- Restriction of food intake.
- Intense fear of putting on weight. This fear is not lessened by weight loss.
- Preoccupation with body weight, size and shape. Self-evaluation and self-esteem become increasingly linked to these.
- Perception of body shape and size are disturbed (body image distortion). Even an obviously emaciated body is experienced as fat.
- Disruption of hormonal balance. In women and adolescent girls the menstrual cycle is upset: periods become irregular and eventually cease (amenorrhoea). In men there can be a loss of libido. In pre-pubertal children growth can be disrupted and sexual development can be delayed.