Eating disorders are life-threatening conditions that affect a person‘s behavior around eating. Symptoms of eating disorders vary, but all involve atypical or irregular eating habits that often affect shape or weight — though this is not always obvious.
It is important to realize that eating disorders are not a lifestyle choice or diet gone too far. They are serious psychological disorders that negatively impact health, emotions and ability to function in day-to-day life. They can impact long-term health, too. Dangerous eating behaviors can take a toll on the body — harming the heart, digestive system, kidneys, bones and teeth.
And though stereotypes and media representation of eating disorders often focus on young, thin white women, they can affect people of any age, any gender identity and any size.
Overcoming an eating disorder isn’t easy, but many people with eating disorders can make a full recovery. With help from health care professionals, people with eating disorders may be able to return to healthy eating habits, become more comfortable with their bodies and reverse serious health complications.
Eating disorder symptoms
While every eating disorder has its own characteristics and symptoms, all eating disorders are about abnormal eating habits and dysfunctional relationships with food.
Some common signs of an eating disorder include:
- Extreme weight loss or gain relative to your personal history.
- Fear of gaining weight.
- Preoccupation with food, body weight and body shape.
- Skipping meals or refusing to eat.
- Adopting rigid eating rituals or rules.
- Exercising excessively.
- Vomiting or regurgitating food.
- Heart, kidney or digestive issues.
- Negative self-esteem.
- Problems with relationships and social functioning.
- Overusing alcohol or drugs.
- Self-injury, suicidal thoughts or suicide attempts.
- Feeling distressed, ashamed or guilty about eating.
Do I have an eating disorder?
If any of the symptoms above sound like you, it’s time to get help. Don’t wait. It’s important to get evaluated by a medical professional as soon as possible. Eating disorders can cause serious health and mental health issues. Early identification of an eating disorder will help you get better quicker and avoid medical complications.
If you’ve been hiding your eating disorder, confide in a person you trust about what’s going on. That way, you’ll have support as you start your journey to better health.
Unsure where to get help? Ask your primary health care provider to refer you to qualified mental health professionals — such as eating disorder therapists — who have experience treating eating disorders. If you need help identifying a mental health provider in your area, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357) or use SAMHSA’s online Behavioral Health Treatment Services Locator.
How can a doctor tell if I have an eating disorder?
There’s not a specific eating disorder test. Doctors diagnose eating disorders based on symptoms, eating habits and other signs of illness. If they suspect you have an eating disorder, doctors will likely conduct:
- A physical exam. Your doctor will examine you to get an understanding of your physical symptoms and rule out other medical causes for your eating issues.
- A psychological evaluation. You can expect your doctor to talk to you about your thoughts, feelings and eating habits. Some doctors also might ask you to complete a psychological self-assessment questionnaire.
- Lab tests. Because eating disorders impact many of your body‘s functions, doctors might do lab tests, such as blood draws. These tests help your doctor check your blood count, electrolytes and protein levels. They also may conduct tests to see how your liver, kidney and thyroid are working.
Are certain people more at risk of developing an eating disorder?
Certain factors do increase the risk of having an eating disorder.
- Age. Eating disorders are more common in teenagers than adults, but people of any age can develop an eating disorder, including younger children and older adults.
- Genetics. Research shows people with a first-degree relative — such as a parent, sibling or child — with an eating disorder have a 28% to 74% risk of being diagnosed with an eating disorder themselves.
- Dieting and starvation. People who diet frequently have a higher risk for developing an eating disorder. Not eating enough food can lead to symptoms of starvation, which affects the brain, mood changes, anxiety and appetite. This makes it difficult to make good decisions about your health.
- Transitions and traumatic events. Stress can increase the risk of eating disorders. For example, an eating disorder may ramp up after someone moves to a new house, breaks up with a partner or experiences the death of a loved one.
- Psychological and emotional issues. Mental health problems, including depression, anxiety disorders and substance abuse, are closely linked with eating disorders.
Ethnicity, race, sexual orientation and gender identity also play roles in the risk of eating disorders. For example, white populations have higher rates of anorexia, while bulimia is more prevalent among Asian, Black, and Hispanic/Latino people. Transgender adolescents and young adults have higher rates of eating disorder diagnoses than cisgender heterosexual females.
Eating disorder statistics
Eating disorders are a global problem that leads to personal consequences. These statistics, compiled by ANAD, show how pervasive and detrimental eating disorders are:
- Almost 29 million Americans have eating disorders during their lifetime.
- Eating disorders are one of the deadliest mental health disorders, and result in 10,200 annual deaths.
Types of eating disorders
There are several kinds of eating disorders, but they all have this in common: They all take a significant toll on the body and interfere with important life activities. Here are a few of the most common eating disorders:
Binge-eating disorder
Binge-eating disorder is actually the most common eating disorder in the U.S. People with binge-eating disorder feel unable to stop eating. They frequently — at least once a week — feel a loss of control while eating. This can occur when eating a large, typical or small amount of food, and is known as bingeing. They feel the compulsion to eat even when they’re not hungry or already uncomfortably full. This loss of control feeling is one of the most important characteristics of a binge episode. The severity of binge-eating disorder is determined by how many episodes of bingeing they have during a week.
After bingeing, people with binge-eating disorder often feel ashamed about the amount of food they ate and vow to stop. This leads them to eat alone or in secret. Eventually, they may become socially isolated and have trouble functioning in social situations, including work.
Though many people with binge-eating disorder become overweight or obese, people of all body types can have this disorder.
Learn more about binge-eating disorder.
Anorexia nervosa
People with anorexia nervosa — commonly called anorexia — usually have an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or body shape. They often equate thinness with self-worth. No matter how thin they are, people with anorexia continue trying to lose weight.
It’s important to note that people with anorexia are considered to have a low weight compared to their personal growth history. Not everyone with anorexia looks emaciated or even thin. Anorexia is no less serious in people who have higher body weights. The issue is in the amount of weight they have lost and their failure to gain expected weight compared to their personal history.
People with anorexia take extreme measures to control their weight. Tactics include limiting calories, excessive exercise, vomiting after eating, and misusing laxatives or diet aids. This can lead to self-starvation.
Although anorexia is an eating disorder, it’s not really about food. It’s a life-threatening way to try to cope with emotional problems. Anorexia has a very high fatality rate compared to other mental health disorders. People with anorexia are at risk of dying from complications associated with starvation or suicide.
There are two types of anorexia. People with anorexia can have:
- Restrictive eating. People with this form of anorexia strictly limit the amount and type of food they eat — sometimes leading to self-starvation.
- Bingeing/purging. People with this form of anorexia also restrict the food they consume. But they also feel loss of control when eating what they feel are large amounts of food. These amounts of food may actually be typical or small portions. Following these binges, they will try to compensate for the calories by vomiting, using laxatives, exercising excessively or using other methods to get rid of the food they consumed. This is known as purging.
Learn more about anorexia nervosa.
Bulimia nervosa
Bulimia nervosa — commonly called bulimia — is a serious, potentially life-threatening eating disorder with symptoms such as:
- Frequent episodes of binge eating and purging the food from the body later.
- Restricting eating during the day.
- Preoccupation with weight and body shape.
- An intense fear of weight gain.
Like some people with anorexia, people with bulimia binge and purge, leading to:
- Chronically inflamed and sore throat.
- 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.
- Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals), which can lead to stroke or heart attack.
Learn more about bulimia nervosa.
Avoidant/restrictive food intake disorder (ARFID)
People with ARFID, often children, are generally uninterested in food. They may avoid specific types of food, such as food with certain colors, textures, smells or tastes. Also, they may avoid food because they’re worried about a consequence of eating, such as choking or experiencing stomach pain or nausea.
Most common in middle childhood, ARFID often has an earlier onset than other eating disorders. Unlike other eating disorders, people with ARFID aren’t trying to lose weight and they don’t have a distorted perception of weight or body shape.
Regardless of why they aren’t eating, people with ARFID fail to reach their minimum daily nutrition requirements. Children with ARFID may not eat enough calories to grow and develop properly, and adults may not get enough calories to maintain basic body function.
Learn more about ARFID.
Eating disorder treatments
If you or someone you love has an eating disorder, there is hope. With early detection and evidence-based treatment, many people can make a full recovery. Treatment plans for eating disorders must be tailored to individual needs. Most treatment plans include a combination of psychotherapy, medical care and monitoring, nutrition education, and medications.
Treating an eating disorder often requires a team of health care experts. Teams might include primary care providers, mental health professionals, dietitians, family and friends.Working together, these teams can help people with eating disorders reestablish healthy eating habits, bring their weight back to a healthy level and eliminate other unhealthy food-related behaviors.
Treatment plans might include:
Working with an eating disorder therapist
Mental health is a key factor in most eating disorders. People with eating disorders often have other mental disorders (such as depression or anxiety) or problems with substance use. They also are at higher risk for suicide and medical complications.
Luckily, several psychotherapy treatments help people recover from eating disorders, including:
- Cognitive behavioral therapy (CBT): CBT focuses on behaviors, thoughts and feelings related to an eating disorder and how to identify distorted or unhelpful thinking patterns. This treatment has good evidence for binge-eating disorder and bulimia nervosa in particular, as well as preliminary evidence for ARFID.
- Family-based treatment (FBT). Family-based treatment engages parents or other guardians to help a child or adolescent maintain healthy eating patterns and achieve a healthy weight until theycan do it on their own. This treatment has good evidence for children and adolescents with anorexia nervosa or bulimia nervosa, with some preliminary evidence for ARFID.
Learning about healthy eating through nutrition education
Registered dietitians and other medical professionals with eating disorder training can help people with eating disorders understand their relationships with food. They create plans to help people with eating disorders form healthy eating habits, establish regular eating patterns, achieve a healthy weight, and avoid dieting and bingeing. They may also work on resolving health-related problems stemming from malnutrition or obesity.
Medications
Medication doesn’t cure eating disorders, but it can help people control behaviors like bingeing and purging. There are also medications that help with the depression and anxiety behind most eating disorders. There are no medications with proven effectiveness to help with malnutrition or anorexia nervosa.
Hospitalization
Eating disorders put people’s lives at risk, and some people may need hospitalization. In the hospital, medical professionals will treat any acute health conditions related to the eating disorder, such as malnutrition, heart failure or suicidal thoughts.
Many hospitals also offer daytime programs that focus on medical care, therapy and nutrition education. People who have been in the hospital many times or need long-term care may be referred to a residential treatment facility instead. They will live at the facility round-the-clock while getting care and support.
Are eating disorders genetic?
For years, health care providers have suspected that eating disorders run in families. Now, a wealth of scientific studies show that genetics play a significant part in eating disorders. Genomic studies have already tied genetics to the risk of getting anorexia, bulimia and binge-eating disorder.
According to the available studies, people with first-degree relatives with eating disorders are more likely to have a disorder compared with someone with no family history. For example:
- Anorexia: First-degree relatives of people with anorexia are 11 times more likely to get the disorder.
- Bulimia: First-degreerelatives of people with bulimia are 9.6 times more likely to get the disorder.
- Binge-eating disorder: First-degree relatives of people with binge-eating disorder are 2.2 times more likely to get the disorder.
Evidence of genetic risk factors for other eating disorders is still evolving. Ask your doctor for the latest information.
How to help someone with an eating disorder
Family and friends play an important role in helping people with eating disorders get the help they need.
Start by noticing the signs of an eating disorder, such as:
- Skipping meals, refusing to eat, or eating alone or in secret.
- Becoming preoccupied with food, dieting and body shape.
- Use of dietary supplements, laxatives or herbal products for weight loss.
- Extreme fluctuations in body weight.
- Excessive exercising.
- Anxiety and depression.
- Persistent worry or complaining about being fat and talk of losing weight.
- Frequently checking the mirror for perceived flaws.
If you suspect a friend or family member has an eating disorder, encourage the person to get help.Be aware that many people with eating disorders may not want — or think they need — treatment. Have an open and honest discussion about your concerns. Ask them to consider scheduling an evaluation or appointment to learn more about eating disorders. Then, provide support throughout the treatment process, from the first doctor’s visit to the graduation from a long-term care facility and beyond.
Preventing eating disorders
There is no foolproof way to prevent eating disorders, but you can make these changes in your daily life that impact the way you and others think about eating and body image. You can:
- Have regular meals with family and friends that model healthy, flexible eating habits.
- Foster a healthy body image in children, no matter what their body looks like. Help them appreciate all the things their bodies can do, such as sports, dancing or laughing.
- Help people build confidence in ways other than their appearance, such as recognizing their kindness, smarts or talents.
- Focus on having a healthy lifestyle, instead of focusing on body weight. For example, talk about healthy eating instead of dieting.
- Address anxiety, depression and other mental health concerns with professionals, if necessary.
By celebrating body diversity and counteracting societal messages about body types, you might help others (and yourself) feel comfortable with their bodies and lessen the risk for eating disorders.
