Anorexia/Atypical Anorexia

Obsessive thoughts about food, fear of gaining weight, going to extremes to lose weight and keep it off, thinking your life will be better when you achieve a certain weight or look a certain way. You're entire life hinges on what you have or haven't eaten each day. You've lost sight of yourself. Anorexia can also feel natural because extreme food restriction has been normalized in our culture, to the point that you may not understand or be aware of the seriousness of the behaviors that you're engaging in.

If you're reading this, you've taken the first step to a better life for yourself or your child. If you or your child suffers from Anorexia, HEAL Marin can join with you on the path to recovery.

You don't have to go it alone; HEAL Marin is here to help.

What is it?

Understanding Anorexia Nervosa: Definition, Causes, Symptoms, and Diagnosis

Anorexia nervosa, often simply referred to as anorexia, is a serious and potentially life-threatening eating disorder that affects individuals physically, emotionally, and psychologically. While it is commonly associated with young women, anorexia can impact people of all genders, ages, and backgrounds. In my practice as a Licensed Marriage and Family Therapist (LMFT) in Marin and San Francisco, I have seen firsthand how this disorder disrupts not only the life of the person struggling but also their families and support systems. Understanding what anorexia is, what causes it, how it manifests, and how it is diagnosed is an essential first step toward seeking appropriate help and healing.

What is Anorexia Nervosa?

Anorexia nervosa is a complex mental health condition characterized by an intense fear of gaining weight, a distorted body image, and a relentless pursuit of thinness. Individuals with anorexia restrict their food intake, often to dangerous levels, in an effort to control their body shape and weight. Despite being underweight or malnourished, they may perceive themselves as overweight and continue to strive for weight loss.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies anorexia nervosa with the following criteria:

Persistent restriction of food intake leading to significantly low body weight.
Intense fear of gaining weight or becoming fat, even when underweight.
Disturbance in how one’s body weight or shape is experienced, undue influence of body weight on self-evaluation, or lack of recognition of the seriousness of low body weight.

Anorexia is not simply about food—it is a disorder rooted in deeper psychological struggles, such as issues with control, self-worth, identity, and coping with difficult emotions. It is one of the deadliest mental health disorders due to its medical complications and increased risk of suicide.

Causes

The causes of anorexia are multifactorial, meaning that there is no single reason why someone develops the disorder. Instead, anorexia emerges from a complex interplay of biological, psychological, and sociocultural factors.

1. Biological Factors

Research suggests that genetics may play a role in the development of anorexia. Individuals with a family history of eating disorders, depression, or anxiety are at higher risk. Some studies show that certain individuals are more biologically vulnerable to perfectionism, obsessional thinking patterns, and anxiety—all traits linked to anorexia.

2. Psychological Factors

Many people with anorexia struggle with perfectionism, low self-esteem, and a desire for control. Restricting food intake can become a coping mechanism to manage overwhelming feelings, stress, or trauma. Anorexia may also serve as a way of expressing emotional pain that feels too difficult to put into words. For some, the illness provides a false sense of mastery or accomplishment, even as it takes a devastating toll on their health.

3. Sociocultural Factors

Cultural ideals that glorify thinness, along with societal pressure to achieve a certain body type, play a significant role in the development of anorexia. Social media, advertising, and the entertainment industry often perpetuate unrealistic beauty standards, which can fuel body dissatisfaction. In areas such as San Francisco and Marin, where there can be a strong emphasis on fitness, appearance, and achievement, these pressures may feel especially intense.

4. Family and Environmental Factors

Family dynamics can also inadvertently influence the development of anorexia. Families that place strong emphasis on appearance, achievement, or control may unintentially contribute to the disorder. Additionally, life transitions, bullying, or stressful events such as divorce or loss can act as triggers.

How Anorexia may show up for you or your loved one...

Symptoms of Anorexia

The symptoms of anorexia vary from person to person, but they generally fall into three categories: physical, behavioral, and emotional.

Physical Symptoms

Do you recognize yourself or your loved one in any of the following?

Significant weight loss or failure to gain expected weight, fatigue, dizziness, or fainting, delayed onset of menses in teens, irregular or absent menstrual cycles (amenorrhea) in women, slow heart rate and/or low blood pressure, noticing that you or your loved one are perpetually cold and can't seem to warm up, dry skin, brittle nails, thinning hair, or hair loss, and GI issues such as constipation or bloating.

Behavioral Symptoms

Changes in food intake or restriction of food intake or avoidance of eating, obsession with calories, food, dieting, eating only "clean" or "healthy", obsessive thoughts about body image and/or questions about one's body, excessive exercise, often to burn calories after eating, ritualistic eating habits, such as cutting food into tiny pieces or eating in secret, avoidance of social situations involving food, frequent weighing or body checking in the mirror.

Emotional and Psychological Symptoms

Distorted body image, with an inability to see oneself accurately, intense fear of weight gain, regardless of actual weight, preoccupation with control, rules, and perfectionism, withdrawal from friends, family, and activities once enjoyed, depression, anxiety, or irritability, difficulty focusing or making decision, a change in grades or performance at work or other responsibilities.

Unsure or the full picture doesn't quite fit?? That's ok, it's not your job to diagnose yourself or your loved one. Let the experts take the lead. We are here to help you along in this process.

CONTACT

How to HEAL

Anorexia nervosa is not a choice, a diet gone too far, or simply a matter of willpower. It is a complex mental health condition with serious consequences if left untreated. By understanding its definition, causes, symptoms, and diagnostic process, individuals and families can take the first steps toward seeking help. No one should have to struggle with anorexia alone, and with comprehensive treatment and support, full recovery is possible.

How to HEAL Treatment often requires a multidisciplinary, collaborative team approach, including:

Medical care: To manage physical health and stabilize weight,

Nutritional counseling: Rebuilding healthy eating patterns,

Psychotherapy, using an integrative approach: CBT (Cognitive Behavioral Therapy) is commonly used along with DBT (Dialectical Behavior Therapy), as well as Family-based therapy (especially effective for adolescents).

HEAL Marin provides individual and family therapy, along with nutrition counseling. We unite with pediatricians and expert medical practices across the Bay Area, such as UCSF and Stanford, to ensure you are getting the gold-standard of care across all disciplines.

HEAL Marin may be for you IF

You're scared, overwhelmed with next steps, or maybe even don't realize you have a problem with food. HEAL Marin removes the inefficient, time consuming process of putting together a plan and a team by providing you with TWO of the most essential components of treatment under one roof- psychotherapy and nutrition counseling. We meet you where you're at, and we collaborate with you on your journey.