Due to the anorexics deep inbuilt self hatred and feeling of worthlessness very often one of the side effects with anorexia is the act of self mutilation. Self mutilation is different from actually having the feeling or wanting to commit suicide, self mutilation is actually defined as the deliberate damage of body tissue.
Just as anorexia has now become a way of coping with life, self mutilation can also become a way of coping. The anorexic very often develops deep feelings of worthlessness, these often stem from childhood events, more often some sort of abuse either physical or mental or family problems.
The anorexic will seek to forget about past experiences and try to release those memories in the form of changing how they look or how they have now come to believe they look through refusal to eat.