Eating Disorders What are eating disorders?

Eating disorders are serious medical illnesses marked by severe disturbances to a person’s eating behaviors. Obsessions with food, body weight, and shape may be signs of an eating disorder. The exact cause of eating disorders is not fully understood, but research suggests a combination of genetic, biological, behavioral, psychological, and social factors can raise a person’s risk.

Eating disorders can affect a person’s physical and mental health; in some cases, they can be life-threatening. But eating disorders can be treated. Learning more about them can help you spot the warning signs and seek treatment early.

Eating disorders can affect people of all ages, racial/ethnic backgrounds, body weights, and genders. Although eating disorders often appear during the teen years or young adulthood, they may also develop during childhood or later in life.

Remember: Eating disorders are not a lifestyle choice. They are biologically-influenced medical illnesses. People with eating disorders may appear healthy, yet be extremely ill.

What are the common types of eating disorders?

Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. If you or someone you know experiences the symptoms listed below, it could be a sign of an eating disorder—call a health provider right away for help.

What is anorexia nervosa?

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.

There are two subtypes of anorexia nervosa: a restrictive subtype and binge-purge subtype.

Restrictive: People with the restrictive subtype of anorexia nervosa place severe restrictions on the amount and type of food they consume.

Binge-Purge: People with the binge-purge subtype of anorexia nervosa also place severe restrictions on the amount and type of food they consume. In addition, they may have binge eating and purging behaviors (such as vomiting, use of laxatives and diuretics, etc.).

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 fatal. Anorexia nervosa has the highest mortality (death) rate of any mental disorder. People with anorexia may die from medical conditions and complications associated with starvation; by comparison, people with other eating disorders die of suicide.

What is bulimia nervosa?

People with bulimia nervosa have recurrent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behaviors that compensate for the overeating, such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. Unlike those with anorexia nervosa, people with bulimia nervosa may maintain a normal weight or be 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 (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

What is 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 are often overweight or obese.

Symptoms include:

• Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
• Eating fast during binge episodes
• Eating even when full or not hungry
• Eating until uncomfortably full
• Eating alone or in secret to avoid embarrassment
• Feeling distressed, ashamed, or guilty about eating
• Frequently dieting, possibly without weight loss

How are eating disorders treated?

It is important to seek treatment early for eating disorders. People with eating disorders are at higher risk for suicide and medical complications. Some people with eating disorders may also have other mental disorders (such as depression or anxiety) or problems with substance use.

Treatment plans for eating disorders include psychotherapy, medical care and monitoring, nutritional counseling, medications, or a combination of these approaches. Typical treatment goals include restoring adequate nutrition, bringing weight to a healthy level, reducing excessive exercise, and stopping binge-purge and binge-eating behaviors. Complete recovery is possible.

Specific forms of psychotherapy (or “talk therapy”) and cognitive behavioral approaches can be effective for treating specific eating disorders. Research also suggests that medications may help treat some eating disorders and co-occurring anxiety or depression related to eating disorders. Information about medications changes frequently, so talk to your health care professional and check the U.S. Food and Drug Administration (FDA) website for the latest warnings, patient medication guides, or newly approved medications.