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Feature Articles: Eating Disorders

Very thin womanAnorexia nervosa

Greta Hopke, RD, and Candance Gabel, MS, RD, LD, associate state nutrition specialist, University of Missouri Extension


The American Psychiatric Association has recognized two clinical eating disorders, anorexia nervosa and bulimia nervosa. Anorexia nervosa, a self starvation disorder, has four diagnostic criteria (according to the American Psychiatric Association).


They include:

  • Refusal to maintain normal body weight OR weight loss leading to body weight less than 85 percent of normal body weight
  • Intense fear of gaining weight
  • Disturbed perception of one's own body and weight
  • Amenorrhea (absence of 3 or more consecutive menstrual cycles) in normal menstruating females


There are 2 types of anorexia nervosa: restricting and binge-eating/purging. In both types the individual is often obsessed with food, but will not allow themselves to eat due to their intense fear of gaining weight. According to Nancy Kolodny's book, The Beginner's Guide to Eating Disorder Recovery, when extreme weight loss has occurred there can be a chemical change in the brain that changes the person's perception so that they feel fat where there is none. This may explain an anorexic's disturbed perception of their body and weight, where they think and feel fat, but are actually dangerously thin.

An eating disorder is a very serious issue. It affects an individual's physical, emotional, social, intellectual, and even economical aspects of life. Physical complications for anorexics can include hair falling out, skin becoming purplish or darker than normal or a yellow-tinged color, difficulty sleeping due to not enough fat to cushion their bones as they lie down, bone loss leading to osteoporosis, dizziness, stomach pains, constipation, and possibly death due to starvation or heart problems. According to Anorexia Nervosa and Related Eating Disorders, Inc.'s Web site, without treatment, up to 20 percent of individuals with serious eating disorders die, but with treatment, that percentage drops to 2-3 percent. As you can see, the results of an eating disorder are not pretty at all. Of course, an eating disorder brings more than physical complications; the disorder affects their social and family life as well. Most people with an eating disorder become depressed and withdraw or isolate themselves from friends and family.


In reported cases, anorexia and bulimia combined affect almost 10 million women and 1 million men (primarily teens and young adults). It is estimated the peak onset of an eating disorder among girls occurs at ages 11-13! (Statistics from National Eating Disorders Association Web site.) It is also reported that approximately 10-20 percent of adolescent and young women exhibit some characteristics of anorexia, but do not meet the diagnostic criteria (Kolodny, 2004). These individuals with disordered eating can still suffer from physical, emotional, and social problems and the condition could potentially develop into an eating disorder, possibly resulting in more serious problems.

For more information, see the other Food, Fitness and Eating Disorders feature articles or visit the following websites:




Kolodny, N. (2004). The beginner's guide to eating disorder recovery. Carlsbad, CA: Gürze Books.


Williams, M. (2005). Nutrition for health, fitness, & sport. 7th Ed. New York: McGraw Hill.


National Eating Disorders Association urges parents and teens to 'get real'. (2004). Retrieved Feb. 8, 2005 from National Eating Disorders Association website at


Statistics: How many people have eating disorders? (2004). Retrieved Feb. 8, 2005 from Anorexia Nervosa and Related Eating Disorders, Inc.'s website at


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Last update: Tuesday, February 22, 2011