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History of Anorexia Nervosa and Information

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

Focus on Size


Friend’s Experience

I have a good friend whose sister has anorexia nervosa. Her sister is in her 30s and weighs about 89 pounds. She has had numerous inpatient and outpatient treatments, all to no avail. She still thinks she weighs too much.

I can only imagine all of the feelings the family members have experienced over the years, from love, concern, fear, frustration and anger at times. Many would like to understand why this is so difficult for patients with this disorder to accept treatment.

Mary, Queen of Scots


History of Anorexia Nervosa

Religious fasting dates back to the medieval period. Mary, Queen of Scots, who reigned over Scotland from 1542-1567, was believed to have suffered from anorexia nervosa. Various visiting ambassadors sent reports back to their sovereignty, which documented her medical history. She suffered from measles at age 5, rubella at age 7, dysentery and malaria at age 14, smallpox at 15 and an unnamed illness as a teenager. This all occurred when she was under the care of Henry II of France.

The first one to diagnosis the disease was an English physician, Richard Morton in 1689. It was not until the 19th century that this disorder was accepted as a recognized condition. In the 20th century anorexia nervosa was finally regarded with more awareness. Hilde Bruch, a German-American psychoanalyst, published her work that was more widely accepted. The famous singer, Karen Carpenter, died in 1983 of anorexia, which increased awareness.



Signs and Symptoms

Anorexia nervosa affects women and men, contrary to popular belief. In 2015, 2.9 million people had this disorder. It can affect a person of any age, race, sexual orientation or ethnicity. It is considered a way to equate being thin with self-worth. This disorder is thought to be more of a psychological problem, which is dangerous and can be life-threatening.

The physical signs and symptoms include:

  • Weight loss and very thin (lack of normal weight gain in growing children)
  • Difficulty maintaining normal weight for height, age and stature
  • Distorted body image
  • Exercising excesiving
  • Person restricting calories to an abnormal range
  • Purging by vomiting, laxatives or enemas
  • Binge eating with a very thin stature
  • Abnormal blood counts
  • Fatigue, yet insomnia
  • Fainting or dizziness
  • Thinning hair that breaks or falls out
  • Soft, downy hair that covers the body
  • Absence of menstruation
  • Abdominal or constipation
  • Dry or yellowish skin
  • Always cold
  • Irregular heart rhythm
  • Low blood pressure
  • Menstrual periods may stop
  • Dehydration
  • Swelling of arms or legs
  • Eroded teeth and calluses on knuckles due to induced vomiting


Being diagnosed with this disorder requires meeting specific criteria according to the DSM-5 and includes:

“Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.

Intense fear of gaining weight or becoming fat, even though underweight.

Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.”

A serious eating disorder may be present even if all these criteria are not met. At times a person may have an atypical anorexia as they may not be underweight despite very significant weight loss. The psychological and medical impact of this disorder are no different for atypical anorexia.

Behavior Changes

There can be subtle or dramatic changes in the person’s behavior and emotional changes may also happen from someone is suffering from this disorder.

These changes may include:

  • A preoccupation with food and elaborate meals may be prepared but not eaten
  • Often skipping meals and simply refusing to eat
  • Looking in the mirror frequently for flaws
  • Wearing several layers of clothing
  • Denying hunger or making an excuse not to eat
  • Very flat affleck, showing no emotion
  • Social withdrawal from friends and events
  • Refusing to eat in public
  • Adoption of a rigid meal schedule or some eating behaviors, even chewing up food and then spitting it out
  • Diet may consist of only foods low in fat and calories
  • Weighing or measuring body parts frequently
  • Not being honest about how much food has been eaten
  • Complaining about being fat
  • Irritable
  • Having insomnia
  • Reduced interest in sex
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Anorexia Nervosa Treatment


The goals of treatment is to try and change behavior, to enter nutrition rehabilitation, to gain weight and restore health. Many refuse treatment until they are extremely thin and unhealthy.

Therapies may include individual counseling, nutritional therapy, group therapy with other patients or even family therapy. Some patients are given antipsychotic medications, such as olanzapine (Zyprexa®). Hospitalization is often used as the symptoms increase to stabilize the nutritional status of the patient. It takes from 5-6 years to recover. Approximately 30% do not recover.

Concerning Signs

An individual is severely malnourished when they reach a BMI less than 70% of normal for an adolescent or a BMI decresed by 15% for an adult. If there has been no calorie intake for more than 10 days a person may need hospitalization.

Refeeding a patient can also be dangerous if the body is unable to restart its metabolism process. There can be whole body swelling, GI problems, heart or lung failure, delirium or even death.

The goal for a hospitalized patient it to regain weight, usually beginning with a 2000-2500 calorie diet. They would hopefully gain 0.2 kg/day (almost ½ pound). Also, normalizing electrolytes is essential, such as blood glucose. This is especially true for adolescents as they are still growing.

Dr. Cyntha Bulik: Q&A About Anorexia Nervosa Genetics Study

Current Research

As people are resistant to receive care, they also do not want to participate in research. Therefore, the studies have a small number of participants. One has found a possible genetic reason for this disorder. Another study revealed the low birth weight of babies when the mother had anorexia nervosa.

In Conclusion

This very difficult disorder is prevalent in about 0.3% of young women. The average onset is 15 years old, and 80-90% are female. This is the most serious psychological disease as so many simply do not recover and so many do not get help until they are seriously ill.



This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Pamela Oglesby


Pamela Oglesby (author) from Sunny Florida on June 21, 2020:

Hi Rajan,

As I understoood this I don't think anyone with this disease has much of a chance of getting better without counselling. Thanks so much for your comments,

Rajan Singh Jolly from From Mumbai, presently in Jalandhar, INDIA. on June 20, 2020:

Very informative. I think counselling should help break the ice by making more people agree to getting treated.

Pamela Oglesby (author) from Sunny Florida on February 13, 2020:

Hi Peggy, I didn't realize so many people never get well until I did the research on this disorder. It is truly sad. Thank you so much for your comments.

Peggy Woods from Houston, Texas on February 13, 2020:

Anorexia nervosa is a serious disorder, and it is sad to know that the majority of people who have it do not wish to be cured. One of my high school friends developed it. She did have psychiatric help, but I do not know if it helped. She is now in a memory care place. So sad!

Pamela Oglesby (author) from Sunny Florida on October 31, 2019:

Hi Patricia, It is painful to love someone with this disease when treatments don't work. I am sorry to hear about your friend. I hope this article might reach someone in the early part of the disease where maybe treatment will owrk.

Your comments are appreciated, Patricia. God Bless you!

Patricia Scott from North Central Florida on October 30, 2019:

This is such a scary disease. My dear friend suffered with it and succumbed at age 35. I do not remember her exact weight at her death but she was bone thin. It broke my heart. She had so much treatment but the illness was more powerful than any intervention. thank you for sharing this...hopefully someone will benefit from your words. Angels are on the way this evening ps

Pamela Oglesby (author) from Sunny Florida on October 28, 2019:

Hi Gerry, I appreciate your very nice comments.

Gerry Glenn Jones from Somerville, Tennessee on October 28, 2019:

This is a very informative, well-researched article, Pamela.

Pamela Oglesby (author) from Sunny Florida on October 27, 2019:

Hi Lora, I would think the earlier this disorder is recognized the better the chances are to treat this disorder, but I can't back up that statement with an research I found.

I think there is a genetic componet and social media is also a problem. Thanks so much for your coments, Lora.

Lora Hollings on October 26, 2019:

This is a very serious disorder that can threaten people's lives. Your article certainly emphasizes this. If you have a child that suffers from this disorder or know of anyone, it is important that you seek help for them. There are obvious genetic components that are the underlying cause as the video discusses. That is why it is essential to get help from professionals who have the experience and training necessary to help those suffering from this potentially fatal disorder. You did a great job in covering all of the aspects of this eating disorder and its consequences, Pamela.

Pamela Oglesby (author) from Sunny Florida on October 25, 2019:

Hi Linda, I think that is especially true for parents to watch their teen carefully as maybe they can intervene early before the unhhealthy patterns are set. I appreciate your comments.

Linda Crampton from British Columbia, Canada on October 24, 2019:

Thank you for creating this interesting and educational article, Pamela. It's important that people are aware of the disorder and the problems that it can cause.

Pamela Oglesby (author) from Sunny Florida on October 24, 2019:

Hi Maria, I was surprised also when I researched the history of this disorder. You are absolutely right about the individual and the family. I am glad you found this information to be valuable and I appreciate your comments as always Maria. Love and hugs for you too.

Pamela Oglesby (author) from Sunny Florida on October 24, 2019:

Hi Mike, I don't think any of us understood it several years ago. Thank goodness your friend's sister got over it, and I know it is difficult for families also.

Thank you so much for your comments.

Readmikenow on October 24, 2019:

Excellent article. I had a friend in college and his twin sister suffered from Anorexia Nervosa. I didn't understand it, but it was a horrible thing for the entire family. She eventually got over it, and my friend told me there were so many hidden issues with his sister. It is a horrible thing as it affects the person and everyone who loves them. Enjoyed reading this!

Maria Jordan from Jeffersonville PA on October 24, 2019:

Dear Pamela,

I was fascinated by learning about the history of anorexia nervosa, stemming back to Mary Queen of Scots.

This is indeed a challenging and heart-wrenching disease - both for the individual and those who love him/her.

Thanks for this valuable information - always on point.

Have a peaceful day.



Pamela Oglesby (author) from Sunny Florida on October 24, 2019:

Hi Ms Dora, This is such a sad disease as it takes years quite often for this individual is recovered, and some never get well. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on October 24, 2019:

Hi Flourish, You have summed up the behavior of most people with this disorder and long term brain damage can happen without the appropriate nutrition over the years. Thanks for your comments Flourish.

FlourishAnyway from USA on October 23, 2019:

I’ve known women with anorexia and others who were just naturally thin and everyone asked then if they had anorexia (how awkward and inappropriate). The anorexics has rigid routines they followed that included exercise, smoking or water intake to help them not eat, and very small meals (celery, tomatoes) involving calorie counting. Very sad because it can cause long term damage and death.

Dora Weithers from The Caribbean on October 23, 2019:

Thanks for underscoring the seriousness of this disease. I think the saddest part is that despite the symptoms, some victims do not accept that they are sick. Your article is very helpful.

Pamela Oglesby (author) from Sunny Florida on October 23, 2019:

Hi Liz, I think your view is spot on. I appreciate your kind comments.

Liz Westwood from UK on October 23, 2019:

This is a worrying condition, which you have described and explained very well. I sometimes view it as a product of an image-obsessed society.

Pamela Oglesby (author) from Sunny Florida on October 23, 2019:

Hi Linda, I fully agree.I think an unrealistic body image is still promoted in many ways on TV and in other social media. It is sad and so many do not recover. I appreciate your comments Linda.

Linda Lum from Washington State, USA on October 23, 2019:

Pamela, this is such a sad illness. Thank you for shining a light on it and explaining. There is so much body shaming; before anyone knows us or even hears us speak we are judged at first glance by how we look. I have heard that advertising agencies that once used photoshopping have now stopped doing so because they were promoting an unrealistic, unattainable body image.

Pamela Oglesby (author) from Sunny Florida on October 23, 2019:

I was surprised at the long history of this disorder as I thought social media was the main cause of people thinking they have to look a particular way. It is truly sad. I think when we see someone who is terribly thin we can assume they have this problem. Thanks, Nell, for your comments.

Nell Rose from England on October 23, 2019:

Its a horrible illness to have, I remember seeing a girl who was a friend of my friend. She was so thin, and obviously suffered from it. It's a sign of control. Things around them are out of control, so this is the only thing they can do. Interesting to see about Mary Queen of Scots, I hadn't heard that before.

Pamela Oglesby (author) from Sunny Florida on October 23, 2019:

Hi Devika, I am glad you found the article informative. This is such a difficult disorder. I appreciate your comments.

Devika Primić from Dubrovnik, Croatia on October 23, 2019:

Hi Pamela Oglesby I had no idea of the behavior changes in Anorexia. Informative and deserves more readers.

Pamela Oglesby (author) from Sunny Florida on October 23, 2019:

Hi Bill, It is good to hear a success story. You are right about the complexity of the human mind. Lorna spoke of the layers of the disorder and the difficulty in treating it. Thanks for stopping by, my friend. Hope you see a bit of sun one day soon.

Bill Holland from Olympia, WA on October 23, 2019:

I had a student once who had this. We almost lost her. Thankfully she is living a wonderful life today. This is nasty stuff for sure. The human mind is such a complex mechanism, isn't it?

Pamela Oglesby (author) from Sunny Florida on October 23, 2019:

Hi Lorna, I am sure you know much more than I do about this disease. When my friend was talking about her sister last week I just felt that awareness is important, which is what I do with most of my writing.

I feel so bad for people that think they have to be perfect and I think social media is responsible for much of that feeling. I read that about 30% recover, which is heartbreaking. I appreciate the work you do and for your comments.

Lorna Lamon on October 23, 2019:

I read your article with interest Pamela as I have treated this disorder in the past and found it to be extremely difficult to treat. It can take many years to properly treat the disorder and sadly some never recover. It has so many layers and social media does not help with the ever increasing need to be that perfect size. Thankfully we are now aware of the dangers,however, these social media sites need to play their part. This is a very informative overview of this condition and thank you for drawing awareness to it.

Pamela Oglesby (author) from Sunny Florida on October 23, 2019:

Hi Lori, I am glad your cousin got treatment. It sounds like the other 2 have not gotten treatment recently. I can't imagine their labwork looks ggo and you would think f for thematigue is a problem. The lady in her 50s demonstrates the symptoms clearly. You can only pray for them if they refuse help and won't admit to even having this disorder.

It is a dificult disorder to overcome as you stated. Thanks for sharing your experience.

Lori Colbo from United States on October 22, 2019:

This is a very difficult illness to overcome. My cousin had it and got treatment around five years ago. I have to good friends with it. One is probably near 70, the other in her 50s. The older lady admits to it but is not getting treatment. She lives on cottage cheese and a few fruits and veggies. The other one has never spoken of it but she's skin and bones and I notice barely eats at potlucks. A few bites. I'm guessing she wears children's clothing. She looks to be 80 pounds. She is short and small boned. The older lady has had it for years. I suspect she may have been to treatment in her past but currently, she is not. She is perfectly coiffed, makeup precision, attire perfect, even when she is ill. She does semi-pro dancing. I worry about her. Thank you for informing us.

Pamela Oglesby (author) from Sunny Florida on October 22, 2019:

Hi Ruby, I remember a young woman who was terribly slim when I was nursing also. This is an awful disorder as it is so difficult to recover. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on October 22, 2019:

Hi Meg, I agree that what adolescents especially see isn't a normal size and we do need to help everyone have a good body image. That is an excellent point. Thank you so much for your comments.

Ruby Jean Richert from Southern Illinois on October 22, 2019:

I remember well when Karen died. I have seen this in my many years of nursing. I remember one young girl, she was so thin she could barely stand, yet she felt fat and weighed herself frequently. I had a neighbor, ( a minister's wife ) who would chew food and spit it out, she was not thin, so possibly just starting down that path. This was a very good article and well detailed.

DreamerMeg from Northern Ireland on October 22, 2019:

It is so important to try and make sure that all young people have a positive body image of themselves, no matter their size. It's dreadful that the images portrayed as "cool" are of young people who are underweight, rather than those of a healthy body size.

Pamela Oglesby (author) from Sunny Florida on October 22, 2019:

Hi Louise, I feel bad for them also. I aooreciate your comments.

Louise Powles from Norfolk, England on October 22, 2019:

I feel sorry for anyone who suffers with this disorder. It's good that there is so much help out there for them these days.

Pamela Oglesby (author) from Sunny Florida on October 22, 2019:

Hi Mel, I miss her too.I appreciate your nice comments.

Mel Carriere from Snowbound and down in Northern Colorado on October 22, 2019:

I surely do miss that little songstress Karen Carpenter, taken down in her prime by this horrible disorder. Very informative, illuminating article.

Pamela Oglesby (author) from Sunny Florida on October 22, 2019:

Hi Eric, Thanks for stopping by and commenting.

Eric Dierker from Spring Valley, CA. U.S.A. on October 22, 2019:

So interesting. We tend on the large side around here. The notions here are interesting. I wonder.

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