The most common element surrounding ALL Eating Disorders is the inherent presence of a low self esteem

Anorexia Nervosa
It is not easy to understand a person suffering Anorexia. People living with the illness often have a low self-esteem and a tremendous need to control their surroundings and emotions. Quite often the Eating Disorder is a unique reaction to an array of external and internal conflicts, such as stress, anxiety, and unhappiness. Anorexia is a negative way to cope with these emotions.

"...starvation fills a void inside when it's approval from you I crave. The desire for food is gone and you are there again... yelling... so negative. Times like this filled with the pounding urge to run far away and disappear..."

The person suffering with Anorexia may be abnormally sensitive about being perceived as fat, or have a massive fear of becoming fat -- though not all people living with Anorexia have this fear. They may be afraid of losing control over the amount of food they eat, accompanied by the desire to control their emotions and reactions to their emotions. With a low self-esteem and need for acceptance they will turn to obsessive dieting and starvation as a way to control not only their weight, but their feelings and actions regarding the emotions attached. Some also feel that they do not deserve pleasure out of life, and will deprive themselves of situations offering pleasure (including eating).

Some of the behavioral signs can be: obsessive exercise, calorie and fat gram counting, starvation and restriction of food, self-induced vomiting, the use of diet pills, laxatives or diuretics to attempt controlling weight, and a persistent concern with body image. See Also, Signs and Symptoms.

It is not uncommon for people suffering with Anorexia to waver through periods of Bulimia (binging and purging) as well.

"... lost in the darkness of my own circumstance, criticizing echoes leaving me awake in the night... the barrier and blockades that keep me safe and in control while I pretend that I am okay... "

It is important to point out that there can be a number of ways a person suffering from Anorexia can portray their disorder. The inherent trait of a person suffering Anorexia is to attempt to maintain strict control over food intake. In a number of cases a man or woman suffering will seem to eat normal meals with only periods of restriction. Anorexics are sometimes known to eat junk food, particularly candy, to drink a lot of coffee or tea, and/or to smoke. They may deny hunger, make excuses to avoid eating, will often hide food they claim to have eaten, use diet pills to control appetite, or attempt to purge the food away with self-induced vomiting, or by taking laxatives.

"...Emotions control me... make me hide in a safe place of silence.... my mind stays distant from what my heart feels. If I say it... it's real... so I say nothing. I can't touch it... if I did I would curl up or crumble. I may seem to be made by heart of stone.... but really just chalk... and I'm afraid to face the possibility that I could easily turn to dust..."

Both Anorexia and Bulimia...
There are many similarities in both illnesses, the most common being the cause. There seems to be a common occurence of sexual and/or physical and emotional abuse in direct relation to eating disorders (though not all people living with Eating Disorders are survivors of abuse). There also seems to be a direct connection in some people to clinical Depression. The eating disorder sometimes causes the depression or the depression can lead to the eating disorder. All in all, eating disorders are very complex emotional issues -- Though they may seem to be nothing more than a dangerously obsessive weight concern on the surface, for most men and women suffering with an eating disorder there are deeper emotional conflicts to be resolved.

"...the only blame I cast is on myself... for wanting the happiness I couldn't have... and still now, can't believe I deserve..."


Diagnostic Criteria
The following is considered the "text book" definition of Anorexia Nervosa to assist doctors in making a clinical diagnosis... it is in no way representative of what a sufferer feels or experiences in living with the illness. It is important to note that you can still suffer from Anorexia even if one of the below signs is not present (also see the Signs and Symptoms section). In other words, if you think you have Anorexia, it's dangerous to read the diagnostic criteria and think "I don't have one of the symptoms, so I must not be Anorexic".

1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
4. In postmenarcheal females (women who have not yet gone through menopause), amenorrhea (the absence of at least three consecutive menstrual cycles).
   • Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
   • Binge-Eating Type or Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating OR purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)