Anorexia nervosa: Australian treatment guide for consumers and carers, 2005

Section 1: Anorexia nervosa - The facts

Page last updated: June 2005

What is anorexia nervosa?

Anorexia nervosa is an eating disorder. It is a severe, very distressing and often chronic mental illness, which can lead to emaciation, physical illnesses such as osteoporosis, and disruption to emotional, social and educational development. It can also be life threatening. It has a mean duration of five to seven years, but for some people, it can be a life-long illness. Partial relapses and remissions are common, but some people show a steady deterioration.

There is confusion in the community as to whether or not anorexia is a mental illness or a physical one. In truth, it is a mental illness involving intense anxiety and preoccupation with body weight and shape, eating and weight control. Perfectionism and low self esteem are common. Depression and obsessional thinking is often part of the illness. Other mental illnesses may also be experienced with anorexia.

Who gets anorexia and why?

Anorexia nervosa can affect people in all age groups, socio-economic and cultural backgrounds. It is much more common in females than males. It usually starts in adolescence, but those most seriously ill from it are often in the 20 - 45 year age group. Anorexia nervosa tends to run in families, which suggests that there may be a genetic component. Of all people with anorexia, one in ten are males.

How common is it?

Anorexia nervosa occurs in about 0.5% of girls and young women in developed societies. It is very rare in men. This is about half as common as the life-time risk of developing schizophrenia.

Anorexia nervosa has the highest death rate (20% in 20 years) of all mental illnesses. Death from physical causes is 5 times that expected in this age group and death by suicide is 32 times that expected.

Is anorexia caused by families?

There is no research evidence that proves a link between family dysfunction and the onset of anorexia. Prior to illness, the proportion of families with relationship problems is about the same as the general population. It is common for families to become distressed once the diagnosis is confirmed, but in spite of this, most families maintain support and are keen to help wherever possible. Many families become frustrated by the illness and with the sometimes inadequate response of health professionals. For some people, by the time they get help, problems in family relationships have developed.

Is there an association between abuse in childhood and anorexia?

Prior emotional, physical or sexual abuse of the person with anorexia nervosa was once thought to be a possible explanation. However, research suggests that abuse may be no higher in these families than in the general population. People with anorexia may still have experienced abuse as children since rates of abuse can be high in the general population. If it is an issue, it can be addressed in treatment to help everyone concerned.

Do people recover from anorexia nervosa?

Yes, people can fully recover from anorexia. Research says that if the condition develops at a younger age, it may be a more severe form, and it might be harder to fully recover. The purging and vomiting form of illness is such an example. Recovery is different for everyone, but possible. Those who return to a near-normal weight during their first treatment period tend to do better than those who don't.

Can anorexia nervosa be prevented?

Research cannot say yet if it is possible to prevent anorexia nervosa or other eating disorders. Research suggests that you can reduce its severity and impact if you treat the problem early.

Denial of anorexia is very common and can delay treatment.

Families do not 'cause' anorexia nervosa.