Anorexia Nervosa is self-starvation. The individual is terrified of gaining weight or maintaining a normal weight. They have a distorted perception of their shape or size, and they may become amenorrheic. An individual with these symptoms can be classified as "clinically anorectic" when they are 15-20% less than normal weight. They are generally in denial about their physical condition, and are often times confused about the realities of their situation. Some (although few) anorexics are "restrictive anorexics," meaning that they loose weight by restricting their intake and doing excessive exercise. Most however, are secretly, binge purgers. They may purge by vomiting and/or by using diuretics or laxatives at least once per week.
Often the individual has a family history of either alcoholism or depression. They may have a tendency towards perfectionism and low self-esteem. At the onset of the disorder they may be suffering intense emotional pain stemming from either family relationships or social pressures. They may feel an inability to deal effectively with their environment and may feel helpless to take charge of their life. The individual who has exhibited symptoms for some time may be in denial about the accurate size of their body, and may compulsively compare themselves to others. The anorexic tends to take pride in their weight loss, gaining a temporary sense of accomplishment and self empowerment by succeeding at losing another pound.
The anorexic may verbally claim to want to gain weight, but secretly, may feel arrogant or proud about their low weight level. Likewise, the anorexic may gain pleasure, or a feeling of being special, by appearing to live without food. It's almost as if they need to show the world how "super human" they are. On the other hand, they inwardly feel "fake." Most secretly crave food. Most binge and purge when their desire for food becomes unbearable. Most anorexics will deny they crave food or binge. To admit this is to admit their failure. They feel ashamed of their behaviors, which increases their stress level - intensifying the symptoms.
In Andrea's case, she began as a restricted anorexic. After initially losing her weight she developed an intense fear of gaining it back. However, because she was human, she began to crave food. Her malnourished body screamed out for anything she saw, smelled or imagined. Before long she began bingeing to satisfy her cravings and purging to keep from gaining weight. Unlike a bulimic, her binge may only have consisted of five cookies or a bowl of plain popcorn. Still she was compelled purge. During the day, she compared herself to others incessantly, feeling superior to those who "had no control over their weight," and feeling inferior to those who appeared thinner. At night she would dream of huge body parts floating in the air around her. Sometimes she would dream of eating huge amounts of food and enjoying it shamelessly. It seemed that there wasn't a moment that her mind wasn't occupied by thoughts of food or body size.