The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioral issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat. It may be difficult to notice signs and symptoms because what is considered a low body weight is different for each person, and some individuals may not appear extremely thin. Also, people with anorexia often disguise their thinness, eating habits or physical problems. Physical symptoms Physical signs and symptoms of anorexia may include: 
Extreme weight loss or not making expected developmental weight gains
Thin appearance
Abnormal blood counts
Fatigue
Insomnia
Dizziness or fainting
Bluish discoloration of the fingers
Hair that thins, breaks or falls out
Soft, downy hair covering the body
Absence of menstruation
Constipation and abdominal pain
Dry or yellowish skin
Intolerance of cold
Irregular heart rhythms
Low blood pressure
Dehydration
Swelling of arms or legs
Eroded teeth and calluses on the knuckles from induced vomiting
 Some people who have anorexia binge and purge, similar to individuals who have bulimia. But people with anorexia generally struggle with an abnormally low body weight, while individuals with bulimia typically are normal to above normal weight. Emotional and behavioral symptoms Behavioral symptoms of anorexia may include attempts to lose weight by: 
Severely restricting food intake through dieting or fasting
Exercising excessively
Bingeing and self-induced vomiting to get rid of food, which may include the use of laxatives, enemas, diet aids or herbal products
 Emotional and behavioral signs and symptoms may include: 
Preoccupation with food, which sometimes includes cooking elaborate meals for others but not eating them
Frequently skipping meals or refusing to eat
Denial of hunger or making excuses for not eating
Eating only a few certain "safe" foods, usually those low in fat and calories
Adopting rigid meal or eating rituals, such as spitting food out after chewing
Not wanting to eat in public
Lying about how much food has been eaten
Fear of gaining weight that may include repeated weighing or measuring the body
Frequent checking in the mirror for perceived flaws
Complaining about being fat or having parts of the body that are fat
Covering up in layers of clothing
Flat mood (lack of emotion)
Social withdrawal
Irritability
Insomnia
Reduced interest in sex
