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photo of a womanIt was 6 months ago when I realized my daughter, Jen, had an eating disorder. Jen has always been a picky eater. But I started to see that she moved food around her plate. And she never ate very much. She exercised all the time—even when she was sick. And she was sick a lot. She became very skinny and pale. Her hair was thinning. Jen was moody and seemed sad—I thought that's what teens act like. But once I put the signs together, I talked to Jen about anorexia. She denied she had a problem, but I knew she needed help. I took her to our doctor, and she asked me to put Jen in the hospital. It's been a tough road since then for all of us, but Jen is back home now. She is still seeing her doctors and may need help for some time. But she's doing much better.

What is anorexia nervosa?

A person with anorexia (a-neh-RECK-see-ah) nervosa, often called anorexia, has an intense fear of gaining weight. Someone with anorexia thinks about food a lot and limits the food she or he eats, even though she or he is too thin. Anorexia is more than just a problem with food. It's a way of using food or starving oneself to feel more in control of life and to ease tension, anger, and anxiety. Most people with anorexia are female. An anorexic:

* has a low body weight for her or his height
* resists keeping a normal body weight
* has an intense fear of gaining weight
* thinks she or he is fat even when very thin
* misses three (menstrual) periods in a row―for girls/women who have started having their periods

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Who becomes anorexic?

While anorexia mostly affects girls and women (90-95 percent), it can also affect boys and men. It was once thought that women of color were shielded from eating disorders by their cultures, which tend to be more accepting of different body sizes. Sadly, research shows that as African American, Latina, Asian/Pacific Islander, and American Indian and Alaska Native women are more exposed to images of thin women, they also become more likely to develop eating disorders.
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What causes anorexia?

There is no single known cause of anorexia. But some things may play a part:

* Culture. Women in the U.S. are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies. More and more, men are also feeling pressure to have a perfect body.
* Families. If you have a mother or sister with anorexia, you are more likely to develop the disorder. Parents who think looks are important, diet themselves, or criticize their children's bodies are more likely to have a child with anorexia.
* Life changes or stressful events. Traumatic events like rape as well as stressful things like starting a new job, can lead to the onset of anorexia.
* Personality traits. Someone with anorexia may not like her or himself, hate the way she or he looks, or feel hopeless. She or he often sets hard-to-reach goals for her or himself and tries to be perfect in every way.
* Biology. Genes, hormones, and chemicals in the brain may be factors in developing anorexia.

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What are signs of anorexia?

Someone with anorexia may look very thin. She or he may use extreme measures to lose weight by:

* making her or himself throw up
* taking pills to urinate or have a bowel movement
* taking diet pills
* not eating or eating very little
* exercising a lot, even in bad weather or when hurt or tired
* weighing food and counting calories
* moving food around the plate instead of eating it

Someone with anorexia may also have a distorted body image, shown by thinking she or he is fat, wearing baggy clothes, weighing her or himself many times a day, and fearing weight gain.

Anorexia can also cause someone to not act like her or himself. She or he may talk about weight and food all the time, not eat in front of others, be moody or sad, or not want to go out with friends.
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What happens to your body with anorexia?

With anorexia, your body doesn't get the energy from foods that it needs, so it slows down. Look at the picture below to find out how anorexia affects your health.

graphic on how Anorexia affects your whole body
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Can someone with anorexia get better?

Yes. Someone with anorexia can get better. A health care team of doctors, nutritionists, and therapists will help the patient get better. They will help her or him learn healthy eating patterns, cope with thoughts and feelings, and gain weight. With outpatient care, the patient receives treatment through visits with members of their health care team. Some patients may need "partial hospitalization." This means that the person goes to the hospital during the day for treatment, but lives at home. Sometimes, the patient goes to a hospital and stays there for treatment. After leaving the hospital, the patient continues to get help from her or his health care team.

Individual counseling can also help someone with anorexia. If the patient is young, counseling may involve the whole family too. Support groups may also be a part of treatment. In support groups, patients and families meet and share what they've been through.

Often, eating disorders happen along with mental health problems such as depression and anxiety. These problems are treated along with the anorexia. Treatment may include medicines that fix hormone imbalances that play a role in these disorders.
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Can women who had anorexia in the past still get pregnant?

It depends. When a woman has active anorexia, meaning she currently has anorexia, she does not get her period and usually does not ovulate. This makes it hard to get pregnant. Women who have recovered from anorexia and are at a healthy weight have a better chance of getting pregnant. If you're having a hard time getting pregnant, see your doctor.
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Can anorexia hurt a baby when the mother is pregnant?

Yes. Women who have anorexia while they are pregnant are more likely to lose the baby. If a woman with anorexia doesn't lose the baby, she is more likely to have the baby early, deliver by C-section, and have depression after the baby is born.
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What should I do if I think someone I know has anorexia?

If someone you know is showing signs of anorexia, you may be able to help.

1. Set a time to talk. Set aside a time to talk privately with your friend. Make sure you talk in a quiet place where you won't be distracted.
2. Tell your friend about your concerns. Be honest. Tell your friend about your worries about her or his not eating or over exercising. Tell your friend you are concerned and that you think these things may be a sign of a problem that needs professional help.
3. Ask your friend to talk to a professional. Your friend can talk to a counselor or doctor who knows about eating issues. Offer to help your friend find a counselor or doctor and make an appointment, and offer to go with her or him to the appointment.
4. Avoid conflicts. If your friend won't admit that she or he has a problem, don't push. Be sure to tell your friend you are always there to listen if she or he wants to talk.
5. Don't place shame, blame, or guilt on your friend. Don't say, "You just need to eat." Instead, say things like, "I'm concerned about you because you won't eat breakfast or lunch." Or, "It makes me afraid to hear you throwing up."
6. Don't give simple solutions. Don't say, "If you'd just stop, then things would be fine!"
7. Let your friend know that you will always be there no matter what
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