Anorexia nervosa

Sometimes our relationship with food can be damaging due to it feeling like the only part of life we can control. Food begins to represent everything negative so eating habits develop into extreme patterns such as excessive lowering of food intake, missing meals and altering what you eat. The loosing of weight makes you feel safe and is your response to low self-worth, extreme fear of rejection and a distorted self-image. This is known as anorexia nervosa.

You can recover from anorexia nervosa and improve the quality of your life. Nightingale Hospital can help you take that vital step to regain a healthy and happy life. Please call us about eating disorder treatment.

Signs and symptoms of anorexia

You may find that you:

  • Worry more and more about your weight
  • Eat less and less
  • Exercise more and more, to burn off calories
  • Can’t stop losing weight, even when you are well below a safe weight for your age and height
  • Smoke more or chew gum to keep your weight down
  • Lose interest in sex
  • In girls or women – monthly menstrual periods become irregular or stop
  • In men or boys – erections and wet dreams stop, testicles shrink

When does it start?

Usually in the teenage years and affects around:

  • 1 fifteen-year-old girl in every 150
  • 1 fifteen-year-old boy in every 1000
  • It can also start in childhood or in later life

What happens?

  • You take in very few calories every day. You eat ‘healthily’ – fruit, vegetables and salads – but they don’t give your body enough energy.
  • You may also exercise, use slimming pills, or smoke more to keep your weight down.
  • You don’t want to eat yourself, but you buy food and cook for other people.
  • You still get as hungry as ever, in fact, you can’t stop thinking about food.
  • You become more afraid of putting on weight, and more determined to keep your weight well below normal.
  • Your family may be the first to notice your thinness and weight loss.
  • You may find yourself lying to other people about the amount you are eating and how much weight you are losing.
  • You may also develop some of the symptoms of bulimia. Unlike someone with Bulimia Nervosa, your weight may continue to be very low.

How can anorexia affect you?

If you aren’t getting enough calories, you may

Psychological symptoms:

  • Sleep badly
  • Find it difficult to concentrate or think clearly about anything other than food or calories
  • Feel depressed
  • Lose interest in other people
  • Become obsessive about food and eating (and sometimes other things such as washing, cleaning or tidiness)

Physical symptoms:

  • Find it harder to eat because your stomach has shrunk
  • Feel tired, weak and cold as your body’s metabolism slows down
  • Become constipated
  • Not grow to your full height
  • Get brittle bones which break easily
  • Be unable to get pregnant
  • Damage your liver, particularly if you drink alcohol
  • In extreme cases, you may die. Anorexia Nervosa has the highest death rate of any psychological disorder

If you vomit, you may:

  • Lose the enamel on your teeth (it is dissolved by the stomach acid in your vomit)
  • Get a puffy face (the salivary glands in your cheeks swell up)
  • Notice your heart beating irregularly – palpitations (vomiting disturbs the balance of salts in your blood)
  • Feel weak
  • Feel tired all the time
  • Damage your kidneys
  • Have epileptic fits
  • Be unable to get pregnant

If you use laxatives regularly, you may:

  • Have persistent stomach pain
  • Get swollen fingers
  • Find that you can’t go to the toilet any more without using laxatives (using laxatives can damage the muscles in your bowel)
  • Have huge weight swings. You lose lots of fluid when you purge, but take it all in again when you drink water afterwards (no calories are lost using laxatives)

Treatment for anorexia nervosa at Nightingale Hospital

We have the expertise in eating disorders to approach the support and treatment we offer adults and adolescents in a personal and flexible way to benefit you the most in your recovery. Treatments for anorexia here at Nightingale Hospital London can be accessed as outpatient therapy, day patient therapy or as an inpatient.

Based on current clinical evidence and put into practice by an experienced, multidisciplinary team of consultant psychiatrists, unit doctors, nurses, a dietitian and specialist specialist therapists, our approach to eating disorder treatment is tailored to the individual.

Therapies for anorexia

Through intensive psychological and emotional support in group therapy sessions and individual counselling and psychotherapy, you can understand underlying factors that have contributed to your anorexia and find strategies to overcome the eating disorder. Cognitive Behavioral Therapy can help you identify your negative thoughts and learn more positive emotional and behavioural responses to your beliefs about yourself and your eating. Family therapy can improve the way family members relate to each other and communicate and occupational therapy can support you practically in returning to a normal life away from anorexia nervosa.

Through therapy, education and alternative supportive approaches such as art and drama therapy, meditation and relaxation, life skills, sleep therapy and support groups for you and your family we aim to give you the knowledge and coping skills to recover from your anorexia.

Aftercare for anorexia

It can be difficult adjusting to life eating disorders after an inpatient admission, so we offer a step-down programme to our eating disorders day care, individual counselling and free aftercare groups post inpatient treatment to sustain motivation for living free from an eating disorder.

Family support groups for anorexia

Those nearest to the sufferer often blame themselves, going through a range of emotions from despair, depression and guilt to anger and frustration, leaving them exhausted and having difficulty coping, as well as feeling powerless in how to deal with the situation.

Research has shown that the involvement of families in the treatment process greatly increases the prospects of a person’s recovery.

Recent family support group feedback

“It was good to meet up with other people who understand the complexities of caring for a loved one with an eating disorder. The group was well-led. Joanna is very knowledgeable and took the time to listen to everyone even though there were many needs and peoples at different stages of the journey.”

“We cannot thank you enough for the education and advice this group has offered and the chance to discuss our questions with yourself and other careers of loved ones. We would be grateful if we could attend future Zoom meetings. We have started to read the advised book and already this is becoming of great help. Thank you again, Joanna.”

Eating disorder treatment telephone consultation

We offer a free telephone consultation to determine if eating disorder treatment would be right for you, or a loved one. Complete the form below and a member of our expert eating disorders team will be in touch to arrange an appointment.

Anorexia nervosa specialists at Nightingale Hospital

Nightingale Hospital London has a number of Consultant Psychiatrists and Specialist Therapists that can help you through your anorexia. It is vital you find an eating disorder specialist that you can trust and work with on your recovery. If you cannot find the information you need on anorexia specialists and anorexia treatment programmes we would welcome your call so you feel secure in the decisions you make.

Our team is led by:

  • Dr Helen Murphy  – Lead Consultant for Eating Disorders, Consultant Psychiatrist at Nightingale Hospital
  • Dr Joanna Silver Lead Therapist for Eating Disorders, Nightingale Hospital

Please contact us confidentially on 020 7535 7700 24 hours a day.

How you can help yourself with your anorexia

Helping yourself

Anorexia usually needs more organised help from a clinic or specialist therapist. It is still worth getting as much information as you can about the options so that you can make the best choices.


  • Stick to regular mealtimes – breakfast, lunch and dinner. If your weight is very low, have morning, afternoon and night-time snacks.
  • Take baby steps – Try to think of one small step you could take towards a healthier way of eating. If you can’t face eating breakfast, try sitting at the table for a few minutes at breakfast time and just drinking a glass of water. When you have got used to doing this, have just a little to eat, even half a slice of toast – but do it every day.
  • Keep a diary – of what you eat, when you eat it and what your thoughts and feelings have been every day. You can use this to see if there are connections between how you feel, what you are thinking about, and how you eat.
  • Be honest – Try to be honest about what you are or are not eating, both with yourself and with other people.
  • Give yourself a break – Remind yourself that you don’t always have to be achieving things – let yourself off the hook sometimes.
  • Stay positive – Remind yourself that, if you lose more weight, you will feel more anxious and depressed.
  • Make two lists – one of what your eating disorder has given you, one of what you have lost through it. A self-help book can help you with this.
  • Be kind to yourself – Try to be kind to your body, don’t punish it.
  • Set a goal – Make sure you know what a reasonable weight is for you and that you understand why.
  • Read stories – of other people’s experiences of recovery. You can find these in self-help books or on the internet.
  • Help yourself – Think about joining a self-help group. Your GP may be able to recommend one, or you can contact Beat.


  • Weigh yourself more than once a week.
  • Spend time checking your body and looking at yourself in the mirror. Nobody is perfect. The longer you look at yourself, the more likely you are to find something you don’t like. Constant checking can make the most attractive person unhappy with the way they look.
  • Cut yourself off from family and friends. You may want to because they think you are too thin, but they can be a lifeline.
  • Avoid websites that encourage you to lose weight and stay at very low body weight. They encourage you to damage your health, but won’t do anything to help when you fall ill.

Please call us on 020 7535 7700 to find out how we can help you.

“When you have a problem and you drink, take drugs or gamble, the problem won’t go away. Stay and tackle the problem”