Anorexia causes more than behavioral and physical symptoms. Some anorexia nervosa symptoms affect how the person with anorexia thinks. Cognitive distortions are thoughts that are not based on reality or fact. Many people have minor cognitive distortions such as saying, “Nothing ever goes right!” after one thing goes wrong.
The distortions of body image that are common among people with anorexia is probably the most problematic psychological symptom of anorexia nervosa. When someone who is dangerously thin from anorexia looks into the mirror, the emaciated anorexic sees excess fat on themselves that is not there.
People with anorexia are often very critical of themselves. They may have some general tendencies towards perfectionism and feeling that everything they do must be perfect. People with anorexia are often perfectionists when it comes to their appearance and grooming.
The self-esteem issues associated with anorexia is judging their personal value as only based on their weight or size. People with anorexia see having excess weight as the ultimate failure as a person. Qualities that others value such as humor or intellect are not nearly as important to the anorexic person. Since they see themselves as having excess weight or fat, people with anorexia can develop severe self-esteem problems.
Obsessions can become a severe psychological anorexia nervosa symptom. An obsession is a preoccupation with a subject to the extent that it interferes with concentrating on other subjects or doing things that are unrelated to the obsession. People with anorexia may become obsessed with dieting, food, exercise, or their appearance.
An obsession is different from a compulsion. The obsession is the constant thinking about the subject of the obsession. A compulsion is doing a behavior in an attempt to alleviate anxiety that occurs when the person avoids the behavior.
For example, an obsession on exercising would involve constantly thinking about exercising, researching exercise, and trying to think of ways to exercise more. The compulsive exercising would be exercising and moving constantly to attempt to burn as many calories as possible every time they have a chance. Anorexia nervosa can cause both obsessions and compulsive behavior.
Anorexia may become part of the individual’s sense of identity. They may seek the company of others with anorexia in real life or on the Internet. While this can be helpful in the healing process and learning to manage the eating disorder, some anorexic people may consider their diagnosis of anorexia as a positive distinction. The term “pro ana” is commonly used to refer to anorexia as a positive. Some groups of people with anorexia will encourage each other to continue to lose weight even if their lives are threatened by the illness.