials or sustain reasoning. Of concern is the recent demonstration that weight improvement is not immediately associated with complete restoration of normality in the MRI brain scan, especially of the gray matter. This may be correlated with the duration of illness as recent studies from adolescents with a history of anorexia nervosa, when weight restored, have not revealed global or regional gray or white matter abnormalities [ 41 ]. Work is under way with positron emission tomography (PET) to localize the specific brain regions most affected by starvation so as to determine their response to treatment. Of note, there are no consistent peripheral nerve findings associated with anorexia nervosa, although with more marked weight loss comes overall weakness and deconditioning.

Bone metabolism

Patients with anorexia nervosa very commonly have impaired bone structure and reduced bone strength. Various modalities exist for assessment of bone density. Dual X-ray absorptiometry (DEXA) is the most commonly-used modality and measures the bone mineral content for a given cross sectional area of bone. Using DEXA scan, a T-score, which reflects a young adult population, and Z-score, which reflects an age-matched population, are determined. The World Health Organization defines osteoporosis in postmenopausal women as a BMD value at the spine, hip, or forearm of 2.5 or more standard deviations (SD) below the young adult mean (T-score ≤ −2.5). Osteopenia is defined as a T-score between −1 and −2.5 [ 42 ]. Definitions for bone density loss among young, pre-menopausal women and men have not been officially defined, however, measurement of bone density remains of great utility in patients with anorexia nervosa. MRI has been used to determine marrow fat content and composition among patients with anorexia. Higher marrow fat inversely correlates with bone mineral density [ 43 ].

In fact, 85% of women with a diagnosis of anorexia nervosa have either osteoporosis or osteopenia [ 44 ]. A study of 310 women showed lifetime fracture prevalence being 60% higher in those with anorexia nervosa as compared to controls [ 45 ]. Individuals who develop anorexia during adolescence are especially of great concern as bone accrual continues normally through the mid-20s and thus these individuals may never reach normal peak bone mass. Women who develop anorexia nervosa as adolescents, end up having lower bone mineral density than women who develop anorexia nervosa during adulthood with similar duration of amenorrhea [ 46 ].

This low bone mass is due to reduced bone formation and increased bone resorption. Multiple hormonal adaptations, designed to decrease energy expenditure during periods of low energy intake, may be to blame for this phenomenon. The aforementioned elevated growth hormone (GH) levels may be important for mobilizing fat stores in the setting of nutritional deprivation. IGF-1 mediates the actions of GH on bone metabolism. Low IGF-1 levels may decrease energy expenditure among several physiologic processes in the body, including the maintenance of bone mass. Also, similar to the effects of estrogen deficiency in postmenopausal women, this deficiency found in anorexia nervosa, due to the ubiquitous hypogonadotropic hypogonadism of anorexia nervosa, results in an increase in bone resorption and decreased bone mass [ 44 ]. According to one study, duration of amenorrhea in anorexia nervosa was the only factor associated with decreased lumbar spine bone mineral density and IGF-1 levels were the only significant independent predictor of decreased bone mineral density (BMD) of the proximal femur [ 47 ].

Males with anorexia nervosa also have osteopenia and osteoporosis as noted above. Charts from 70 consecutive males treated for anorexia nervosa revealed 36% had osteoporosis and 26% had osteopenia at the lumbar spine. Lower BMI and longer illness duration predicted lumbar Z-scores [ 44 ]. Low testosterone levels may also correlate directly with degree of bone mineral density loss [ 48 ]. In fact, male patients with anorexia nervosa seem to have worse degrees of low bone density compared with female anorexia nervosa patients [ 49 ].

Bradycardia (pulse <60) and hypotension are among the most common physical findings in patients with anorexia nervosa, with bradycardia seen in up to 95% of patients. Anorexia nervosa should be considered in the differential for unexplained bradycardia in the outpatient setting [ 50 ]. In addition, resting tachycardia is highly unusual and may be indicative of a superimposed infection or other complication [ 51 ]. Heightened vagal tone has been suggested as the cause of bradycardia in the setting of anorexia nervosa [ 52 ]. Low blood pressure and heart rate universally increase to normal levels after refeeding and restoration of normal weight [ 53 ].

Structural abnormalities, including pericardial effusion and decreased left ventricular size are also commonplace in the setting of anorexia nervosa. Silent pericardial effusion is present in 22% to 71% of patients with anorexia nervosa by echocardiography [ 54 - 56 ]. Factors which may correlate with pericardial effusion in this patient population include low BMI, rapid weight loss, low T 3 levels, and IGF-1 levels [ 57 ]. Most patients show resolution of the effusion after weight restoration without further intervention necessary; however, there are case reports of cardiac tamponade and the rare need for urgent pericardiocentesis for prevention thereof [ 58 , 59 ].

Multiple studies of patients with anorexia nervosa have revealed findings of decreased left ventricular mass, left ventricular index, cardiac output, and left ventricular diastolic and systolic dimensions [ 56 ]. Longstanding hypovolemia has been postulated as a potential cause for these findings [ 60 ]. Mitral valve motion abnormalities, including mitral valve prolapse, may also be seen in a distinct minority. This can cause chest pain and palpitations in these patients. However, the ejection fraction appears to remain preserved in most cases [ 54 ]. Weight restoration has also been shown to correlate with normalization of cardiac dimensions [ 61 ].

Beyond bradycardia, more subtle arrhythmias have the potential to create significant complications for patients with anorexia nervosa. The QT interval, as measured on electrocardiogram (ECG), is commonly used in cardiology as a marker for arrhythmogenicity. QT dispersion, or the difference between maximum QT interval and minimum QT interval on ECG, is another concerning marker when increased. Prolonged QT and increased QT dispersion may also indicate that the patient is at risk for sudden cardiac death [ 62 ]. Increased QT interval and QT dispersion among patients with anorexia have been reported in the literature [ 63 , 64 ]. However, some studies have linked QT prolongation to hypokalemia and increased vagal activity and not intrinsically related to anorexia nervosa [ 65 ]. Prolonged QT has thus not been suggested as an inherent marker for disease severity in anorexia nervosa as many confounding factors exist, including prolongation due to commonly-prescribed medications such as antipsychotic medications. Weight restoration has been shown to resolve findings of prolonged QT and QT dispersion [ 61 , 53 ]. It should be noted that there are case reports of an extremely rare cause of reversible acute heart failure, known as takotsubo cardiomyopathy, among patients with anorexia. This condition has previously been linked to prolonged QT interval [ 66 , 62 ] but is more commonly related to elevated catecholamine levels due to severe psychological or physical stress.

The lungs are not immune to the adverse effects of anorexia nervosa and malnutrition as was once thought. Multiple case reports now show findings of emphysema on imaging among patients with anorexia nervosa, even without a smoking history [ 67 , 68 ]. Diffusion capacity of the lung for carbon monoxide (DLCO) and lung diffusion capacity for oxygen have been shown to progressively worsen with anorexia nervosa disease duration [ 69 ]. Findings of emphysema and decreased pulmonary function are by no means universal among patients with anorexia nervosa [ 70 ].

Two potentially life-threatening, albeit rare complications, of anorexia nervosa include pneumothorax and pneumomediastinum. These are infrequently known to occur spontaneously among patients with anorexia [ 71 , 72 ] and may pose significant difficulties with management [ 73 ]. Spontaneous tension pneumoperitoneum and tension pneumothorax have also been reported as resulting from acute gastric rupture in eating disorder patients who both restrict and purge via self-induced vomiting [ 74 ].

Males with anorexia nervosa

The very starved male and female patients are similar medically with the exception that males start with a lower reserve percentage of body fat and a higher lean muscle mass, allowing him less weight loss before the onset of ketosis and protein breakdown. In contrast to the occurrence of amenorrhea in females, males have no comparable “signal” that alerts family to the medical consequences of weight loss. In addition, boys and men who suspect they may have an eating disorder often perceive, quite accurately, stigma from society, from eating-disordered females, and from peers. Thus, they may be hesitant to discuss this possibility with clinicians. Therefore, they often present after more severe weight loss and with more extensive clinical and laboratory findings [ 75 ].

Their history will include changes in sexual functioning, including a decrease in sexual drive. Physical exam will note the general degree of emaciation and decline in lean muscle mass, as well as the aforementioned general medical findings including vital sign changes. Laboratory studies in the male should include serum testosterone level. Testosterone declines in proportion to weight loss. LH and FSH will be correspondingly diminished in anorexia nervosa because the changes in gonadotropins are due to central hypothalamic hypogonadism secondary to starvation, rather than increasing as would be expected with a failing gonad. Testicular examination will often reveal testes that are small.

Conclusions

In summary, anorexia nervosa has a litany of medical complications which are associated with it. The general rule is that they become more apparent as the patient’s weight falls further from normal. Most body systems can be adversely affected. However, the encouraging message is that the vast majority of these, often serious medical complications, are reversible with weight gain and nutritional rehabilitation as will be described in the third segment of this series.

Abbreviations

Alanine transaminase

  • Anorexia nervosa

Aspartate aminotransferase

Bone mineral density

Body mass index

Computed tomography

Dual x-ray absorptiometry

Diffusion capacity of the lung for carbon monoxide

Electrocardiogram

Follicle stimulating hormone

Growth hormone

Gonadotropin releasing hormone

Insulin like growth factor

International normalized ratio

Luteinizing hormone

Magnetic resonance imaging

Position emission tomography

Standard deviation

Superior mesenteric artery

Triiodothyronine

Thyroid stimulating hormone

Mehler PS. Diagnosis and care of patients with anorexia nervosa in primary care settings. Ann Intern Med. 2001;134:1048–59.

Article   CAS   PubMed   Google Scholar  

Eating Disorders. Core Interventions in the Treatment of and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. National Institute for Clinical Excellence, Clinical Guideline 9. [ http://guidance.nice.org.uk ]

Löwe B, Zipfel S, Buchholz C, Dupont Y, Reas DL, Herzog W. Long-term outcome of anorexia nervosa in a prospective 21-year follow-up study. Psychol Med. 2001;31:881–90.

Article   PubMed   Google Scholar  

Herzog W, Deter HC, Fiehn W, Petzold E. Medical findings and predictors of long-term physical outcome in anorexia nervosa: a prospective, 12-year follow-up study. Psychol Med. 1997;27:269–79.

Miller KK, Grinspoon SK, Ciampa J, Hier J, Herzog D, Klibanski A. Medical findings in outpatients with anorexia nervosa. Arch Intern Med. 2005;165:561–6.

Strumia R. Dermatologic signs in patients with eating disorders. Am J Clin Dermatol. 2005;6:1–10.

Article   Google Scholar  

Kamal N, Chami T, Andersen A, Rosell FA, Schuster MM, Whitehead WE. Delayed gastrointestinal transit times in anorexia nervosa and bulimia nervosa. Gastroenterology. 1991;101:1320–4.

CAS   PubMed   Google Scholar  

Arie E, Uri G, Bickel A. Acute gastric dilation, necrosis and perforation complicating restrictive-type anorexia nervosa. J Gastrointest Surg. 2008;12:985–7.

Kim SC, Cho HJ, Kim MC, Ko YG. Sudden cardiac arrest due to acute gastric dilatation in a patient with an eating disorder. Emerg Med J. 2009;26:227–8.

Porcelli P, Leandro G, De Carne M. Functional gastrointestinal disorders and eating disorders. Relevance of the association in clinical management. Scand J Gastroenterol. 1998;33:577–82.

Smith RW, Korenblum C, Thacker K, Bonifacio HJ, Gonska T, Katzman DK. Severely elevated transaminases in an adolescent male with anorexia nervosa. Int J Eat Disord. 2013;46:751–4.

De Caprio C, Alfano A, Senatore I, Zarrella L, Pasanisi F, Contaldo F. Severe acute liver damage in anorexia nervosa: two case reports. Nutrition. 2006;22:572–5.

Harris RH, Sasson G, Mehler PS. Elevation of liver function tests in severe anorexia nervosa. Int J Eat Disord. 2013;46:369–74.

Hanachi M, Melchior JC, Crenn P. Hypertransaminasemia in severely malnourished adult anorexia nervosa patients: risk factors and evolution under enteral nutrition. Clin Nutr. 2013;32:391–5.

Mehler PS, Weiner KL. Use of total parenteral nutrition in the refeeding of selected patients with severe anorexia nervosa. Int J Eat Disord. 2007;40:285–7.

Holmes SR, Gudridge TA, Gaudiani JL, Mehler PS. Dysphagia in severe anorexia nervosa and potential therapeutic intervention: a case series. Ann Otol Rhinol Laryngol. 2012;121:449–56.

Morris LG, Stephenson KE, Herring S, Marti JL. Recurrent acute pancreatitis in anorexia and bulimia. JOP. 2004;5:231–4.

PubMed   Google Scholar  

Lo Sauro C, Ravaldi C, Cabras PL, Faravelli C, Ricca V. Stress, hypothalamic-pituitary-adrenal axis and eating disorder. Neuropsychobiology. 2008;57:95–101.

Estour B, Germain N, Diconne E, Frere D, Cottet-Emard JM, Carrot G, et al. Hormonal profile heterogeneity and short-term physical risk in restrictive anorexia nervosa. J Clin Endocrinol Metab. 2010;95:2203–10.

Utiger RD. Altered thyroid function in nonthyroidal illness and surgery. To treat or not to treat? N Engl J Med. 1995;7:1562–3.

Gaudiani JL, Sabel AL, Mascolo M, Mehler PS. Severe anorexia nervosa: outcomes from a medical stabilization unit. Int J Eat Disord. 2012;45:85–92.

Rich LM, Caine MR, Findling JW, Shaker JL. Hypoglycemic coma in anorexia nervosa. Case report and review of the literature. Arch Intern Med. 1990;150:894–5.

Tseng CL, Soroka O, Maney M, Aron DC, Pogach LM. Assessing potential glycemic overtreatment in persons at hypoglycemic risk. JAMA Int Med. 2014;174:259–68.

Yashuhara D, Deguchi D, Tsutsui J, Nagai N, Nozone S, Nauro T. Reactive hypoglycemia induced by rapid change in eating behavior in anorexia nervosa. Int J Eat Disord. 2003;34:273–7.

Nielsen S, Emborg C, Molbak AG. Mortality in concurrent type 1 diabetes and anorexia nervosa. Diabetes Care. 2002;25:309–12.

Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: a systematic review. JAMA. 2007;298:902–16.

Brown C, Mehler PS. Anorexia nervosa complicated by diabetes mellitus: The case for permissive hyperglycemia. Int J Eat Disord. 2014;47:671–4.

Doufas AG, Mastorakos G. The hypothalamic-pituitary-thyroid axis and the female reproductive system. Ann N Y Acad Sci. 2000;900:65–76.

Dalle-Grave R, Calugi S, Marchesini G. Is amenorrhea a useful criterion for the diagnosis of anorexia nervosa? Behav Res Ther. 2008;46:1290–6.

Katz MG, Vollenhoven B. The reproductive endocrine consequences of anorexia nervosa. BJOG. 2000;107:707–13.

Bulik CM, Hoffman ER, Von Holle A, Torgersen L, Stoltenberg C, Reichborn-Kjennerud T. Unplanned pregnancy in women with anorexia nervosa. Obstet Gynecol. 2010;116:1136–40.

Article   PubMed Central   PubMed   Google Scholar  

Koubaa S, Hallstrom T, Lindholm C, Hirschberg AL. Pregnancy and neonatal outcomes in women with eating disorders. Obstet Gynecol. 2005;105:255–60.

Bulik CM, Sullivan PF, Fear JL, Pickering A, Dawn A, McCullin M. Fertility and reproduction in women with anorexia nervosa: a controlled study. J Clin Psychiatry. 1999;60:130–5.

Hutter G, Ganepola S, Hofmann WK. The hematology of anorexia nervosa. Int J Eat Disord. 2009;42:293–300.

Abella E, Feliu E, Granada I, Milla F, Oriol A, Ribera JM, et al. Bone marrow changes in anorexia nervosa are correlated with the amount of weight loss and not with other clinical findings. Am J Clin Pathol. 2002;118:582–8.

Sabel AL, Gaudiani JL, Statland B, Mehler PS. Hematological abnormalities in severe anorexia nervosa. Ann Hematol. 2013;92:605–13.

Strumia R. Skin signs in anorexia nervosa. Dermatoendocrinol. 2009;1:268–70.

Brown RF, Bartrop R, Beaumont P, Birmingham CL. Bacterial infections in anorexia nervosa: delayed recognition increases complications. Int J Eat Disord. 2005;37:261–5.

Ehrlich S, Burghardt R, Weiss D, Salbach-Andrae H, Craciun EM, Goldhahn K, et al. Glial and neuronal damage markers in patients with anorexia nervosa. J Neural Transm. 2008;115:921–7.

Kraeft JJ, Uppot RN, Heffess AM. Imaging findings in eating disorders. AJR Am J Roentgenol. 2013;200:W328–35.

Lazaro L, Andres S, Calvo A, Cullell C, Moreno E, Plana MT, et al. Normal gray and white matter volume after weight restoration in adolescents with anorexia nervosa. Int J Eat Disord. 2013;46:841–8.

Kanis JA, Melton 3rd LJ, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9:1137.

Bredella MA, Fazeli PK, Daley SM, Miller KK, Rosen CJ, Klibanski A, et al. Marrow fat composition in anorexia nervosa. Bone. 2014;66C:199–204.

Fazeli PK, Klibanski A. Bone metabolism in anorexia nervosa. Curr Osteoporos Rep. 2014;12:82–9.

Faje AT, Fazeli PK, Miller KK, Katzman DK, Ebrahimi S, Lee H, et al. Fracture risk and areal bone mineral density in adolescent females with anorexia nervosa. Int J Eat Disord. 2014;47:458–66.

Misra M, Klibanski A. Anorexia nervosa and bone. J Endocrinol. 2014;221:R163–76.

Article   PubMed Central   CAS   PubMed   Google Scholar  

Trombetti A, Richert L, Herrmann FR, Chevalley T, Graf JD, Rizzoli R. Selective determinants of low bone mineral mass in adult women with anorexia nervosa. Int J Endocrinol. 2013;2013:897193.

Behre HM, Kliesch S, Leifke E, Link TM, Nieschlag E. Long-term effect of testosterone therapy on bone mineral density in hypogonadal men. J Clin Endocrinol Metab. 1997;82:2386–90.

Mehler PS, Sabel AL, Watson T, Andersen AE. High risk of osteoporosis in male patients with eating disorders. Int J Eat Disord. 2008;41:666–72.

Yahalom M, Spitz M, Sandler L, Heno N, Roguin N, Turgeman Y. The significance of bradycardia in anorexia nervosa. Int J Angiol. 2013;22:83–94.

Krantz MJ, Mehler PS. Resting tachycardia, a warning sign in anorexia nervosa: case report. BMC Cardiovasc Disord. 2004;4:10.

Krantz MJ, Gaudiani JL, Johnson VW, Mehler PS. Exercise electrocardiography extinguishes persistent junctional rhythm in a patient with severe anorexia nervosa. Cardiology. 2011;120:217–20.

Ulger Z, Gürses D, Ozyurek AR, Arikan C, Levent E, Aydoğdu S. Follow-up of cardiac abnormalities in female adolescents with anorexia nervosa after refeeding. Acta Cardiol. 2006;61:43–9.

Ramacciotti CE, Coli E, Biadi O, Dell’Osso L. Silent pericardial effusion in a sample of anorexic patients. Eat Weight Disord. 2003;8:68–71.

Docx MK, Gewillig M, Simons A, Vandenberghe P, Weyler J, Ramet J, et al. Pericardial effusions in adolescent girls with anorexia nervosa: clinical course and risk factors. Eat Disord. 2010;18:218–25.

Kastner S, Salbach-Andrae H, Renneberg B, Pfeiffer E, Lehmkuhl U, Schmitz L. Echocardiographic findings in adolescents with anorexia nervosa at beginning of treatment and after weight recovery. Eur Child Adolesc Psychiatry. 2012;21:15–21.

Inagaki T, Yamamoto M, Tsubouchi K, Miyaoka T, Uegaki J, Maeda T, et al. Echocardiographic investigation of pericardial effusion in a case of anorexia nervosa. Int J Eat Disord. 2003;33:364–6.

Polli N, Blengino S, Moro M, Zappulli D, Scacchi M, Cavagnini F. Pericardial effusion requiring pericardiocentesis in a girl with anorexia nervosa. Int J Eat Disord. 2006;39:609–11.

Kircher JN, Park MH, Cheezum MK, Hulten EA, Kunz JS, Haigney M, et al. Cardiac tamponade in association with anorexia nervosa: a case report and review of the literature. Cardiol J. 2012;19:635–8.

Casiero D, Frishman WH. Cardiovascular complications of eating disorders. Cardiol Rev. 2006;14:227–31.

Olivares JL, Vázquez M, Fleta J, Moreno LA, Pérez-González JM, Bueno M. Cardiac findings in adolescents with anorexia nervosa at diagnosis and after weight restoration. Eur J Pediatr. 2005;164:383–6.

Rotondi F, Manganelli F, Lanzillo T, Candelmo F, Lorenzo ED, Marino L, et al. Tako-tsubo cardiomyopathy complicated by recurrent torsade de pointes in a patient with anorexia nervosa. Intern Med. 2010;49:1133–7.

Koschke M, Boettger MK, Macholdt C, Schulz S, Yeragani VK, Voss A, et al. Increased QT variability in patients with anorexia nervosa–an indicator for increased cardiac mortality? Int J Eat Disord. 2010;43:743–50.

Krantz MJ, Sabel AL, Sagar U, Long CS, Barbey JT, White KV, et al. Factors influencing QT prolongation in patients hospitalized with severe anorexia nervosa. Gen Hosp Psychiatry. 2012;34:173–7.

Facchini M, Sala L, Malfatto G, Bragato R, Redaelli G, Invitti C. Low-K+ dependent QT prolongation and risk for ventricular arrhythmia in anorexia nervosa. Int J Cardiol. 2006;106:170–6.

Vadalá S, Pellegrini D, Verdaguer MF, Schrappe M, Alvarez J, Bruetman JE. [Stress (Takotsubo) cardiomyopathy in a patient with anorexia nervosa] Med (B Aires). 2014;74:222–4.

Google Scholar  

Shamim T, Golden NH, Arden M, Filiberto L, Shenker IR. Resolution of vital sign instability: an objective measure of medical stability in anorexia nervosa. J Adolesc Health. 2003;32:73–7.

Coxson HO, Chan IH, Mayo JR, Hlynsky J, Nakano Y, Birmingham CL. Early emphysema in patients with anorexia nervosa. Am J Respir Crit Care Med. 2004;170:748–52.

Gardini Gardenghi G, Boni E, Todisco P, Manara F, Borghesi A, Tantucci C. Respiratory function in patients with stable anorexia nervosa. Chest. 2009;136:1356–63.

Pieters T, Boland B, Beguin C, Veriter C, Stanescu D, Frans A, et al. Lung function study and diffusion capacity in anorexia nervosa. J Intern Med. 2000;248:137–42.

Danzer G, Mulzer J, Weber G, Lembke A, Kocalevent R, Klapp BF. Advanced anorexia nervosa, associated with pneumomediastinum, pneumothorax, and soft-tissue emphysema without esophageal lesion. Int J Eat Disord. 2005;38:281–4.

Hochlehnert A, Löwe B, Bludau HB, Borst M, Zipfel S, Herzog W. Spontaneous pneumomediastinum in anorexia nervosa: a case report and review of the literature on pneumomediastinum and pneumothorax. Eur Eat Disord Rev. 2010;18:107–15.

Biffl WL, Narayanan V, Gaudiani JL, Mehler P. The management of pneumothorax in patients with anorexia nervosa: A case report and review of the literature. Patient Saf Surg. 2010;4:1.

Morse JL, Safdar B. Acute tension pneumothorax and tension pneumoperitoneum in a patient with anorexia nervosa. J Emerg Med. 2010;38:e13–6.

Sabel AL, Rosen E, Mehler P. Severe anorexia nervosa in males: clinical presentations and medical treatment. Eat Disord. 2014;22:209–20.

Download references

Author information

Authors and affiliations.

Department of Medicine, University of Colorado Health Sciences Center, ACUTE at Denver Health, and Eating Recovery Center, Denver, CO – 777 Bannock Street, MC4000, Denver, CO 80204, 7351 E Lowry Blvd, Suite 200, Denver, CO, 80230, USA

Philip S Mehler

Department of Medicine, University of Colorado Health Sciences Center and ACUTE at Denver Health, Denver, CO – 777 Bannock Street, MC4000, Denver, CO, 80204, USA

Carrie Brown

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Philip S Mehler .

Additional information

Competing interests.

Dr. Philip S. Mehler and Dr. Carrie Brown declare that they have no significant competing financial, professional or personal interests that might have influenced the performance or presentation of the work described in this manuscript.

Authors’ contributions

Both authors read and approved the final manuscript.

Authors’ information

Philip S. Mehler and Carrie Brown: these authors contributed significantly to this work with Dr. Mehler writing about 70% of the manuscript.

Rights and permissions

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Cite this article.

Mehler, P.S., Brown, C. Anorexia nervosa – medical complications. J Eat Disord 3 , 11 (2015). https://doi.org/10.1186/s40337-015-0040-8

Download citation

Received : 08 August 2014

Accepted : 17 February 2015

Published : 31 March 2015

DOI : https://doi.org/10.1186/s40337-015-0040-8

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

  • Complications
  • Osteoporosis

Journal of Eating Disorders

ISSN: 2050-2974

anorexia nervosa with hair loss

  • Binge-eating disorder
  • Healthy Eating
  • For Parents/Families
  • Medical Issues
  • For Professionals
  • Organizations
  • Conferences and Events
  • Treatment Centers
  • Treatment Providers
  • Helpful Links
  • Support Groups

Hair Loss and Anorexia: A Sign of Greater Danger

anorexia nervosa with hair loss

When we hear someone mention hair loss, we usually think of aging. Others may associate hair loss with chemotherapy or the compulsive hair pulling associated with trichotillomania . What most people would not normally associate hair loss with is anorexia nervosa , unless they treat patients with the disorder or have been affected by it personally. In reality, people of all genders and ages with anorexia, bulimia , and other eating disorders commonly experience hair loss, including hair thinning and areas of balding.

So what causes the hair loss? When a person’s body is malnourished, such as during an eating disorder, the protein stores in their body become depleted. When this occurs, the body has to make sure that it takes care of essential functions (such as organ function and retaining muscle tissue) above all else. Our hair, which is made up of a protein called keratin, is not as essential to our body’s functioning. So, hair growth stops so the body can focus on keeping that person alive. Depending on a person’s age, genetic makeup, and other developmental factors, regular hair growth will most likely return to normal after a person maintains nutritional stabilization for six months or more.

When someone is experiencing hair loss associated with anorexia, there are usually plenty of co-occurring symptoms such as dehydration (which can lead to kidney failure), cold intolerance, fatigue, lightheadedness, and more. These are in addition to their likely significant weight loss. Hair loss can be a very distressing symptom for someone with anorexia to experience, but the true cause for concern is the high mortality rate among people with this disorder, which is between five and 10 percent [1] . Eating disorders have a higher mortality rate than any other behavioral health disorder. 

Oftentimes when someone reaches out for eating disorder treatment, his or her body is already dangerously malnourished and they are probably experiencing physical, emotional, and cognitive side effects. Hair loss might be one example of a physical side effect. If you notice that a family member or friend is avoiding meals, entire food groups, or social gatherings related to food—and maybe losing their hair—it may be a good idea to ask them about their relationship with food. Although an eating disorder is not always the cause, it’s best to express your concern for your loved one’s well-being and good health. If they do decide to seek professional eating disorder services, let them know that you will be a part of their support network both through treatment and beyond.

Although the possibility of hair loss is not as significant as many of the symptoms of anorexia, for some the symptom serves as motivation to seek treatment, change their eating behaviors, and rebuild their relationship with food and nutrition. Many individuals who struggle with anorexia base their self-worth off of their body image, but the reality is that malnutrition damages the body in numerous ways. Hair loss reflects the damage that has already happened on the inside of the body and can help someone with anorexia finally realize the true dangers of their eating habits.

1 Anorexia Nervosa | National Eating Disorders Association. (n.d.). Retrieved January 28, 2016, from https://www.nationaleatingdisorders.org/anorexia-nervosa

About the author –

Jordan Murray, RD, CD, is a primary registered dietitian for adult males and females at the Eating Disorder Center at Rogers Memorial Hospital–Oconomowoc , a facility for residential eating disorder treatment. He has experience providing nutritional education and meal planning services in various levels of care, including inpatient and partial hospital programs at Rogers. Murray is a graduate of Viterbo University, where he received his bachelor’s degree in nutrition and dietetics.

Temperament-Based Therapy with Support for Anorexia: A Novel Treatment Interview

Progression of anorexia nervosa: longitudinal staging framework, emílee: the story of a girl and her family hijacked by anorexia interview, most popular, teaching clients why it’s okay to “waste” food, opening the doors to compassion and self-compassion through helplessness, i am me interview, introducing the body freedom project, recent comments, editor picks, popular posts, popular category.

  • Podcast 245
  • Recovery 187
  • For Parents/Families 68
  • For Professionals 66
  • Body Image 60

Newspaper is your news, entertainment, music fashion website. We provide you with the latest breaking news and videos straight from the entertainment industry.

Contact us: [email protected]

© Newspaper WordPress Theme by TagDiv

  • Privacy Policy
  • Terms of Use
  • Advertise with Us

Coronavirus (COVID-19): Latest Updates | Visitation Policies Visitation Policies Visitation Policies Visitation Policies Visitation Policies | COVID-19 Testing | Vaccine Information Vaccine Information Vaccine Information

Child and Adolescent Eating Disorders Program

Anorexia nervosa, what is anorexia nervosa.

Anorexia nervosa is an eating disorder in which a person intentionally limits the intake of food or beverage because of a strong drive for thinness and an intense fear of gaining weight. This can happen even if a person is already thin. The perception of body weight and shape is distorted and has an unduly strong influence on a person’s self-concept. The resulting weight loss and nutritional imbalance can lead to serious complications, including death.

Obsessions and anxiety about food and weight may cause monotonous eating rituals, including reluctance to be seen eating by others. It is not uncommon for people with anorexia nervosa to collect recipes and prepare food for family and friends, but not partake in the food that they prepared. They may also adhere to strict, intensive exercise routines to lose or keep off weight.

What Causes Anorexia Nervosa?

Anorexia nervosa does not have a single cause, but is related to many different factors. These factors are sometimes divided into predisposing, precipitating, and perpetuating factors, that make a person vulnerable to develop, trigger the onset, and maintain the eating disorder, respectively.  Anorexia nervosa often begins as simple dieting to "get in shape" or to "eat healthier" but progresses to extreme and unhealthy weight loss. Social attitudes toward body appearance, family influences, genetics, and neurochemical and developmental factors may contribute to the development and maintenance of anorexia nervosa. A personal or family history of anxiety, depression or obsessive-compulsive habits is common. Although families in which anorexia nervosa occurs were once labeled as having difficulties with conflict resolution, rigidity, intrusiveness, and over-protectiveness, it is now clear that parents do not cause eating disorders. Research suggests that certain areas of the brain function different with an active eating disorder.

Who is Affected by Anorexia Nervosa?

Anorexia nervosa not only affects individuals who have the diagnosis, but also their family, friends and loved ones. The diagnosis of anorexia nervosa has become more common over the past 20 years. Approximately 90 percent are women between 12 and 25 years of age. Initially found mostly in upper- and middle-class families, anorexia nervosa is now known to affect both sexes and span all ages, socioeconomic, ethnic, and racial groups.

What Kind of Person Tends to Get Anorexia Nervosa?

The typical profile of a person with anorexia nervosa is an adolescent to young adult female who is perfectionistic, hard-working, introverted, resistant to change and highly self-critical. They also tend to have low self-esteem based on body image distortion and avoid risky or potentially harmful behaviors or situations. However, regardless of the age, sex or other characteristics of the individual, weight control habits focused on reducing intake and increasing output of calories (particularly fats and carbohydrates) initially reduces anxiety, stress and negative mood by giving the person a sense of control in at least one are of her/his life. That is, a sense of mastery and accomplishment is achieved as weight is lost. Over time, these habits cause problems of their own that may increase anxiety, stress and negative mood.

What are the Different Types of Anorexia Nervosa?

There are two subgroups of behavior aimed at reducing caloric intake, including the following:

  • restrictive type - severely limits the intake of food and usually compulsively over-exercises.
  • binge/purge subtype – eats large amounts of food in a brief period of time (binges) and then compensates by intentionally vomiting (sometimes called purging), taking laxatives, exercising or fasting.

What are the Symptoms of Anorexia Nervosa?

  • Intense dieting or preoccupation with food
  • Intense fear of gaining weight , even when losing weight or at a very low weight
  • Distorted view of one's body weight, size, or shape; sees self as too fat, even when very underweight; expresses feeling fat, even when very thin
  • In females, absence of menstrual cycles without another cause
  • Hiding/discarding food
  • Counting calories, grams of fat in the diet
  • Rapid or excessive weight loss
  • Feeling tired, cold and weak
  • Lack of energy
  • Denial of feelings of hunger
  • Cold and blue hands and feet
  • Constipation
  • Dizziness or fainting
  • Slow heart rate
  • Absent or irregular menstruation
  • Excessive facial/body hair
  • Binge eating alternating with fasting
  • Vomiting or taking laxatives after over-eating
  • Compulsive or excessive exercise
  • Self-worth determined by weight or shape

Persons with anorexia nervosa may also be socially withdrawn, irritable, moody, and/or depressed. The symptoms of anorexia nervosa may resemble other medical problems or psychiatric conditions. Always consult your physician for a diagnosis.

How is Anorexia Nervosa Diagnosed?

Parents, family members, spouses, teachers, coaches, and instructors may be able to identify an individual with anorexia nervosa, although many persons with the disorder initially keep their illness very private and hidden. A detailed history of the individual's behavior from family, parents, and teachers, clinical observations of the person's behavior, contribute to the diagnosis.  Because a number of medical conditions can mimic some features of anorexia nervosa, a complete medical evaluation is needed.  Family members who note symptoms of anorexia nervosa in a loved one can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems.

Anorexia nervosa, and the malnutrition that results, can adversely affect nearly every organ system in the body, increasing the importance of early diagnosis and treatment. Anorexia can be fatal. Consult your physician for more information.

Treatment for Anorexia Nervosa

Specific treatment for anorexia nervosa will be determined by a physician based on:

  • age, overall health, and medical history
  • extent of the symptoms
  • tolerance for specific meal plans, therapies, or medications
  • individual and family preferences

Anorexia nervosa is usually treated with a combination of medical care focused on nutritional rehabilitation and modification of behaviors related to eating and exercise to restore body weight and health, and family and/or individual therapy. Treatment should always be based on a comprehensive evaluation of the individual and family. Family therapy is focused on providing support and limit-setting on problem behaviors. Individual therapy usually includes both cognitive and behavioral techniques. Medication may be helpful if depressed moods or worrisome thoughts interfere with daily life.   Re-establishing a normal weight may relieve depression on its own, and anti-depressants are not effective at very low body weight. The frequent occurrence of medical complications and the possibility of death during the course of acute and rehabilitative treatment requires both your physician and a nutritionist to be active members of the management team. Families play a vital supportive role in any treatment process.

Possible Complications of Anorexia Nervosa

Medical complications are common in  anorexia nervosa.  Almost all complications are reversible with weight restoration related to healthy eating and physical activity.  Without treatment, complications persist and can worsen, and can be associated with death.  The short-term complications include, but are not limited to, the following:

  •  irregular heartbeat
  • slow heartbeat
  • low blood pressure
  • with chronic low weight, fatal heart decompensation
  • Red blood cells that carry oxygen and the white blood cells that fight infection are often low.
  • Stomach. liver and intestines Loss of muscles in the gastrointestinal track results in shrinkage of the stomach and slow movement of foods through the track. Paradoxically, starvation can be associated with deposits of fat in the liver.  Full, bloated feeling after eating a small meal Feeling that the food does not empty from the Constipation due to loss of muscle in the gastrointestinal track Inflammation of the liver due to fatty deposits with starvation
  • Kidney Dehydration associated with anorexia results in highly concentrated urine. Increased urine production may also develop in patients when the kidneys ability to concentrate urine decreases.
  • Hormones Absence of the menstrual cycle is one of the hallmark symptoms of anorexia nervosa, and may precede significant weight loss..
  • Bones Persons with anorexia nervosa are at an increased risk for broken bones due to osteoporosis.

Biochemistry and Eating Disorders

To understand eating disorders, researchers have studied the neuroendocrine system, which is made up of a combination of the central nervous and hormonal systems.

The neuroendocrine system regulates multiple functions of the mind and body. It has been found that many of the following regulatory mechanisms may be, to some degree, disturbed in persons with eating disorders:

  • temperature regulation
  • sexual function
  • physical growth and development
  • appetite and digestion
  • sleep heart rate
  • kidney function

Eating Disorders, Anxiety and Depression

As already noted, many people with eating disorders may also have anxiety, depression, and obsessive-compulsive traits.  There may be a link between anorexia nervosa and these other disorders.  For example

  • In the central nervous system, chemical messengers known as neurotransmitters control hormone production. The neurotransmitters serotonin and norepinephrine, which function abnormally in people who have depression, have been discovered to also have decreased levels in both acutely-ill anorexia and bulimia patients, and long-term recovered anorexia patients.
  • Research has shown that some patients with anorexia nervosa may respond well to selective serotonin reuptake inhibitors (SSRIs) after weight is restored.
  • People with anorexia, or certain forms of depression, seem to have higher than normal levels of cortisol, a brain hormone released in response to stress. It has been shown that the excess levels of cortisol in both persons with anorexia and in persons with depression are caused by a problem that occurs in, or near, the hypothalamus of the brain.

The first line of treatment for Anorexia nervosa is food. Improving nutrition alone often improves depression, although anxiety may increase initially.

Genetic/Environmental Factors Related to Eating Disorders

Because eating disorders tend to run in families, and female relatives are the most often affected, genetic factors are believed to play a role in the disorders. But, other influences, both behavioral and environmental, may also play a role. Consider these facts from the National Institute of Mental Health:

  • Genetic factors are known to contribute to the anxiety, depression and obsessive-compulsive traits often occurring in anorexia nervosa.  This does NOT mean that parents who are anxious, depressed or have obsessive-compulsive traits CAUSE anorexia nervosa, but that there is an increased vulnerability to develop it.
  • “Innocent” teasing about body weight or appearance, especially by fathers and/or brother(s), may contribute to the onset of anorexia nervosa (precipitating cause).  .
  • Although most individuals with anorexia nervosa are adolescent and young adult women, these illnesses can also strike men and older women.
  • Anorexia nervosa is found most often in Caucasians, but these illnesses also affect African Americans and other races.
  • People pursuing activities or professions that emphasize thinness - such as modeling, dancing, gymnastics, wrestling, and long-distance running - are more susceptible to these disorders.

Prevention of Anorexia Nervosa

Preventive measures to reduce the incidence of anorexia nervosa are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the individual's normal growth and development, and improve the quality of life experienced by persons with anorexia nervosa.  Decreasing emphasis on weight and focusing on the balance between energy input and output can be useful.  Moreover, having healthy adult role models who do not talk about body shape or size, dieting, fat, or losing weight is helpful.  Also, encouraging healthy eating habits and realistic attitudes toward weight and diet may be an effective preventative measure. 

anorexia nervosa with hair loss

Personalize Your Experience

Log in or create an account for a personalized experience based on your selected interests.

Already have an account? Log In

Free standard shipping is valid on orders of $45 or more (after promotions and discounts are applied, regular shipping rates do not qualify as part of the $45 or more) shipped to US addresses only. Not valid on previous purchases or when combined with any other promotional offers.

Register for an enhanced, personalized experience.

Receive free access to exclusive content, a personalized homepage based on your interests, and a weekly newsletter with topics of your choice.

Home / Mental Health / What is disordered eating and when does it become an eating disorder?

What is disordered eating and when does it become an eating disorder?

Please login to bookmark.

anorexia nervosa with hair loss

Disordered eating refers to a wide range of behaviors that involve eating in a way that prevents full participation in life activities or impairs healthy growth and development. At best, disordered eating can lead to physical and psychological symptoms in children and teens. At worst, disordered eating can develop into an eating disorder. Eating disorders refer to a number of related mental illness diagnoses that affect millions of Americans each year. If left untreated they can become life-threatening. Eating disorders have one of the highest rates of death associated with them of any mental health diagnosis. Though the phrase “ disordered eating” can be used to describe a range of problematic eating behaviors, there are specific criteria for eating disorders defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 TR). These include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID), and other specified feeding and eating disorders.

Who is most at risk for eating disorders?

“More and more, our data suggests that eating disorders are much more equal opportunity and affect a much broader range of individuals than the stereotypical white, cisgender, wealthy, emaciated adolescent girl,” states Dr. Jocelyn Lebow, Ph.D., L.P., a clinical psychologist at Mayo Clinic in Rochester, Minnesota. Eating disorders affect people of all gender identities, ethnicities, cultures, ages and body sizes.

What causes eating disorders?

A variety of factors increase the risk of eating disorders including family history, trauma, weight-related bullying and many mental health diagnoses such as obsessive-compulsive disorder. People who identify as transgender or nonbinary also are at increased risk. One of the biggest risk factors, Dr. Lebow stresses, is any sort of dieting or food restriction, even when these behaviors begin as a result of good intentions to “get healthier” or even in response to advice from professionals. Certain sports where size or weight plays a role also can put young athletes at risk. Weight bias also increases the risk of eating disorders, which is important, as more than 40% of American adults report having faced some sort of stigma, teasing or unfair treatment related to their weight, according to the American Psychological Association. Additional culprits may include individual biology and personality traits, environmental triggers such as trauma, and societal influence including social media and the too-common unspoken narrative that “thin = good,” which is often referred to as the “thin ideal.”

When does being health-conscious cross over into eating disorder risk?

“In kids, one of the signs that eating behaviors have crossed the line is when we see a large deviation from their growth curve or trend. This doesn ‘ t just happen with weight loss; we also see it when kids stop making the gains in height or weight we’d expect based on their age,” says Dr. Lebow. Additional physiological warning signs can include:

* Changes to or even the loss of a period in girls.

* Abnormal lab values or negative change to vital signs.

* A stress fracture or other injury that indicates loss of bone strength.

Those symptoms occur frequently, but an eating disorder may still be present even if things look clinically normal.

Behaviorally, disordered eating often presents as inflexibility or rigidity around diet and exercise. For example:

* Are eating or exercise habits so rigid that they interfere with normal activities or functioning?

* Does the thought of eating certain foods provoke anxiety or fear?

* Can all different kinds of foods be enjoyed without significant guilt or overthinking?

Impairment or impact on life is key to look for. Although physiological markers also can be present in adults, someone is likely to be quite ill by the time they show up.

How can I address my concern about their eating with a family member or friend?

“There’s no guarantee it’s going to go well. That doesn’t mean you shouldn’t say something if you are worried,” states Dr. Lebow. She emphasizes the ideal approach should be free of blame or judgement, as eating disorders often are characterized by a lot of shame and suffering for the people who have them. Concerned friends and family should take a compassionate, respectful and direct approach. For example: “I’m concerned. I’m noticing you’re not eating very much. Do you think it might be a good idea to talk to your doctor about this?” This type of conversation, of course, depends on your relationship. If it is a child you’re concerned about, talk to their parent or guardian privately first.

What does treatment look like?

If you or a family member believes you may need treatment for an eating disorder, start with your primary care provider. They should be able to make an assessment, ensure your medical stability and determine the best treatment type. Treatment for eating disorders may occur in an outpatient, day treatment, inpatient or residential setting. Seek out a therapist and a registered dietitian who specializes in eating disorders. Eating disorder treatment is not something all therapists and dieticians are trained to do.

In children, family-based treatment (FBT) is the first line treatment for anorexia nervosa, while bulimia nervosa may be addressed through family-based treatment (FBT), enhanced cognitive behavioral therapy (CBT-E), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT). For adults with anorexia nervosa, there are unfortunately no evidence-based outpatient approaches. Many adults with anorexia nervosa need to be treated in higher levels of care, like day treatment or residential programs. For adults with bulimia nervosa or binge-eating disorder, options include enhanced cognitive behavioral therapy (CBT-E), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), or integrative cognitive-affective therapy (ICAT). Intervention options and recommendations are dependent on age, diagnosis, health status and severity.

anorexia nervosa with hair loss

Discover more Mental Health content from articles, podcasts, to videos.

You May Also Enjoy

anorexia nervosa with hair loss

Privacy Policy

We've made some updates to our Privacy Policy. Please take a moment to review.

DermNet provides Google Translate, a free machine translation service. Note that this may not provide an exact translation in all languages

  • Skin checker

Malnutrition including anorexia nervosa

Author: Dr Marie Hartley, Staff Writer, 2010.

What is malnutrition?

Malnutrition occurs when the supply of nutrients and energy is inadequate to meet the body's requirements.

What causes malnutrition?

Worldwide, the most common cause of malnutrition is an inadequate food supply. Gastrointestinal infections , particularly parasitic infections, exacerbate this problem. Preschool-aged children in developing countries are most at risk because of their increased protein and energy requirements, greater susceptibility to infection , and exposure to unhygienic conditions. Protein-energy malnutrition  occurs mainly in young children from developing countries at the time of weaning.

In developed countries, other causes of malnutrition are more prominent:

  • Reduced absorption or abnormal metabolism of nutrients and energy due to illnesses such as inflammatory bowel disease (e.g. Crohn disease ), gastrointestinal infections, cystic fibrosis , extensive thermal burns , or cancer .
  • Insufficient food intake e.g. anorexia nervosa.
  • Complex social and medical problems – for example, elderly people can become malnourished due to a combination of reduced appetite, impaired mental functioning, medications, coexisting illnesses, psychosocial isolation, heavy alcohol intake, and/or depression.
  • Inadequate food supply can also be a problem in low-income areas of developed countries.

Dermatological features of malnutrition

Although malnutrition affects almost every organ in the body, this page focuses on the dermatological features.

When malnutrition is caused by anorexia nervosa, a number of specific dermatological features are seen:

Skin changes associated with anorexia nervosa become more frequent when the body mass index (BMI) falls to 16 kg/m2 or less. Patients with bulimia nervosa (and some patients with anorexia nervosa) engage in uncontrollable binge-eating episodes, followed by purging behaviours such as self-induced vomiting or the use of laxatives. Dermatological features associated with purging behaviours include:

  • Calluses over the knuckles (also called Russell sign ) caused by repeated rubbing of the skin against the upper front teeth when the hand is used to induce vomiting.
  • Erosion of dental enamel and tooth loss due to vomiting.
  • Post-vomiting facial petechiae – tiny red, purple, or brown spots due to breakage of small blood vessels and bleeding into the skin.
  • Post-vomiting subconjunctival haemorrhage – red eye/s due to damage to small blood vessels in the eyes.
  • Adverse reactions to drugs such as laxatives, diuretics, and appetite suppressants e.g. thiazide diuretics may induce drug photosensitivity .

Diagnosis of malnutrition

  • Progressive weight loss; children may have poor growth.
  • Blood tests may reveal low levels of protein; electrolyte imbalances (abnormal levels of salts in the blood); and evidence of iron deficiency or vitamin deficiencies.

What is the treatment for malnutrition?

In patients with severe malnutrition, fluid and electrolyte imbalances should be corrected first. Food should be introduced slowly and carefully. Vitamin and mineral supplements may be needed. The skin changes associated with malnutrition generally resolve when nutritional deficiencies are corrected and the patient gains weight.

  • Strumia R. Dermatologic signs in patients with eating disorders. Am J Clin Dermatol. 2005;6(3):165–73.
  • Tyler I, Wiseman MC, Crawford RI, Birmingham CL. Cutaneous manifestations of eating disorders. J Cutan Med Surg. 2002 Jul-Aug;6(4):345–53. Epub 2002 Apr 15. Review. PubMed
  • Protein-Energy Malnutrition  — eMedicine Dermatology
  • Malnutrition  — eMedicine Pediatrics: General Medicine
  • Kwashiorkor
  • Iron deficiency
  • Metabolic syndrome
  • Vitamin A deficiency

Other websites

  • Anorexia Nervosa
  • Protein-Energy Malnutrition
  • Eating Disorder, Anorexia
  • Bulimia Nervosa
  • Eating Disorders  — MedlinePlus

Books about skin diseases

  • Books about the skin
  • Dermatology Made Easy  - second edition

Related information

Sign up to the newsletter.

© 2024 DermNet.

DermNet does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice.

ChaChingQueen

Common Eating Disorder Symptoms and Treatments

https://www.pexels.com/photo/a-nutritionist-educating-a-woman-8844553/

Eating disorders affect almost 5% of the population worldwide. These disorders usually develop during adolescence but can develop in adulthood as well.

Some disorders, such as anorexia nervosa, are more common in women. However, these disorders can affect anyone irrespective of gender, age, or other characteristics. 

Eating disorders are severe conditions that can cause numerous complex medical issues and result in severe emotional distress.

People with severe eating disorders may require help from more than one medical professional to recover.

To root out the issue in its entirety, not only is medical assistance required, but mental health counseling is also paramount since eating disorders are mainly psychological issues. 

Some serious eating disorders may require daily supervision. Nurses can play a significant role in this regard. From the point a patient walks through the hospital doors until they leave, nurses are the primary point of contact for most patients. 

From this critical position, nurses can help patients identify their eating disorders earlier.

These disorders almost always stay under the radar until they’ve progressed in severity. Developing the eye to recognize the signs of an eating disorder in a patient requires exceptional knowledge and skill. 

To develop and gain that knowledge, nurses can pursue an MSN or DNP degree.

Defining Eating Disorders

Eating disorders can be defined as certain behavioral conditions characterized by severe and persistent disturbances in an individual’s eating behaviors. Eating disorders are considered among the  deadliest of mental illnesses . They can impair a person’s social, psychological, and physiological functioning. 

So, let’s take a closer look at some of the common eating disorders:

Anorexia Nervosa

Anorexia nervosa is one of the most commonly known eating disorders. This disorder is prevalent among women more than men and often starts during adolescence or early adulthood. 

People suffering from anorexia view themselves as overweight despite often being severely underweight. They restrict their food intake and try to eat as little as possible. 

Some common symptoms of anorexia nervosa are:

  • Considerably underweight as compared to other people of their age
  • Engaging in restricted eating behaviors
  • Intense fear of gaining weight
  • Engaging in behaviors that will prevent them from gaining weight
  • They have a distorted body image and may face self-esteem issues due to it 
  • They deny accepting that they are underweight
  • May also develop depression and anxiety
  • They may use laxatives, diet pills and often fall ill 

There can be many long-term side effects of anorexia nervosa if it goes undiagnosed and untreated for a long time. For instance, such people may face fertility issues, weak or brittle nails, and hair.

Moreover, the lack of important nutrients can also lead to organ failure.

Bulimia Nervosa

Bulimia is characterized by binge eating episodes where they eat till it is painful. This is followed by purging. This includes behaviors like forced vomiting, excessive exercise, using laxatives, and so on.

Common symptoms include:

  • Recurring episodes of binge eating and inability to control them
  • Fear of gaining weight
  • Frequently engaging in purging behaviors to avoid weight gain
  • Self-esteem and body image issues

Bulimia nervosa can negatively impact one’s physical health if not treated. People with this disorder may experience a sore throat, digestive problems, dehydration, and hormonal imbalances. Moreover, they also have higher chances of experiencing a stroke.

Binge Eating Disorder

This is one of the most common eating disorders in the United States. It often gets confused with bulimia nervosa. However, it does not include purging behaviors.

People with BED eat large amounts of food and cannot control themselves. 

This disorder is characterized by the following:

  • Eating large amounts of food in a short time, even if they do not feel hungry
  • Unable to control or stop eating
  • Feelings of guilt and shame regarding this behavior
  • Absence of purging behaviors

Pica is a disorder in which a person craves non-food items like sand, soap, paper, chalk, ice, and more. It is commonly found in children, pregnant women, or people with mental disabilities.

Such people are at a higher risk of poisoning, gut injuries, and various deficiencies.

Rumination Disorder

This disorder can affect anyone, irrespective of their age. In this disorder, a person tends to regurgitate food, swallow it, chew it again then swallow or spit it out. 

It can also result in severe malnutrition and extreme weight loss if it is not properly treated. 

Avoidant/Restrictive Food Intake Disorder (ARFID)

ARFID starts during infancy or early childhood but can also persist into adulthood. Furthermore, it is commonly found in both men and women.

In this disorder, the person has disturbed eating patterns due to a lack of interest in eating or dislike towards certain tastes and smells.

  • Avoiding or restricting food intake
  • Eating habits interfere with normal social functioning
  • Malnutrition and weight loss
  • May also be dependent on supplements of tube feeding

How Can An Eating Disorder Be Treated?

Even though eating disorders are severe and can cause numerous problems, they are treatable. People suffering from disorders can recover and lead healthy lives with the help of early detection and the proper treatment.

Some treatment methods for eating disorders are:

Psychotherapy

This is effective for all eating disorders. It helps identify underlying issues, which helps understand the causes of the disorder. Moreover, it helps establish healthy eating patterns and coping mechanisms. 

It is also used to deal with the psychological side effects of eating disorders, such as depression, anxiety, and low self-esteem. Commonly used therapeutic interventions include CBT, behavioral therapy, and family therapy.

Medication can be used for treating the side effects of eating disorders. For instance, anti-depressants can be prescribed to fight off depression and increase  serotonin  levels.

Nutritional Counseling

Nutritional counseling helps the patient in learning about healthy eating habits. It helps you recognize signs of hunger and satiation. Furthermore, following a healthy diet plan helps you maintain body weight and overcome any deficiencies caused by the disorder.

Hospitalization

This option is often required for severe cases requiring intensive treatment and care. However, it is not very common.

In Conclusion

Eating disorders are mental health conditions that involve disturbed eating behaviors. Moreover, these disorders can hurt a person’s mental and physical health. Therefore, they require effective and immediate treatment as they can worsen if left untreated.

Next Up From ChaChingQueen

  • Nursing And Nutrition: How To Combine Your Love Of Both
  • Is Your 3 Year Old Exhibiting Sign Of Autism?
  • Overcoming Low Self-Esteem
  • Dietician Shares 12 Foods You Can Eat A Lot Of Without Getting Fat

Six common types of eating disorders explained. Treatments includes medication, therapy, nutrition planning, and hospitalization if severe.

Anorexia Nervosa and Osteoporosis: A Possible Complication to Remember

Affiliations.

  • 1 Family Medicine, USF Cidade Jardim, Viseu Dão Lafões, PRT.
  • 2 Internal Medicine, Centro Hospitalar Tondela-Viseu, Viseu Dão Lafões, PRT.
  • 3 Family Medicine, UCSP Fornos de Algodres, Guarda, PRT.
  • PMID: 38380189
  • PMCID: PMC10877225
  • DOI: 10.7759/cureus.52670

Anorexia nervosa (AN) belongs to the spectrum of food disorders and affects approximately 2.9 million people worldwide. It is responsible for numerous and serious medical complications. Osteoporosis is a common complication, and the decrease in bone mineral density (BMD) is one of the few potentially irreversible consequences of AN. When associated with AN, it can manifest at a very young age, possibly leading to irreparable damage. We describe the case of a 30-year-old woman with a one-year evolution diagnosis of AN, complaining of back pain. Physical examination revealed a slight elevation of the right shoulder and pain at compression of paravertebral right dorsal musculature with a palpable strained muscle. Full-length X-ray imaging of the dorsal spine revealed a slight dextroconvex dorsolumbar scoliosis. A dorsal spine computerized tomography (CT) was performed, confirming a fracture of the upper platform of the sixth dorsal vertebrae. Osteodensitometry showed lumbar spine osteoporosis and femoral osteopenia. The decrease in BMD and, later on, the development of osteoporosis can occur in both types of AN. It is a severe complication that affects up to 50% of these patients. It can be irreversible and increase the lifetime risk of bone fractures and, therefore, morbimortality. Low body weight and body mass index (BMI) strongly correlate with the decrease in BMD. Treatment of osteoporosis associated with AN is not standardized and clearly labeled. Weight gain is described as the strategy with the most impact in reversing the loss of bone mass and increasing the BMD. The regularization of gonadal function also seems to independently potentiate the increase of BMD. The occurrence of long bone and vertebrae fractures frequently results in a decrease in height and chronic back pain, culminating in greater morbimortality and healthcare costs. This clinical case aims to show theclose relationship between restrictive food disorders and the decrease of BMD and the subsequent development of osteoporosis and its complications. Although rare in young and healthy people, when associated with restrictive food disorders, it should raise a red flag in its clinical evaluation. Preventing osteoporosis development and reduction of fracture risk in this population is essential. The current absence of consistent evidence regarding screening of osteoporosis in this particular group should raise awareness and promote further larger-scale studies to establish standardized recommendations concerning not only screening but also pharmacological treatment of osteoporosis in patients with AN.

Keywords: anorexia nervosa; back pain; feeding and eating disorders; osteoporosis; spinal fractures.

Copyright © 2024, Rosas Pereira et al.

Publication types

  • Case Reports

IMAGES

  1. Anorexia Hair Loss

    anorexia nervosa with hair loss

  2. Anorexia And Hair Loss: What You Need To Know

    anorexia nervosa with hair loss

  3. Anorexia Before And After

    anorexia nervosa with hair loss

  4. Anorexia Hair Loss

    anorexia nervosa with hair loss

  5. Anorexia Hair Loss

    anorexia nervosa with hair loss

  6. Stunning before-and-afters of people who conquered anorexia

    anorexia nervosa with hair loss

VIDEO

  1. Anorexia Nervosa [Lecture 22]

  2. Anorexia|| indigestion and loss of appetite Treatment on cow @VETPRAKASHACHARYA

  3. [by Request] Anorexia Nervosa 厭食症 by Dr. Patrick Cheung (Jan 2021)

  4. Anorexia Nervosa

  5. Anorexia Nervosa #eatingdisorderrecovery #healing #mentalhealthawareness

  6. Anorexia Nervosa Insanity Disease

COMMENTS

  1. Anorexia And Hair Loss: What You Need To Know

    People suffering from anorexia nervosa may experience a receding hairline, hair loss, and thinning hair. They can also undergo loss of vitality, due to vitamin deficiencies caused by their disordered eating. As a result, sufferers in some cases lose their eyelashes and experience receding cuticles and gums as well.

  2. Anorexia Hair Loss Explained

    With anorexia nervosa (here referred to as anorexia), hair loss occurs after one restricts their food or engages in other eating disorder behaviors ( purging, excessive exercise ). Over time, as the eating disorder behaviors continue, an individual with anorexia becomes malnourished, causing hair loss and numerous other serious health risks.

  3. Anorexia Hair Loss Treatment

    Hair loss, hair thinning, brittle fingernails, and flaky skin are all common side effects of anorexia nervosa and bulimia nervosa. Even though hair loss is not the most dangerous side effect of anorexia, the subsequent change in appearance and body image is often one of the most distressing outcomes for people with an eating disorder.

  4. Anorexia and Hair Loss

    Anorexia and Hair Loss Anorexia and Bulimia Nervosa. Social pressures to stay thin are primary causes of Anorexia and Bulimia. Many sufferers are persons with low personal esteem. Excessive shedding of terminal scalp hairs may follow Anorexia Nervosa or Bulimia Nervosa. Anorexia

  5. Anorexia nervosa

    Hair that thins, breaks or falls out Soft, downy hair covering the body Absence of menstruation Constipation and abdominal pain Dry or yellowish skin Intolerance of cold

  6. Lanugo and Anorexia

    Anorexia nervosa can lead to eating disorder-related hair loss, through the changes incurred in the body during periods of starvation. For the body to operate properly when it is starved of energy in the form of calories and essential nutrients, it slows down non-essential functions in order to survive.

  7. Anorexia Nervosa

    Anorexia nervosa, also known as just anorexia, is an eating disorder. This disorder makes you obsess about your weight and food. If you have this problem, you may have a warped body image. You may see yourself as fat even though you have a very low body weight. With anorexia, you may use unusual eating habits to cope with stress, anxiety, and ...

  8. Anorexia nervosa

    Diagnosis. If your doctor suspects that you have anorexia nervosa, he or she will typically do several tests and exams to help pinpoint a diagnosis, rule out medical causes for the weight loss, and check for any related complications. These exams and tests generally include: Physical exam. This may include measuring your height and weight ...

  9. Anorexia Nervosa

    Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia nervosa generally restrict the number of calories and the types of ...

  10. Anorexia Nervosa: Symptoms, Causes, Diagnosis and Treatment

    Anorexia nervosa is a serious psychological and eating disorder. The complications can be fatal, but treatment and recovery are possible. ... hair loss; loss of menstruation or less frequent ...

  11. Anorexia Nervosa: Symptoms, Causes, Diagnosis, Treatment

    Anorexia nervosa, also called anorexia, is a potentially life-threatening eating disorder. ... The term anorexia means "loss of appetite." But this definition is misleading. ... Brittle hair and ...

  12. What Causes Lanugo in People with Anorexia?

    This hair, known as lanugo, usually goes away within a couple of weeks. But lanugo can also show up in adults, especially those with eating disorders. What Is Lanugo? Lanugo is soft, feathery...

  13. Will your hair grow back after anorexia?

    Hair loss stemming from anorexia is usually temporary. That means when you begin to eat more, your hair will usually return. It isn't easy to overcome an eating disorder. But with proper psychological treatment, it is possible to return to a healthy body weight and restore strong hair after anorexia nervosa.

  14. Lanugo Anorexia

    Lanugo hair is one of the most common dermatological signs of anorexia nervosa. 3 People struggling with the eating disorder generally experience this symptom when they lose significant weight, and with it, body fat. 1 As body fat diminishes, there are less layers to help keep the internal organs warm.

  15. Anorexia Nervosa: Symptoms, Causes, and Treatments

    inability to maintain a normal weight. fatigue. insomnia. skin that is yellow or blotchy and covered with soft, fine hairs. hair thinning or falling out. constipation. more than three cycles ...

  16. Hair Regrowth After Treatment for Anorexia Nervosa

    For women, resumption of regular menstrual cycles is a positive sign that hair is likely to be receiving adequate nutrients but many patients with anorexia nervosa do experience significant improvements in hair density even if menstrual cycles remain irregular.

  17. Symptoms

    dry skin, hair loss from the scalp, or fine downy hair growing on the body reduced sex drive People with anorexia often have other mental health problems, such as depression or anxiety. Warning signs of anorexia in someone else The following warning signs could indicate that someone you care about has an eating disorder: dramatic weight loss

  18. Eating Disorder Hair Loss

    Eating disorders like anorexia nervosa and bulimia nervosa are most often linked to hair loss, thinning, and shedding. This is mainly due to the eating-related behaviors practiced by individuals with these conditions, including starvation, self-induced vomiting, reduced food intake, and over-exercising.

  19. Anorexia nervosa

    Lanugo hair growth, which is fine downy hair on the sides of the face and along the spine, is regularly noted with anorexia nervosa and may represent an attempt by the body to conserve heat. Decubitus ulcers over boney prominences may develop due to loss of supporting subcutaneous tissue and needs to be looked for at the time of physical ...

  20. Atypical Anorexia Nervosa: Symptoms, Causes, Treatment

    Physical health issues: symptoms such as fatigue, dizziness, fainting, hair loss, gastrointestinal problems, ... Atypical anorexia nervosa challenges the stereotypical image of anorexia, affecting ...

  21. Hair Loss and Anorexia: A Sign of Greater Danger

    When someone is experiencing hair loss associated with anorexia, there are usually plenty of co-occurring symptoms such as dehydration (which can lead to kidney failure), cold intolerance, fatigue, lightheadedness, and more. These are in addition to their likely significant weight loss.

  22. Anorexia Nervosa

    Hair loss; Slow heart rate; Absent or irregular menstruation; Excessive facial/body hair; Binge eating alternating with fasting; Vomiting or taking laxatives after over-eating; Compulsive or excessive exercise; Self-worth determined by weight or shape; Persons with anorexia nervosa may also be socially withdrawn, irritable, moody, and/or depressed.

  23. What is disordered eating and when does it become an eating disorder

    * Changes to or even the loss of a period in girls. * Abnormal lab values or negative change to vital signs. ... For adults with anorexia nervosa, there are unfortunately no evidence-based outpatient approaches. Many adults with anorexia nervosa need to be treated in higher levels of care, like day treatment or residential programs. For adults ...

  24. Malnutrition including anorexia nervosa

    Self-inflicted cutting or burning, as well as trichotillomania (hair loss due to hair pulling), may be evident. Pompholyx (blistering hand dermatitis) A rare complication of anorexia nervosa. Pili torti (twisted hair) Possibly due to malnutrition combined with excessive ingestion of carotene containing fruit and vegetables.

  25. 10 Signs of Anorexia: When To See a Doctor

    10. Teeth Decay. Teeth, like bones, require calcium and other essential vitamins to remain healthy and strong. Anorexia ensures your body doesn't get the nutrients it needs, and your teeth will ...

  26. Common Eating Disorder Symptoms and Treatments

    There can be many long-term side effects of anorexia nervosa if it goes undiagnosed and untreated for a long time. For instance, such people may face fertility issues, weak or brittle nails, and hair.

  27. Anorexia Nervosa and Osteoporosis: A Possible Complication to ...

    Anorexia nervosa (AN) belongs to the spectrum of food disorders and affects approximately 2.9 million people worldwide. It is responsible for numerous and serious medical complications. Osteoporosis is a common complication, and the decrease in bone mineral density (BMD) is one of the few potentially irreversible consequences of AN.