Clinical features

Possible features include: (1)

• a body weight more than 15% below the standard weight for a person's height, age and sex or BMI less than 17.5 in adults. In pre-pubertal children, growth and physical development may be affected and puberty delayed
• an intense desire to be thin
• amenorrhoea in women
• restricted carbohydrate and fat intake
  • individuals may become preoccupied with food and enjoy cooking for other people
  • 50% suffer periods of binge eating with the consequent guilt and remorse
  • binges are seen as a loss of control
• self-induced vomiting in 50%
• use of laxatives or diuretics in 50%
• vigorous exercising
• there may be a lack of sexual interest in females and males with anorexia nervosa
• the "core psychopathology" consists of a characteristic set of extreme concerns about shape and weight, often believing:
  • that to be valued one must be thin
  • that one must maintain strict control over one's food intake
• body shape misperception (overestimation of body size)
• no true "anorexia" (i.e. loss of appetite) except in very extreme cases
• features that may be largely secondary to starvation e.g. depressed mood, impaired concentration, social withdrawal

Reference:

1. NICE. Eating disorders: recognition and treatment. NICE guideline NG69. Published May 2017, last updated December 2020