Eating Disorders

What are Eating Disorders?

Eating disorders are illnesses in which the people experience severe disturbances in their eating behaviors and related thoughts and emotions. People with eating disorders typically become preoccupied with food and their body weight. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

What are the Symptoms?

Anorexia nervosa

People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, often exercise excessively, and/or may force themselves to vomit or use laxatives to lose weight. Anorexia nervosa has the highest mortality rate of any mental disorder. While many people with this disorder die from complications associated with starvation, others die of suicide.

Symptoms include:

  • Extremely restricted eating
  • 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

Other symptoms may develop over time, including:

  • Thinning of the bones (osteopenia or osteoporosis)
  • Mild anemia and muscle wasting and weakness
  • Brittle hair and nails
  • Dry and yellowish skin
  • Growth of fine hair all over the body (lanugo)
  • Severe constipation
  • Low blood pressure slowed breathing and pulse
  • Damage to the structure and function of the heart
  • Brain damage
  • Multiorgan failure
  • Drop in internal body temperature, causing a person to feel cold all the time
  • Lethargy, sluggishness, or feeling tired all the time
  • Infertility

**Any person at any weight may experience some or all of these symptoms; a person who is overweight or in a healthy weight range can also be diagnosed with anorexia.

Bulimia nervosa

People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or overweight.

Symptoms include:

  • Chronically inflamed and sore throat
  • Swollen salivary glands in the neck and jaw area
  • Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
  • Acid reflux disorder and other gastrointestinal problems
  • Intestinal distress and irritation from laxative abuse
  • Severe dehydration from purging of fluids
  • Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack

**Many patients with anorexia also have symptoms associated with Bulimia nervosa and may be diagnosed with both disorders.

Binge-eating disorder

People with binge-eating disorder 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 binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S. 

Symptoms include:

  • Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
  • 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

What are the causes?

Eating disorders can affect people of all ages, racial/ethnic backgrounds, body weights, and genders. BIPOC, males, and members of the LGBT+ are less likely to be diagnosed and receive treatment for eating disorders, which is very dangerous for those communities. Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life. These disorders affect both genders, although rates among women are higher than among men. 
Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Researchers are using the latest technology and science to better understand eating disorders. One approach involves the study of human genes. Eating disorders run in families. Researchers are working to identify DNA variations that are linked to the increased risk of developing eating disorders. Brain imaging studies are also providing a better understanding of eating disorders. For example, researchers have found differences in patterns of brain activity in women with eating disorders in comparison with healthy women.

Treatment

It is important to seek treatment early for eating disorders. People with eating disorders are at higher risk for suicide and medical complications. People with eating disorders can often have other mental disorders (such as depression or anxiety) or problems with substance use. Eating disorders can be completely cured and with help sufferers can go on to live a normal life with a healthy relationship with food and their body. 

Treatment plans are tailored to individual needs and may include one or more of the following: 

  • Individual, group, and/or family psychotherapy
  • Medical care and monitoring
  • Nutritional counseling
  • Medications

Psychotherapies

Psychotherapies such as a family-based therapy called the Maudsley approach, where parents of adolescents with anorexia nervosa assume responsibility for feeding their child, appear to be very effective in helping people maintain a healthy weight and improve eating habits and moods.
To reduce or eliminate binge-eating and purging behaviors, people may undergo cognitive behavioral therapy (CBT), which is another type of psychotherapy that helps a person learn how to identify distorted or unhelpful thinking patterns and recognize and change inaccurate beliefs.

Medications

Evidence also suggests that medications such as antidepressants, antipsychotics, or mood stabilizers may also be helpful for treating eating disorders and other co-occurring illnesses such as anxiety or depression.

If you are currently experiencing a medical emergency, please call 911. Check the Food and Drug Administration’s (FDA) website, for the latest information on warnings, patient medication guides, or newly approved medications. A medical professional is your greatest ally in your personal mental health journey. While we are here to help, we should not be your last stop for advice and information. For general information on mental health and to locate treatment services in your area, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357). SAMHSA also has a Behavioral Health Treatment Locator on its website that can be searched by location.

Key Figures

Nearly 29 million Americans

9% of the U.S. population, will have an eating disorder in their lifetime. Less than 6% of people with eating disorders are medically diagnosed as “underweight.”

Age of onset

The median age of onset (when symptoms first start to appear) was 21 years old for binge eating disorder, and 18 years old for both bulimia nervosa and anorexia nervosa.

Mortality rates

Anorexia nervosa, although less common than binge eating disorder or bulimia nervosa (0.6% of adults in the US), is the mental illness with the highest death rate due to malnutrition and increased risk of suicide.

By Race

BIPOC, as well as people in larger bodies, are half as likely to be diagnosed or to receive treatment compared to their white or normal/underweight counterparts.

Additional Resources For Your Research

6 Common Types of Eating Disorders (and Their Symptoms)

Although the term eating is in the name, eating disorders are about more than food. They’re complex mental health conditions that often require the intervention of medical and psychological experts to alter their course. This article describes 6 of the most common types of eating disorders and their symptoms.

Diversity and Eating Disorders: Changing the Face of the Diagnosis

The truth is that eating disorders do not discriminate. Eating disorders can affect people of all racial and ethnic backgrounds, sexual orientations, body types, and gender identities. Given the widespread impact of eating disorder representation, we must take a close look at the absence of diversity in eating disorder spaces, and work to change the face of eating disorders.

School BMI Screening Tied to Reduced Weight Satisfaction Among Youth

School-based weight checks and BMI reporting don’t appear to impact BMI z scores and may increase the potential for youth to become dissatisfied about their weight, a California study suggests.

COVID Isolation, Anxiety ‘Really Reinforce’ Eating Disorders

Stockpiling of food at home because of lockdowns can be a temptation to overeating for the average individual. But some people with eating disorders may avoid keeping the necessary food stocks on hand.

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