People with anorexia nervosa often hide their illness and may even deny having a problem. Because anorexia nervosa can cause serious medical complications, it is important to seek help as soon as you suspect it in your child.
When someone has anorexia nervosa, they may not want to share how they’re feeling. Young people with anorexia nervosa can develop many medical problems when they don’t take in the nutritious food that provides their body with the energy or fuel it needs to grow and develop. When this happens, the young person can experience a variety of signs and symptoms.
Anorexia nervosa has a range of behavioural and physical signs and symptoms. Click the icons in the image below to find out more.
Behavioural signs of anorexia nervosa
Avoiding family meals or eating alone
People with anorexia nervosa will make excuses to avoid eating meals with others, especially their family. They may say they have already eaten or schedule other activities during mealtimes to avoid eating in front of others. They may also skip meals, such as breakfast.
Dieting or limiting food choices
People with anorexia nervosa may avoid eating food they think is fattening or eat only low-calorie food. They may want to carefully check the labels of food before they eat them. They may also put an emphasis on only eating a particular way, for example following a low-carb diet, and have a hard time being flexible with different foods.
Wearing baggy clothes
People with anorexia nervosa may wear baggy clothes, or many layers of clothing, to hide their weight loss from their parents.
Becoming more irritable
People with anorexia nervosa may lack concentration and be very irritable (cranky). Because their brains are starved of nutrients they may not think clearly and, as a result, may react in a way that is out of proportion to the situation. This may result in emotional outbursts or becoming obsessed and inflexible about how something is done.
Becoming very interested in food or cooking
People with anorexia nervosa may spend more time watching cooking shows or trying new recipes but will rarely eat what they prepare. A teen with anorexia nervosa may start giving more direction to their parents about the type of groceries they want to be bought.
Spending more time with parents
Younger children may want to spend more time around their parents or less time with their friends.
Other behavioural symptoms include:
- skipping meals
- cutting out whole food groups
- counting calories and grams of fat
- weighing or measuring food
- following specific food rules
- denying weight loss or not feeling that it’s a problem
- having a distorted body image
- comparing body weight, size, shape or appearance to unrealistic ideals
- spending time alone and increasing social isolation from friends
- poor concentration
- poor self-esteem
- experiencing mood swings, including increased irritability, sadness and anxiety
Physical signs of anorexia nervosa nervosa
Not gaining weight
As children are growing, they should always be getting bigger in terms of height and weight. If a child stops growing or gaining weight, it might be a sign they have anorexia nervosa. Signs that a child has stopped growing include not needing to change their clothing or shoe size over many months.
Losing weight
In teens, anorexia nervosa is more likely to be suspected if someone loses weight rather than stops growing (which is a natural occurrence). If your teen is losing weight, see your child's doctor immediately.
Feeling cold
People with anorexia nervosa have decreased circulation. Because of this, they may feel cold even when most people feel comfortable or warm. They may wear clothes that are warmer than necessary for the weather.
Having low energy
Because of their lower calorie intake, people with anorexia nervosa usually have very low energy levels.
Feeling dizzy
Lack of nutrition and fluids, and decreased muscle tissue, can make people with anorexia nervosa feel dizzy or faint.
Other physical symptoms may include:
- delay in the onset of puberty
- constipation
- irregular or missed periods
- fine hair on the back, upper arms, thighs and face and/or loss of head hair
- heart palpitations or low heart rate
- shortness of breath
- swelling of feet
At SickKids
SickKids has an eating disorder program that treats children and teens who are struggling with symptoms of anorexia nervosa, bulimia nervosa and avoidant restrictive food intake disorder. For more information on our program visit: www.sickkids.ca/adolescentmedicine/eating-disorders-program
Further information
For more information on anorexia nervosa, please see the following pages:
Anorexia nervosa: Medical complications
Anorexia nervosa: Treatment options
Anorexia nervosa: How to help your child at home
Resources
NEDIC – National Eating Disorder Information Centre (Canada)
NEDA – National Eating Disorder Association (United States)
American Academy of Pediatrics – Eating Disorders in Children
BEAT – Beating Eating Disorders (United Kingdom)
Kelty Eating Disorders (Kelty Mental Health Resource Centre, BC Children's Hospital)
Children's Hospital of Eastern Ontario – Eating Disorders
ANAD – National Association of Anorexia Nervosa and Associated Disorders (United States)