What are the tell-tale signs of anorexia

asks rtell:
A. Anorexia nervosa is the best-known eating disorder. Anorexics have a tremendous fear of putting on weight, and are obsessed with the shape or size of their bodies. Most are women, but men can suffer from it, too.

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Q. Why does it happen
A. No-one knows. It's generally accepted that this focus on food starts as an attempt to cope with life, but the illness itself soon takes control. A recent theory is that sufferers may have a genetic predisposition which is triggered by a life event, such as puberty or death in the family.

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Q. Do the sufferers recognise that they have a problem
A. On the contrary, they usually feel quite strongly that they don't. Part of the problem is that not eating makes them feel better: by depriving themselves of food they are giving themselves an artificial high. They also feel better because they are controlling their lives.

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Q. So, what sort of behaviour should you look out for
A. Anorexia develops over time, so it can be very hard to spot, especially in teenagers, whose weight can fluctuate almost as much their behaviour. Tell-tale signs include:

• constipation
• downy hair growing over the body
• excessive exercise
• fasting
• fear of gaining weight
• feeling cold
• invented rules about how much food they can have and how much exercise they have to do to compensate
• looking thin and drawn
• periods stopping or puberty delayed
• severely restricting the amount they eat and drink
• talking about being too fat even when they obviously aren't
• using laxatives
• wearing baggy clothes.

Q. Is anorexia always dangerous
A. It can cause hormonal disturbances (periods stop, fertility problems), depression, osteoporosis, and damage to the heart, liver, kidneys and brain. Without treatment it can be fatal.

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Q. What should you do if you suspect someone in your family is anorexic
A. Don't try to force them to eat: the problem has nothing to do with food, it goes far deeper than that. An anorexic needs professional help, but they need to be part of the process and that can be difficult. Treatment takes time and is usually a combination of family and GP support, counselling, possibly anti-depressants, together with advice from the Eating Disorders Association. Most importantly, they need your care and support: a negative response only reinforces their feeling of low-self worth.

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By Sheena Miller