Anorexia usually begins as a diet to lose a few pounds, although the person may already be thin. A person with anorexia may see no problem with their behavior. Dieting becomes obsessive and the person may even develop elaborate food rituals such as cutting food into tiny pieces or weighing food before eating it. Anorexia basically tricks the mind and becomes more controlling as time passes. Children who show signs of other "perfectionist" behavior are most prone to the disorder.

Purging behavior may also be present with symptoms of Anorexia Nervosa, when a person spends days, weeks or even longer starving, then finally binge eats. The person may feel guilty for having eaten and feel compelled to purge. Feelings of guilt may be present even before the person eats and may be unrelated to food. Anorexic behavior often coincides with other forms of self-injury, including punching, hair pulling, cutting, etc. Many anorectics use purging methods as a form of "punishment" for allowing themselves the "pleasure" of food. Anorectics tend to have a very low opinion of themselves and have feelings of worthlessness or hopelessness. Individuals with anorexia also demonstrate a very distorted body image. Anorexic behavior may also be a means for anorectics to "starve away bad feelings". Starvation or purging what little food the anorectic may allow themselves usually increases following an unpleasant or disappointing event.

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