Anorexia is a serious eating disorder in which people deliberately starve themselves to lose weight. No matter how thin they become, they still believe they are overweight. Without proper treatment, the disorder can be fatal. More than 90 percent of people with anorexia are females, though a growing number of males now have the disorder. It usually begins between the ages of 13 and 18 and is often triggered by a severe emotional shock.

• Extreme weight loss due to self-imposed starvation
• Compulsive exercising
• A number of symptoms associated with starvation including anemia, brittle hair and nails, dry skin, hypothermia, constipation, and the appearance of soft, downy hair on the torso
• Depression, withdrawal, irritability, sleeplessness, low sex desire
• Obsession with food, such as collecting recipes; hoarding food
• Unwillingness to eat in public
• Inflexible thinking; strictly controlled emotional responses
• The loss of menstrual periods for three months or more
• An irrational fear of gaining weight

• An overwhelming sense of being out of control, and attempting to take control of one's life by regulating food intake
• Unrealistic fear of developing an adult body
• Severe trauma or emotional shock during puberty or pre-puberty
• Anorexia is known to run in families.
• Abnormal levels of certain chemicals in the brain may exist.
• Frequent dieters stand an 8-times greater chance of anorexia.
• Society's unrealistic emphasis on thinness places certain individuals such as cheerleaders, dancers, runners, models, jockeys, wrestlers, and actresses and actors at higher risk for anorexia.

Your health care provider will ask you questions about your eating habits—how much and what you eat—and your exercise routine. He or she will do blood and other diagnostic tests to eliminate the possibility that your weight loss is caused by medical problems. You will most likely be referred to a therapist or psychiatrist who understands eating disorders.

It is best to get treatment as soon as the symptoms appear. Try to find a psychiatrist specially trained both in treating the disorder and in nutritional counseling. It will be the most beneficial. You may receive cognitive-behavioral, group, relaxation, or psychodynamic therapy. Your health care provider will help you "relearn" how to eat correctly. In severe cases, hospitalization may be needed.

• Antidepressants— in combination with psychotherapy, may be helpful once normal weight is obtained

• Protein supplements

Alternative therapies may be especially helpful in people who have fixated on avoiding anything "artificial."

• Zinc (15 mg per day increased to 50 mg twice a day)—may improve mood and appetite.
• Protein supplements (1 to 3 servings a day)—will help ensure sufficient amino acids and help prevent wasting.
• A multivitamin will help compensate for dietary deficiencies.

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.

• Goldenseal (Hydrastis canadensis)—a strong digestive stimulant, and tonic to the digestive tract; is a specific to anorexia nervosa
• Condurango (Marsdenia condurango)—digestive stimulant for diminished appetite or dietary abuse; is a specific to anorexia nervosa
• Licorice (Glycyrrhiza glabra)—antidepressant effects, heals mucous membranes of the digestive tract. Do not take if you have high blood pressure. May cause peripheral edema (fluid retention), which goes away when licorice is stopped.
• Wild yam (Dioscorea villosa)—hormone balancing, antidepressant.
• Valerian (Valeriana officinalis)—sedative, digestive bitter, and appetite stimulant
• Lemon balm (Melissa officinalis)—mild sedative, spasmolytic, may gently help regulate thyroid-stimulating hormone and thyroid function
• Oatstraw (Avena sativa)—nerve tonic, antidepressant, relieves irritation of mucous membranes. This herb is slow to start acting but is long-lasting.
• St. John's wort (Hypericum perforatum)—for depression or anxiety leading to fatigue and adrenal gland exhaustion
• Fenugreek (Trigonella foenum-graecum)—nutritive and digestive tonic used where there is digestive debility and poor nutrition.
• Saw Palmetto (Serenoa repens, S. serrulatta, S. serrullatum)—digestive tonic and connective-tissue rebuilder.
• Siberian ginseng (Eleuthrocuccus senticosus)—a supportive adaptogen used to improve vitality and stamina.

Homeopathy may be useful as a supportive therapy.

May be helpful in restoring energy and reducing stress.

May be helpful if the patient is willing to be touched. Essential oils (lavender, rosemary, verbena) can be added to increase the relaxing effect.

Long-term monitoring and support is necessary.

• Seek care from professionals specializing in eating disorders.
• Because the disorder is primarily psychological and not simply due to appetite loss, psychotherapy is usually necessary.
• Anorexia causes difficulties in conceiving and carrying a baby to term.
• The common medical complications of anorexia include osteoporosis, kidney damage, and heart failure.

Balch JF, Balch PA. Prescription for Nutritional Healing. 2nd ed. Garden City Park, NY: Avery Publishing Group; 1997.

Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

Garner DM, Garfinkel PE, eds. Handbook of Treatment for Eating Disorders. 2nd ed. New York, NY: The Guilford Press; 1997.

The Harvard Mental Health Letter. October & November, 1997.

Kalasky KL, ed. The Alternative Health & Medicine Encyclopedia. 2nd ed. Detroit, MI: Gale Research; 1998.

Kaplan AS, Garfinkel PE, eds. Medical Issues and the Eating Disorders—The Interface. New York, NY: Brunner/Mazel Publishers; 1993.

Shils ME, Olson JA, Shike M, ed. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, Pa: Lea & Febiger; 1994:2.

Werbach MR. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing Inc; 1987.