Anorexia Nervosa (AN)

Diagnostic Criteria of AN
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight* in the context of age, sex, developmental trajectory, and physical health.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. 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 persistent lack of recognition of the seriousness of the current low body weight.

Note. *Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.

Diagnostic Criteria is retrieved from Diagnostic and Statistical Manual of Mental Disorders 5th Edition.



Subtypes of AN

Restrictive Type

  • Restrictive diet/ excessive exercise (No binge eating or purging behaviors occurred)

Binging-Eating / Purging Type

  • Binge eating or purging behaviors occurred.


Signs and Symptoms of AN


  • Drastic and persistent weight loss
  • For female, disrupted menstrual cycles or amenorrhea, even worst to infertility and osteoporosis (bone abnormalities)
  • For male, loss of libido
  • Cold intolerance, lethargy and fainting
  • Constipation and abdominal bloating
  • Dry skin, hair loss, brittle nails
  • Muscle (heart muscle and cerebral atrophy) wasting
  • Slow pulse and low blood pressure
  • Dehydration


  • Intense fear of gaining weight and want to be thinner even though being underweight
  • Distorted perceptions on body shape
  • Denial of the existing problems of getting thin and make many excuses to avoid eating
  • Depressed, anxious and irritated
  • Changes in personality and mood swings
  • Intense and conflicting relationship with the family members
  • Diminished social network due to ongoing avoidance to eat with others
  • Indecisive, preoccupied with obsessive and compulsive thinking and behavior (especially during extremely underweight)


  • Refuse to eat or have unusual diet habits:
    • Cut food into tiny pieces and eating slowly
    • Only allow vegetables and food with low calories or specific types of food
    • Spit out the food after chewed
  • Doing excessive exercises, self-induced vomiting and abuse diet pills, laxatives or diuretics to avoid weight gain
  • Wear big baggy clothes to conceal thin body shape
  • Force family members to eat or supervise their family members on cooking
  • Prepare food by themselves
  • Stealing (especially food at the beginning)


** If you suspect your family members, friends or yourself suffering from eating disorders, call us as soon as possible at our hotline 2850 4448.