Anorexia often starts around puberty, but can occur across the lifespan. It is a life threatening disorder and to receive an official diagnosis the following symptoms must be present over a period of at least three months:
- Persistent behaviours that interfere with maintaining an adequate weight, including: restricting food, compensating for calorie intake using intense exercise and/or purging through vomiting, laxatives, diuretics, enemas, or insulin.
- An intense fear of gaining weight or becoming fat. The individual may feel this way even if they are at a weight that is dangerously low. Their fear often leads to body checking – behaviors such as frequent weighing, obsessively measuring body parts and persistent use of mirrors.
- Distortion in how the person experiences their weight and shape. This involves an overestimate in body size, evaluating their size in negative ways, and placing the greatest value on their weight and shape.
- The person does not fully appreciate the seriousness of their struggles.
Other symptoms may include: depressed mood, anxiety (especially social anxiety), obsessive-compulsive disorder, social withdrawal, irritability, insomnia, and intense preoccupation with food, feelings of inefficacy, all-or-nothing/rigid thinking, strong desire for control, and perfectionism.