Clearly, there is a distorted view of reality. The emaciated appearance is a hallmark of the condition and is completely obvious to most, accept the person with the condition. Even though a person with the condition may have lost 60 to 80 pounds and a vague shadow of the prior self, they still feel they are too fat. The extreme weight loss often includes loss of hair, growth of fine body hair, constipation, intolerance of cold, and low pulse rate. Further, menstruation often ceases, and will not resume until endocrine balance is restored.
Ovulation is suppressed because of the inadequate appropriate hormones.
Anorexia affects boys very much the same as girls, including severe weight loss, psycho-social problems and interruption of normal reproductive system processes. Many differences in symptoms are apparent between anorectics and bulimics. Anorexia nervosa patients usually are not obese before onset of their illness. Typically, they are good students who become socially withdrawn before becoming ill and often came from families who fit the anorexia prototype described earlier. Bulimics, on the other hand, usually are extroverted before their illness, are inclined to be overweight, have voracious appetites and have episodes of binge eating.