Approximately 30 million people in the United States have some type of eating disorder. Some overeat and become obese, some don’t eat enough and literally starve themselves, while others overeat and then purge themselves by vomiting up food or using other methods to rid their bodies of excess calories. There is often a hyper-focus on body shape and weight. The one issue all eating disorders have in common—besides a lack of control over eating habits—is that they can progress and cause serious, even permanent damage to your mental and physical health. That’s why it’s important to recognize if you or someone you know shows signs or symptoms of an eating disorder, and reach out to get the right kind of help.

What are the different types of eating disorders?

There are many types of eating issues, but the four eating disorders recognized in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are:

Any two people with the same eating disorder can have somewhat different symptoms and experiences. Overall, however, these are the common, most recognizable signs and symptoms that meet the diagnostic criteria for each of the four recognized eating disorders:

Anorexia Nervosa

  • Food intake is limited, leading to very low body weight for one’s age and height
  • Extreme fear of weight gain and being fat or extreme measures to prevent weight gain, even though the individual is underweight
  • Issues with body image or denial that underweight condition is a serious problem

Bulimia Nervosa 

  • Eating often, eating large amounts of food, feeling out of control over eating behavior and amount of food eaten
  • Frequently purging to prevent weight gain using such methods as self-induced vomiting, laxatives or diuretics, routine fasting or overexercising.
  • Overly concerned with body weight and shape
  • Disordered eating and purging behaviors occur at least once a week for 3 months

Binge Eating Disorder 

  • Binge eating at least once a week for 3 months, plus:
  • Eating more food in a specific period of time than most people would eat in the same amount of time, and
  • Feeling out of control over eating behavior and the amount of food eaten

Plus, episodes of binge eating that involve at least three of these five behaviors:

  • Eating much faster than normal
  • Eating until uncomfortably full
  • Eating huge amounts of food even when not feeling hungry
  • Eating secretively or alone out of shame
  • Experiencing feelings of disgust, depression or extreme guilt after bingeing

Avoidant Restrictive Food Intake Disorder

  • Lack of interest or other avoidance of food due to the sensory characteristics of food, such as colors and textures. Avoidance is associated with at least one of the following: Significant weight loss or, in children, failure to reach expected weight and height, Significant nutrient deficiency, Dependence on nutritional supplements or oral feeding tube, Disruption of psycho-social functioning
  • The condition cannot be explained away by the unavailability of foods or culturally approved eating practices.
  • There are no issues with body weight or body image and avoidance is not associated with anorexia or bulimia.
  • There is no other eating disturbance or medical condition present that would explain the avoidance, or the avoidance is more extreme than would normally be associated with another condition.
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What about other eating issues?

There are many different types of eating and body image issues that can affect anyone, at any age, though they are less common than the four primary eating disorders. These include Rumination Disorder, when someone consistently regurgitates food after eating; Orthorexia, a form of extreme “clean-eating;” and Food Addiction when someone cannot control their intake of specific types of foods or ingredients. These, and any other abnormal or excessive behaviors that relate to diet or body image are conditions that often require professional treatment to prevent symptoms from worsening.

Who is at risk for an eating disorder?

Eating disorders are most often associated with females during adolescence and young adulthood, but anyone, rich or poor, young or old, and of any race, ability, culture, gender or sexual orientation can develop an eating disorder. Genes, the environment, societal norms, and psychological health all play a role. People with other mental and behavioral health challenges, such as depression, anxiety, or drug and alcohol use, are also more likely to engage in unhealthy eating behaviors. High-stress situations, including peer pressure, and activities that encourage a stricter diet—such as participating in sports, dancing, or modeling—can also increase the risk.

How do I know if a friend or family member has an eating disorder?

Only a physician or mental health professional can give an accurate diagnosis, but here are some signs you may observe if you or any of your loved ones struggle with disordered eating habits.

  • Eating in secret or leaving meals to go to the bathroom
  • Expressing guilt about eating habits
  • Constantly talking about weight or losing weight
  • Being overly and obsessively focused on eating healthy foods
  • Consistently skipping meals
  • Exercising excessively
  • Frequently checking the mirror or scale
  • Using dietary supplements or laxatives

How will an eating disorder impact my life?

In addition to disrupting your day-to-day activities, an eating disorder can affect your mental and emotional health. You might find yourself feeling more anxious about the number of calories you consume or ashamed about your weight. You may start to isolate from friends and family who express concerns about your health, and that isolation can lead to depression.

The physical impact of an eating disorder can be significant. Over time, disordered eating behaviors can damage your digestive tract, skin, bones, and teeth, as well as the functioning of various other organs, such as your heart. Eating disorders have the highest death rate among mental health conditions, especially anorexia. In fact, the risk of early death for those with anorexia is 18 times higher than that of their peers. That’s why early recognition of symptoms and appropriate treatment are essential. 

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See Part 2 of this story

Eating Disorder Treatment: Getting the Help You Need

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If you need help and you cannot get it from someone in your immediate support circle, call the National Eating Disorders Association helpline toll-free at 1-800-931-2237.

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Last Updated: Oct 21, 2019