Eating disorders are complex and potentially devastating conditions that can have serious consequences for health, productivity, and relationships.
In the United States, 9% of the population, or 28.8 million Americans, will have an eating disorder such as anorexia nervosa, bulimia nervosa or binge eating disorder in their lifetime. Eating disorders can be fatal, with 10,200 deaths per year reported as a direct result of an eating disorder. That equates to one death every 52 minutes.
Although eating disorders can affect people of any gender, at any life stage, they’re most often reported in adolescents and young women. In fact, up to 13% of young women may experience at least one eating disorder by the age of 20.
If you or a loved one are coping with an eating disorder, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237.
For more mental health resources, see our National Helpline Database.
How Do I Tell if I Have an Eating Disorder?
The chance for recovery increases the earlier an eating disorder is detected. Therefore, it is important to be aware of some of the warning signs of an eating disorder.
Someone struggling with an eating disorder generally won’t have all of these signs and symptoms at once, and the warning signs don’t always fit into neat categories. These lists are intended as a general overview of the types of behaviors that may indicate a problem.
People with anorexia nervosa avoid food, severely restrict food, or eat very small quantities of only certain foods. Even when they are dangerously underweight, they may see themselves as overweight. They may also weigh themselves repeatedly.
Common signs and symptoms include:
- Extremely restricted eating and/or intensive and excessive exercise
- Extreme thinness (emaciation)
- A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
- Intense fear of gaining weight
- Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight
Anorexia can be very damaging to the body. Over time, individuals may experience thinning of their bones, infertility, brittle hair and nails, and the growth of a layer of fine hair all over their body.
In severe cases, anorexia can result in heart, brain, or multi-organ failure and death.
Bulimia nervosa is characterized by binge eating followed by purging or other methods to avoid weight gain. Purging usually involves vomiting, but it may also include the use of laxatives, excessive exercise, or fasting.
Common signs and symptoms include:
- Recurrent episodes of binge eating (rapid consumption of a large amount of food in a discrete period of time, usually less than two hours).
- Loss of control. The person must feel as though they have lost control of overeating and are unable to stop themselves or control how much they are eating.
- Use of “compensatory behaviors” to avoid weight gain such as self-induced vomiting, the misuse of laxatives, diuretics and/or enemas, and excessive exercise.
- Both the binge eating and compensatory behaviors occur at least once a week for three months.
- The person’s weight and/or body shape must have a significant impact on the way the person views themselves.
Side effects of bulimia may include an inflamed and sore throat, worn tooth enamel, tooth decay, acid reflux, irritation of the gut, severe dehydration, and hormonal disturbances.
The binge-and-purge cycles of bulimia can lead to chemical imbalances in the body (too low or too high levels of sodium, calcium, potassium, and other minerals) that affect the heart and other major organ functions.
Binge eating disorder (BED)
People with BED lose control over their eating. Unlike bulimia nervosa, periods of binge eating are not followed by purging, excessive exercise, or fasting. As a result, people with BED are often overweight or obese, although most people who are labeled clinically obese do not necessarily have BED. BED is the most common eating disorder in the U.S.
Signs and symptoms include:
- Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period, and feeling a sense of lack of control over eating during the episode.
- Eating even when you’re full or not hungry
- Eating fast during binge episodes
- Eating until you’re uncomfortably full
- Eating alone or in secret to avoid embarrassment
- Feeling distressed, ashamed, or guilty about your eating
- Frequently dieting, possibly without weight loss
Other Eating Disorders
In addition to the ones listed above, other eating disorders include:
- Avoidant/Restrictive Food Intake Disorder (ARFID)
- Other Specified Feeding and Eating Disorder (OSFED)
- Night eating syndrome
- Purging disorder
- Rumination disorder
There is no single test to screen for eating disorders. Healthcare providers use physical and psychological evaluations to diagnose the condition. They’ll also make sure you meet the diagnostic criteria for an eating disorder outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
During an evaluation, the healthcare provider will ask you questions about your eating habits. The goal is to understand your attitude toward food and eating. The healthcare provider also needs to get an idea of how you perceive your body.
It’s important to answer honestly so your healthcare provider can make an accurate diagnosis and recommend a treatment plan.
Within the course of a physical examination, a healthcare provider may also use several diagnostic tools, including— but not limited to—blood work, a bone density exam, and/or an electrocardiogram (EKG), to assess whether there are any medical complications from the eating disorder.
Risks of long-term medical and psychiatric problems associated with eating disorders
Because sufficient intake of nutritionally balanced foods is essential for healthy functioning, eating disorders can significantly affect physical and mental operations. Eating disorders affect every system of the body and can lead to physical health problems like:
- Cardiovascular problems
- Gastrointestinal issues (e.g. chronic constipation, gastroesophageal reflux)
- Dental problems
- Disrupted sleep patterns
- Fainting spells
- Hair loss or downy hair all over the body (called lanugo)
- Loss of menstrual period post-puberty (or delay of the first period)
- Musculoskeletal injuries and pain
- Weakened bones
Eating disorders often occur along with other mental disorders, most often anxiety disorders.
Why Do People Develop Eating Disorders?
Eating disorders can affect people of all ages, racial and ethnic backgrounds, body weights, and genders. Although eating disorders often appear during young adulthood, they may also develop during childhood or later in life.
Scientists can’t say for sure exactly what causes an eating disorder or predict who will develop an eating disorder. In general, most experts agree that eating disorders are complicated illnesses that stem not from a single cause but a complex interaction of biological, psychological, and environmental factors.
Genetics of eating disorders
Coming from a family with a history of eating disorders can increase a person’s risk of developing an eating disorder. A portion of this increased risk could be due to the modeling of eating disorder-linked behaviors within a family (e.g., observing a family member dieting).
However, twin study research, which can isolate the role of genetics, has confirmed that approximately 40% to 60% of the risk for anorexia nervosa, bulimia nervosa, and binge eating disorder arises from genetic influence.
How Do I Get Help If I Have an Eating Disorder?
If you recognize disordered eating attitudes and behaviors in yourself, you have already taken the first step to getting help. The second step—telling a trusted friend, family member, or medical professional—is equally as important.
You should not attempt to address your disordered eating alone; discussing the feelings you’re experiencing with someone else can provide essential comfort, support, and direction.
If you don’t feel comfortable talking to a friend, you can access support through the National Eating Disorders Association (NEDA), either through web chat, text or phone.
There are a number of treatment options available for eating disorders.
Recovering from an eating disorder doesn’t happen overnight and often involves a combination of treatments. Identifying some healthy distractions can help when you feel yourself experiencing the urge to turn to disordered eating or behaviors.
Here are a few to consider:
- Explore a new hobby, like crafting or photography
- Try an online drawing class
- Take a gentle walk
- Listen to a podcast
- Try an online yoga class
Psychological treatment is an important component of eating disorder recovery. It involves seeing a psychologist or another mental health professional on a regular basis.
Therapy may last from a few months to years. It can help you to:
- Understand the relationship of your eating disorder to your emotions
- Normalize your eating patterns and achieve a healthy weight
- Exchange unhealthy habits for healthy ones
- Learn how to monitor your eating and your moods
- Develop problem-solving skills
- Explore healthy ways to cope with stressful situations
- Improve your relationships
- Improve your mood
Treatment may take place one-on-one, with your family, or group therapy with others who are diagnosed with an eating disorder.
Your mental health professional may ask you to do homework, such as keep a food journal to review in therapy sessions and identify triggers that cause you to binge, purge or do other unhealthy eating behaviors.
Family-based therapy (FBT) for children and teenagers
Family-based treatment (FBT) is considered by some to be the treatment of choice for adolescents with eating disorders who are medically stable and fit for outpatient treatment.
FBT is a manualized therapy that is administered in weekly sessions by a psychotherapist who meets with the entire family. Parents are empowered to play an active role in the treatment. The adolescent remains in the home and parents provide meal support to help normalize eating behaviors.
For eating disorders like anorexia, food (and the normalization of eating patterns and nutrition) is the primary medicine, along with therapy to help disordered thoughts surrounding food, weight, eating, and body image.
Many people with eating disorders also struggle with anxiety and depression and medication may help with those symptoms.
Hospitalization may be necessary if you have serious physical or mental health problems or if you have anorexia and are unable to eat or gain weight. Severe or life-threatening physical health problems that occur with anorexia can be a medical emergency.
It’s worth noting that the majority of eating and weight restoration takes place in the outpatient setting.
The different levels of care from least to most intensive include:
- Outpatient treatment: This typically entails individual, one-hour sessions once or twice a week with each individual provider.
- Intensive outpatient treatment (IOP): This can be two to three sessions a week, a few hours each time, while you live at home and possibly work or attend school.
- Partial hospitalization programs (PHP): These are usually held five days a week for six to 11 hours per day, allowing you to sleep at home.
- Residential treatment centers (RTC): These provide 24-hour care for those who are medically stable but require supervision.
- Medical hospitalizations: This is for those who require 24-hour care and medical supervision.
A Word From Get Meds Info
If you or someone you love is struggling with an eating disorder, please seek help from a trained professional who can provide treatment recommendations.
Eating disorders are complex and can be devastating on your body and mind, but research indicates that early identification and treatment improves the speed of recovery, reduces symptoms to a greater extent, and improves the likelihood of staying free of the illness.