Can a person be anorexic without any physical symptoms other than thinness?

I’m pretty sure all of those symptoms are just signs of malnutrition, so one could have those symptoms and not be anorexic, or one could be suffering from anorexia nervosa without showing those particular signs.

Certainly at the beginning of their anorexia journey and not all people develop all of the symptoms you list. I think there are more anorexics out there than we know.

It’s possible to be anorexic without even being thin. A lot of big girls suffer from anorexia as well and it’s even harder to tell when they’re in trouble.

It honestly depends on each individual person. I used to frequent a lot of pro-ana websites and many girls actually did make sure they ate protein and had their vitamins each day. They’d just eat ridiculously small amounts of food without ever looking sick. In fact, many girls I knew looked beautiful even after starving themselves for years. Shiny hair, pretty skin, pink nails, the works. They would moderate every aspect of their lives. From the outside, they looked healthier than most healthnuts I’ve met.

In many cases of anorexia, the most lasting effects of the disorder are the mental ones that are very hard to detect.

@iWitch Do you have any of these sites I could look at?

@papayalily I’ve made a point to stop going on those websites since I passed out in class a few years ago. I would point you in the right direction, but the places I went to for the most advice were blog rings on xanga.com that were moderated about a year ago.

@iWitch What’s the most amount of food someone could eat a day and still be anorexic? What about someone who, except for their morning caffeine, skips breakfast and lunch, but then eats a normal sized dinner?

There’s a problem with mental disorders – we only hear about the severe cases. We don’t hear about the mild or even moderate cases, and as such, it can be hard to tell if there’s an issue until it warrants hospitalization. I’d love to know more about the mild and moderate cases of anorexia, but from online diagnostic quizzes to memoirs at Barnes and Noble, it seems that there is nowhere to find them.

@papayalily It really has nothing to do with how much someone eats in a day. It’s all about the mental state. I’m not sure if it’s textbook anorexia, but from what I personally struggled with and watched other girls struggle with, anorexia is hating what you look like the point where your physical need to eat isn’t as important as your mental need to look “better”. I felt guilty every time I put something in my mouth, and looking in mirrors was equivalent with torture because the reflection was never good enough. To this day, sometimes I think, “If only I was strong enough to stop eating again.” Anorexia is tying your self worth with your ability to control your body’s need to eat.

Your example describes my father—who frequently forgets to eat but isn’t anorexic. However, if I remember correctly, it also describes a favorite blogger of mine from a couple years ago that couldn’t get away with not eating dinner with her family.

You’re right about the fact that we can never get information about mild cases of anorexia. It really is an epidemic, and I know this because I was a part of it. Mild to moderate anorexia is everywhere and I’m sure they’ve found a new place to congregate since Xanga shut them down. I knew girls that described anorexia (they call her Ana) as a person whom they had to be loyal to in order to have self-worth.

There are thousands of people with anorexia that need help but will never get it because they will never be diagnosed as “sick”.

@iWitch The problem isn’t just an issue within the eating disorder community. While over-diagnosis is a problem, it often has to do more with a discomfort people have with normal emotions and reactions than anything else. At the same time, many people who are bipolar aren’t getting diagnosed because they aren’t thousands of dollars in debt, sleeping with scores of people every year, on drugs, and randomly driving their car up onto a hill. Likewise, many people are depressed but don’t seek help because they think that they’re fine so long as they aren’t cutting their wrists. At the same time, many who are diagnosed but aren’t severe cases are treated to the same stigma as those who are truly out of control. I was diagnosed as bipolar years ago (although my doctor has now revoked that diagnosis), and for years I thought that it was inevitable that I would become a junkie who was seriously physically abusive to her kids because no one ever told me that not all cases are that severe (or that the diagnosis doesn’t dictate your fate or your actions, but that’s really another rant…).

@papayalily I didn’t mean to suggest that the problem was within the eating disorder community, and just from what I’ve seen, over-diagnosis is not a problem with eating disorders. I don’t know if it’s documented as a problem, though. Don’t quote me. All I know is speculation and personal experience in the community, not research.

I understand what you mean; however, I feel the problem with not understanding mild cases of eating disorders is very different than not understanding the differences between mild and severe manic depression. When people don’t understand mild eating disorders, girls don’t get help. When people don’t understand mild depression, people get too much help.

@iWitch A woman in my life has always been very thin, and very concerned about being thin. About 10 years ago, I remember her saying that she had joined Weight Watchers because she needed to “loose the flab”. At the time, she was 120 lbs and 5’9. She’s always been very meticulous about food, and a total control freak (both in general and in regards to food). These past couple of years, however, things have gotten worse. She has no food in her house except for a full box of Raisin Bran, low-cal/fat-free/sugar-free fudgesicles, coffee, and a box of baking soda in her fridge. I know that she doesn’t run out and get something to eat for lunch, so that means she doesn’t eat lunch most days. This past week, we’ve gone to the movies twice, both letting out right around dinner, and she said that she was full from the popcorn (which she didn’t actually get) and the box of Junior Mints, which was actually still half-full, and that’s why she couldn’t get dinner with me. Last week, when we went to see a movie, she claimed that she needed “real food”, and got a hot dog there – and I KNOW that had one of her children called a hot dog “real food” she would have berated them until they had acknowledged that real food involves balanced nutrition and a lack of 7–11.

@iWitch I did not take it that way. From what I have observed (which isn’t really that much), eating disorders are, imho, much like the diagnosis of bipolar. People are quick to point out the smallest thing – the first time a girl misses a meal, ever, even though she really did have a big lunch, but then won’t say anything ever again until she’s in the ICU. But again, I really haven’t had much conscious experience with eating disorders.

They also won’t say anything if she’s over the age of 30, which means that tons of women are in severe pain, but just aren’t seen as having enough in common with a model anymore to be noticed.

@papayalily It sounds like this woman needs help. She’s struggling, that’s obvious. Whether or not she’s admitted to herself that she has a problem is the real question. I very strongly suggest talking to her about this. Eating the hot dog may have been a give-in. In the eating disorder community, it’s a binge. For many girls I used to know, this was punishable by days of fasting.

You’re right. As I’m not very familiar with bipolar disorder, we may be touching completely different bases. However, what I do know is that even if people notice the little things with anorexia, since they don’t do anything about it, very few people actually get the help they need. Especially women over thirty—an age group that’s heavily affected by eating disorders.

As for this friend you’ve spoken of, it doesn’t sound like a mild case of anorexia. It sounds like a life-long struggle.

@iWitch She’s always been VERY thin, and has always had issues with food and control, as well as issues with self-image/esteem/worth. But, she’s also never had yellow skin or tons of brittle hair falling out, so I always just thought that she was uptight and controlling, more so than most, but not to a “disorder” level. Now I wish I’d examined it earlier.

@iWitch I’ve honestly never heard about any woman over 30 having anorexia except for the occasional Oscar-winning actress. I had no idea that the group was so affected by it. Are these women that were anorexic when they were younger, and simply never stopped, or are they picking up the disorder later in life?

@papayalily It’s possible that you were always right and that she just has a higher control.

I am not a person that says that every woman who cares deeply about the way she looks is anorexic or has a disorder.

However, it’s also possible that she’s struggling and could use a hand. It doesn’t hurt to talk to her and let her know that you’d be willing to support her if she ever felt like she needed help. It’s a subtle art, though, so don’t start by saying she has a disorder. It makes it sound like there’s something wrong with her, even though you don’t mean it that way.

It’s both: girls have problems and grow up with the problems and women grow up feeling okay about their bodies and then lose their job or go through a divorce and lose their self-worth. I didn’t know many 30+ women, but the couple I did know started getting sick after traumatizing events in their lives. Honestly, though, most women don’t notice what they’re doing is destructive because no one ever says adult women can be anorexic.

EDIT: Therefore they never make it to the communities I frequented.

@iWitch She’s also a recovering alcoholic and has various other mental health issues, so she is at a higher risk for an eating disorder.

It’s sad that all these women get thrown aside by society once they are no longer seen as innocent and virginal.

@papayalily Intuition is usually never completely wrong. If you’re this worried about her, there’s good reason for it. Talk to her, and maybe pick up some materials for her about healthy nutrition.

I agree, it is sad. Women post-50 are said to be the most disadvantaged age group in America, and I tend to agree in many respects. However, even younger women are sometimes ignored. Since women are “supposed” to put everyone before themselves, realizing they need help is usually not at the top of their to-do lists.

One of the most deadly things about anorexia is an electrolyte imbalance that can lead to heart attack and death. It sounds like this woman has to obsess or be addicted to something to cope with whatever it is that bothers her psychologically. Focusing on counting calories, even thinking about how hungry she is and denying herself, occupies her mind so she is not thinking about other disturbing thoughts in my opinion. Does she exercise also?

@JLeslie Yup. Her ex-husband was (and still is) seriously addicted to exercise, and would become belligerent and even violent if he didn’t get x amount of exercise that day. They exercised together, and she doesn’t do it as much anymore, but she still exercises a lot.

@papayalily So she is kind of anorexic/bulimic. She is purging the calories through exercise. Does she want it to change, or is she happy being anorexic?

@JLeslie I’ve always thought she was one of the most miserable people I’d ever known, but she’s lashed out at even the most minor criticism, so while I seriously doubt she’s happy, I don’t know that she wants to change at all.

@papayalily I think you probably can’t do anything. Well, you can be supportive and emphasize what is fantastic about her, to help her build her self esteem, help her feel empowered. Did you say she has been in therapy before? I skimmed the posts above earlier, but I don’t remember. I hope you don’t mind me asking instead of trying to find it.

@JLeslie As far as I know, only right after her divorce to deal with the grief, never for any kind of… saying “personal work” isn’t quite right, because grief from a divorce is personal work, but I’m blanking on what else to call it.