Anorexia Hair Loss Explained

Anorexia and hair loss

Hair loss is one of many side effects of anorexia nervosa, a restrictive eating disorder. With anorexia nervosa (here referred to as anorexia), hair loss occurs after one restricts their food or engages in other eating disorder behaviors (purging, excessive exercise). Over time, as the eating disorder behaviors continue, an individual with anorexia becomes malnourished, causing hair loss and numerous other serious health risks.

What is anorexia?

Anorexia is an eating disorder that affects people of all genders, races, ethnicities and ages. People with anorexia experience some or all the following symptoms:

• Intense fear of weight gain
• Body image issues
• Restricted eating
• Binge eating and purging

One of the hallmark signs of anorexia is the denial that anything is wrong. People with eating disorders often do not see their symptoms as others see them. They may not think they have a problem at all. This can make it hard for people with anorexia to reach out for help or to seek eating disorder treatment.

What causes hair loss with anorexia?

When a person restricts the food they eat by eating less or engaging in other eating disorder behaviors, the body becomes depleted of nutrients. Without enough nutrients, the body cannot function normally.

When food is restricted over a period, malnourishment can occur. A malnourished body will try to redistribute any remaining nutrients/energy to keep the body’s organs and systems functioning as well as possible. This can lead to hair loss. Here’s an example of how it happens.

• The body continues to send nutrients to the most essential body functions (cardiovascular, respiratory, etc.).
• The body stops sending nutrients to nonessential body functions.
• Hair loss occurs as the body stops sending nutrients to the hair follicles.

Along with the process mentioned above, there are other potential causes of hair loss in individuals with anorexia, such as:

• Stress
• Hormonal changes
• Medications
• Vitamin or nutrient deficiencies
• Trauma
• Hypothyroidism

What does anorexia hair loss look like?

When hair loss occurs with anorexia, one’s hair can become brittle and break easily. The fingernails may also become brittle and break easily. Additional signs of anorexia include:

• Receding hairline
• Thinning of the scalp hair
• Clumps of hair falling out
• Bald spots on the head
• Eyelash thinning

These symptoms can occur in people of all genders and all ages. When hair loss occurs with anorexia, it is a sign that other health complications may already be taking place.

If you know someone that has been losing hair and they also are showing signs of an eating disorder, they may be experiencing multiple other health problems, as well. Hair loss with anorexia is serious, but it can be treated.

How long does it take for the hair to grow back?

Once an individual has recovered from their eating disorder and has taken in enough nutrients to resolve any medical complications, it may take a few months for hair growth to re-occur. Some individuals may continue to shed hair before the hair growth resumes [1].

What about anorexia and body hair?

Interestingly, anorexia is associated with new hair growth on the body -- even while scalp hair is lost. Fine, downy hair can grow on certain places on the body, including the face, arms and back. This new hair growth is called lanugo. Lanugo develops to keep the body warm as body fat percentage drops in people with anorexia [2].

Learn more about lanugo and anorexia here.

Complications of anorexia

Hair loss is just one of the many medical complications related to anorexia. After restricting food for some time, all the body’s systems can potentially be affected, including:

• Skeletal (loss of bone density)
• Muscular (loss of muscle mass)
• Nervous
• Endocrine
• Cardiovascular (bradycardia and hypotension)
• Lymphatic
• Respiratory
• Digestive (constipation)
• Urinary
• Reproductive (missed or absent periods)

Notably, anorexia can cause functional changes of the heart that may show up as dizziness, headache, exercise intolerance or fatigue. The eating disorder can also cause permanent loss of bone density and irreversible changes to the brain. When anorexia occurs in early adolescence, growth can be stunted. The individual may not achieve their full adult growth potential [2].

Signs of anorexia

Food restriction, starvation, weight loss and malnutrition can impact nearly every organ system in the body and dramatically affect one’s thoughts and behaviors [3]. And, unfortunately, diagnosing anorexia is not always straightforward.

Even when a person is seriously ill from anorexia, their lab work may come back normal. Therefore, it is important to know the signs of anorexia to watch for. Here are some of the physical and mental signs of anorexia:

• Reduced strength
• Reduced libido
• Hormone imbalances 
• Preoccupation or obsession with food
• Anxiety
• Irritability
• Depression
• Social isolation
• Self-harm (cutting)
• Sleep problems
• Fainting
• Constipation

Thankfully, most of the complications associated with anorexia can be reversed with treatment. However, if the eating disorder is left untreated, an individual may experience many chronic health issues, including hair loss, throughout their lifespan.

How to stop hair loss from anorexia

The best way to stop hair loss from anorexia is to recover from the eating disorder. A three-pronged approach to treatment is recommended, including:

• Evidence-based therapies for eating disorders
• Nutritional counseling
• Medical management

The most effective eating disorder treatment is found by working with a multidisciplinary team that includes a psychiatrist, primary care physician, therapist and registered dietitian.

Learn more about eating disorder treatment here.

Find help for hair loss and anorexia

Every day, my team provides support to individuals experiencing hair loss related to anorexia, helping people of all ages and genders recover from their eating disorders.

If you would like to learn more about anorexia treatment at Eating Recovery Center, we invite you to send us a message here or call us at 866-622-5914. 

Help is available and recovery is possible.

Read more articles on this topic:

• Anorexia vs. Bulimia: What’s the Difference?
• Anorexia Subtypes: Understanding Restricting Type and Binge-Purge Type
• Lanugo: Anorexia Hair Growth Explained
• Male Anorexia: A Comprehensive Overview
• Anorexia in Teens: The Growing Risk of Eating Disorders

Sources

1. Hughes, E.C., & Saleh, D. (2023). Telogen effluvium. StatPearls Publishing. Accessed November 21, 2023.
2. Mehler, P.S., & Andersen, A.E. (2022). Eating disorders: A comprehensive guide to medical care and complications (4th ed.). Johns Hopkins University Press.
3. Sidiropoulos, M. (2007). Anorexia nervosa: The physiological consequences of starvation and the need for primary prevention efforts. McGill Journal of Medicine, 10(1), 20-25.