As she becomes truly cachectic, specific characteristics of starvation are superimposed on the already disturbed psychological state of an adolescent with anorexia nervosa. Unhealthful behaviors, distorted perceptions, and weight phobia become more pronounced. Cognitive processes center on food. Behavior includes toying with food and hoarding it, especially during re-nourishment. Coherent, creative thinking is impaired.
Mental function is characterized by apathy, dullness, exhaustion, and depression.
Interest in sex wanes. Most adolescents with anorexia nervosa resist what they see as intrusions by professionals or others seeking to intervene. They are secretive and hide their rituals. They may appear apathetic but have sudden flashes of bad temper, as starving people of all ages usually do. Adolescents with anorexia nervosa may obsessively plan menus, read recipes, cook and serve food to others, manipulate food before eating it, and record all that they eat.