Anorexia (ICD-10:R63), or loss of appetite, occurs for various reasons, from underlying medical conditions such as heart disease, GI motility disorders, and infectious diseases such as influenza (flu) or the common cold to foodborne illnesses, natural aging changes, and more. Anorexia nervosa (ICD-10:F50) represents a psychological, emotional, physical, and socially triggered disorder where hunger isn't the issue.
Anorexia (ICD-10:R63) refers to the simple loss of appetite. This can occur because of an underlying disease or as a result of the normal aging process.
Anorexia nervosa (ICD-10:F50) refers to a condition where people often have an appetite but choose not to eat sufficiently to sustain themselves.
Conditions that cause a general loss of appetite include constipation, diarrhea, upper respiratory infections, heart disease, dementia, and more.
The development of anorexia nervosa is complex and includes social, psychological, environmental, and probable genetic factors.
Anorexia nervosa can become life threatening. Seek help if you or a loved one suffer from this disease to prevent long-term complications.
It isn't a loss of appetite but a combination of food aversion, weight loss, abnormal body image perceptions, and more, leading to a potentially fatal condition without prompt treatment.
Anorexia vs. anorexia nervosa
ICD-10 codes standardize diagnoses for a plethora of conditions globally and for medical insurance purposes.
Anorexia is simply a loss of appetite (ICD-10: R63) or involves conditions with signs and symptoms related to changes in food and fluid intake.
Anorexia nervosa (ICD-10: F50), the condition that non-medical people likely think of when hearing the term anorexia, is found in the section on eating disorders.
Eating disorders include conditions such as anorexia nervosa, bulimia nervosa, overeating-related conditions, psychogenic vomiting, and others. The distinction revolves around underlying triggers.
Medical professionals use the term anorexia to refer to a loss of appetite. This can happen for many reasons, from disruptions in various body systems, such as the brain and endocrine system, to metabolism-related conditions and even cancers. However, loss of appetite can also arise from psychological imbalances or conditions with underlying abnormalities associated with inner turmoil, dread of obesity, or misconstrued body image expectations and desires.
When anorexia occurs due to underlying psychiatric-related causes, it is termed anorexia nervosa. The disease can lead to malnutrition, which in turn creates body function disturbances. There can be severe to life-threatening weight loss and associated complications. An appetite stimulant isn’t going to be sufficient to address this condition. Addressing the underlying reasons for food aversion and avoidance is paramount to addressing those with anorexia nervosa.
Loss of appetite: Anorexia (ICD-10:R63)
When looking at anorexia, we look at various causes that can cause loss of appetite. Things that cause you to feel full or not hungry or cause aversion to food (you don’t like the smell or taste or sight of food), conditions that cause nausea or vomiting, or the presence of constipation or diarrhea can lead to appetite loss. Additional reasons one may lose their appetite include:
- Underlying disease, e.g., kidney disease, heart disease, lung disease
- The flu or COVID-19
- Food poisoning
- The common cold or other viral-type upper respiratory infections
- Medication side effects
- Motility disorders
General signs of appetite loss
Signs of general appetite loss include:
- Not eating your favorite foods even when readily available
- Skipping meals
- Weight loss
- Having no appetite or no interest in food
Anorexia nervosa: ICD-10:R50
Again, anorexia means loss of appetite. However, anorexia nervosa is much more than a simple loss of appetite; it often has minimal, if anything, to do with hunger. Many anorexics actually are usually hungry but use smoking, sucking candies, or other means to satiate themselves or eat the bare minimum to satisfy that hunger. People who develop this condition will usually be underweight (sometimes severely), have skewed perceptions of what appropriate weights and body condition appearances should be, and often have an irrational fear of weight gain.
People who suffer from this and related eating disorders demonstrate very restricted eating patterns, controlling calories and fat intake, some exercise to the point of excess, and others may vomit after eating (bulimia nervosa) or use laxatives, diuretics, enemas, or diet drugs to achieve what they perceive to be the ideal body image. It isn’t truly about food; it is much more than that, involving emotional concerns and self-worth.
Anorexia: ICD-10 vs. DSM-V
While the ICD-10 code helps for insurance and billing purposes and encompasses all ailments considered possible, the DSM-V (Diagnostic and Statistical Manual of Mental Disorders) is designed to help medical professionals diagnose various psychiatric conditions. The ICD-10 codes are considered more comprehensive and are used internationally. At the same time, the DSM-V is more accurate, though primarily used in the U.S.
The DMS-V defines anorexia nervosa in various ways, including having an "intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain." It further discusses that those with the illness are bothered by their weight, shape, or self-worth to the point where it negatively impacts body weight and form. People with this condition often fail to recognize the dangers associated with low body weight. As a result, those with anorexia nervosa restrict energy intake, which negatively affects their weight, natural aging, and overall physical health.
Causes of anorexia nervosa
Anorexia Nervosa causes are multifactorial. Generally, most people develop it around puberty, but it can develop at any age. Environmental, social, and psychological factors contribute to the disease. There also may be a genetic predisposition as it can run in families, with a person having up to 10 times the risk of developing it if a first-degree relative (parent, sibling) has the disease. Research has started demonstrating various gene expressions that may play a role in developing anorexia nervosa. However, a direct cause and effect have yet to be proven after over 30 years of research. Additional research is needed.
Complications of anorexia nervosa
Complications of anorexia nervosa may arise for various reasons. Without sufficient calories, the body breaks down tissue to produce energy. Muscles, including the heart muscle, are the first to go. This lack of proper nutrition can lead to systemic changes negatively impacting health and well-being. We can see
- Electrolyte abnormalities
- An increased risk of malnutrition
- Anemia often due to insufficient iron intake
- Negative impacts on the cardiovascular system
- Increased risk of osteoporosis
- Weakened immune system
- Neurological abnormalities
- Endocrine abnormalities
- Sleep disturbances
Regarding endocrine abnormalities, the endocrine system produces the hormones our body needs to regulate digestion, metabolism, thyroid function, and other physiological needs. Changes in hormone production can cause reproductive issues, increase the risk of bone loss, decrease the body’s normal resting metabolic rate, and even cause the body’s normal temperature to drop.
Eating disorder resources
If you or a loved one could be suffering from anorexia or another eating disorder, help is available. You can call and speak with trained professionals and find support groups, additional information, and assistance. You are not alone!
- National Eating Disorders Association (NEDA) helpline.
- National Association of Anorexia Nervosa and Associated Disorders (ANAD).
Identify non-psychiatric causes of appetite loss
If you have a loss of appetite and aren’t sure why, talk to your healthcare professional. There could be an underlying medical problem that is triggering this and bloodwork or other diagnostics may help identify the reason.
If no underlying hormonal imbalance, endocrine disease, or other problem is found, perhaps you need to look into psychological aspects of yourself for answers. Regardless of why one shows a lack of appetite, it isn’t normal and regardless of how we classify anorexia, anorexia nervosa, or other eating disorders for insurance purposes, these conditions manifest differently in different people.
Regardless of the cause, the loss of appetite isn’t a laughing matter, and seeking prompt assistance from a healthcare professional may be life-saving.
Anorexia nervosa: a serious matter
Anorexia can be crippling and life-threatening and lead to life-long mental struggles. Identifying that a problem exists in yourself is the first step. Seeking help and working to improve your overall health and mental well-being, outlook on life, and relationship with food and your body will go a long way to improving your quality of life and ability to move forward. The sooner one seeks help, the sooner one can reach inner peace. Further, the earlier treatment is received, the less likely one is to develop chronic health issues.
The anorexic mindset never fully leaves. People who suffer from eating disorders will have a life-long struggle but can overcome nutritional deficiencies, maintain a healthy body weight, and maintain a healthy mental outlook. Some days will be harder than others. Still, recovery is feasible, and many sufferers go on to live healthy, fulfilling lives.
- ICD-10 Version: 2019. Chapter V Mental and behavioral disorders. (F00-F99).
- National Eating Disorders Association (NEDA). Health consequences.
- International Journal of Child and Adolescent Health. The Genetics of Anorexia Nervosa: Current Findings and Future Perspectives.
- Mayo Clinic. Anorexia Nervosa.
- Current Psychiatry Reports. Genetics of Anorexia Nervosa.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
- Cleveland Clinic. Loss of Appetite.