The following symptoms and complaints may occur together with anorexia nervosa (anorexia):
Leading symptoms
- Fear of gaining weight
- Excessive weight checks several times a day
- Very greatly increased physical activity
- Avoidance of high-calorie food to almost complete abstention from food
- Eating slowly
- “Purging” behavior (i.e., self-induced vomiting or misuse of laxatives (purgatives), diuretics (dehydrators), or enemas)
- Excessive physical activity (e.g., jogging, sit-ups, push-ups)
- Body schema disorder – this means that sufferers perceive their body as too fat, despite the sometimes extreme emaciation.
- Amenorrhea – failure of menstruation.
Accompanying symptoms
- Acrocyanosis – blue coloration of the body end limbs such as the fingers.
- Alopecia (hair loss)
- Anemia (anemia)
- Failure of breast development in young girls
- Bradycardia – too slow heartbeat: < 60 beats per minute.
- Depression
- Elevated liver function values such as alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT).
- Increased renal function values such as urea and creatinine.
- Eating attacks – occur in up to 50% of patients.
- Extreme focus on school, study, diet, or athletic performance.
- Cardiac arrhythmias
- Hypercortisoneemia – increased blood cortisone levels.
- Hypoglycemia (low blood sugar)
- Hyponatremia (sodium deficiency)
- Hypotension – too low blood pressure
- Cold intolerance
- Lanugo hairiness – downy hairiness, especially on the back.
- Capriciousness
- Leukopenia – deficiency of white blood cells, which are responsible for the immune response
- Loss of libido
- Constipation (constipation)
- Osteopenia (reduction in bone density).
- Peripheral edema – water retention in the tissues.
- Mental compulsions
- Sleep disorders
- Sialosis – enlargement of the salivary glands.
- Social withdrawal
- Constant weighing
- Dry flaky skin
- Restlessness
- Delayed gastrointestinal passage
- Prematurely terminated bone growth
- Dental caries (tooth decay)
According to the S3 guideline “Diagnosis and treatment of eating disorders”, anorexia nervosa should be clarified for the following symptoms:
- Altered eating behavior
- Low body weight
- Weight concerns with underweight or normal weight
- Indications of malnutrition
- Gastrointestinal symptoms
- Growth disturbance in children
- Cycle disorders/amenorrhea
Classification of underweight by body mass index (BMI).
| BMI in kg/m3 | Classification |
| < 13,0 | high degree underweight grade II |
| 13,0-15,99 | high degree underweight grade I |
| 16,0-16,99 | Moderate degree underweight |
| 17,0-18,49 | Slightly underweight |
| 18,5-24,99 | Normal weight |
Warning signs (red flags)
- Familial clustering of mental illness,
- Depressive symptomatology
- Increased anxiety,
Other indications
- Patients with anorexia nervosa must be determined if they participate in competitive sports (women: especially figure-enhancing sports such as gymnastics, dancing or gymnastics). In these cases, it is necessary that patients refrain from sports.
