Eating Disorders

What Are Eating Disorders?

Eating disorders are problems that affect a person’s eating behaviors as well as their attitudes and feelings about food — and about their body.

Eating disorders affect a person’s mental health and can cause serious harm to a person’s physical health.

There are several types of eating disorders. 

What Are the Different Types of Eating Disorders?

Common types of eating disorders are anorexia, bulimia, binge eating, and avoidant/restrictive food intake disorder (ARFID).

Anorexia. People with anorexia:

• eat very little on purpose, leading to a very low body weight
• have an intense fear of weight gain and fear looking fat
• have a distorted body image and see themselves as fat even when they are very thin

People with anorexia are very strict about what and how much they will eat. They may think about food or calories almost all the time.

To lose weight, some people with anorexia fast or exercise too much. Others may use laxatives, diuretics (water pills), or enemas.

Bulimia. People with bulimia:

• overeat and feel out of control to stop, called binge eating
• do things to make up for overeating, such as:
  • make themselves throw up on purpose after overeating, called purging
  • use laxatives, diuretics, weight loss pills, fast, or exercise a lot to prevent weight gain
• judge themselves based on body shape and weight

People with bulimia eat much more (during a set period of time) than most people would. If a person regularly binges and purges, it may be a sign of bulimia. Unlike people with anorexia who are very low weight, people with bulimia may be thin, average weight, or overweight. People with bulimia often hide their eating and purging from others.

Binge eating. People with binge eating disorder:

• overeat and feel out of control to stop
• eat large amounts even when they are not hungry
• may feel upset or guilty after binge eating
• often gain weight and may become very overweight

Many people with binge eating disorder eat faster than normal. They may eat alone so others don't see how much they are eating. Unlike people with bulimia, those with binge eating disorder do not make themselves throw up, use laxatives, or exercise a lot to make up for binge eating. If a person binge eats at least once a week for 3 months, it may be a sign of binge eating disorder.

ARFID. People with avoidant/restrictive food intake disorder:

• are not interested in food or avoid foods
• lose weight, or don't gain expected amount of weight
• are not afraid of gaining weight
• don't have a poor body image

People with ARFID don't eat because they are turned off by the smell, taste, texture, or color of food. They may be afraid that they will choke or vomit. They don't have anorexia, bulimia, or another medical problem that would explain their eating behaviors.

How Do Eating Disorders Affect Health and Emotions?

Eating disorders can cause serious problems throughout the body.

Anorexia can lead to health problems caused by undernutrition and low body weight, such as:

• low blood pressure
• slow or irregular heartbeats
• feeling tired, weak, dizzy, or faint
• constipation and bloating
• irregular periods
• weak bones
• delayed puberty and slow growth

People with anorexia may find it hard to focus and have trouble remembering things. Mood changes and emotional problems include:

• feeling alone, sad, or depressed
• anxiety and fears about gaining weight
• thoughts of hurting themselves

Bulimia can lead to health problems caused by vomiting, laxatives, and diuretics, such as:

• low blood pressure
• irregular heartbeats
• feeling tired, weak, dizzy, or faint
• blood in vomit or stool (poop)
• tooth erosion and cavities
• swollen cheeks (salivary glands)

People with bulimia may have these emotional problems:

• low self-esteem, anxiety, and depression
• alcohol or drug problems
• thoughts of hurting themselves

Binge eating can lead to weight-related health problems, such as:

• diabetes
• high blood pressure
• high cholesterol and triglycerides
• fatty liver
• sleep apnea

People with binge eating disorder may:

• have low self-esteem, anxiety, or depression
• feel alone, out of control, angry, or helpless
• have trouble coping with strong emotions or stressful events

ARFID may lead to health problems that stem from poor nutrition, similar to anorexia. People with ARFID may:

• not get enough vitamins, minerals, and protein
• need tube feeding and nutrition supplements
• grow poorly

People with ARFID are more likely to have:

• anxiety or obsessive-compulsive disorder (OCD)
• autism spectrum disorder or attention deficit hyperactivity disorder (ADHD)
• problems at home and school because of eating behavior

What Causes Eating Disorders?

There's no one cause for eating disorders. Genes, environment, and stressful events all play a role. Some things can increase a person's chance of having an eating disorder, such as:

• poor body image
• too much focus on weight or looks
• dieting at a young age
• playing sports that focus on weight (gymnastics, ballet, ice skating, and wrestling)
• having a family member with an eating disorder
• mental health problems such as anxiety, depression, or OCD

How Are Eating Disorders Diagnosed?

Health care providers and mental health professionals diagnose eating disorders based on history, symptoms, thought patterns, eating behaviors, and an exam.

The doctor will check weight and height and compare these to previous measurements on growth charts. The doctor may order tests to see if there is another reason for the eating problems and to check for problems caused by the eating disorder.

How Are Eating Disorders Treated?

Eating disorders are best treated by a team that includes a doctor, dietitian, and therapist. Treatment includes nutrition counseling, medical care, and talk therapy (individual, group, and family therapy). The doctor might prescribe medicine to treat binge eating, anxiety, depression, or other mental health concerns.

The details of the treatment depend on the type of eating disorder and how severe it is. Some people are hospitalized because of extreme weight loss and medical complications. 

What if I Have an Eating Disorder?

If you think you may have an eating disorder:

Tell someone. Tell a parent, teacher, counselor, or an adult you trust. Let them know what you're going through. Ask them to help.

Get help early. When an eating disorder is caught early, a person has a better chance of recovery. Make an appointment with your doctor or an eating disorders specialist.

Go to all appointments. Treatment takes time and effort. Work hard to learn about yourself and your emotions. Ask questions any time you have them.

Be patient with yourself. There's so much to learn, and change happens a little at a time. Take care of yourself and be with people who support you.

Where Can I Learn More About Eating Disorders?

For more information on eating disorders, visit the National Eating Disorders Association (NEDA).

For more help and support, the National Association of Anorexia Nervosa and Associated Disorders (ANAD) offers these free resources:

• eating disorders helpline
  
• peer support groups
• recovery mentors