Eating disorders are mental health conditions characterized by harmful and severe eating behaviors. These may include an obsession with weight or body image, eating too much or too little, or having strict control over eating habits.

In the United States, around 28.8 million people will experience an eating disorder during their lifetime, yet most do not receive treatment. Eating disorders can affect individuals of all ages, genders, and body sizes but are most prevalent among people aged 12 to 35, particularly women. One in eight individuals experiences at least one form of eating disorder before the age of 20.

Eating disorders can lead to severe and potentially life-threatening health issues. While many individuals recover fully, recovery often takes time and ongoing support. Treatment generally involves psychotherapy and nutritional guidance.

Types of Eating Disorders

Eating disorders involve significant disruptions in eating behaviors. Each type manifests differently, both by category and by individual. Common types include anorexia nervosa, bulimia nervosa, binge-eating disorder (BED), and avoidant restrictive food intake disorder (ARFID).

As with other mental health conditions, diagnosis depends on meeting specific criteria over a set period. For example, binge-eating disorder requires at least one binge episode weekly, with at least three symptoms such as eating rapidly or when not hungry, over a three-month period.

Anorexia Nervosa

Anorexia nervosa, commonly referred to as anorexia, is the most widely known eating disorder and has the highest mortality rate among mental health conditions. Those with anorexia may avoid eating, drastically limit food intake, or eat very small quantities.

There are two main subtypes:

  • Restrictive type: Characterized by extreme limitation of food and sometimes excessive exercise.

  • Binge-purge type: Involves food restriction combined with bingeing and purging through vomiting or using laxatives, diuretics, or diet pills.

People with anorexia may see themselves as overweight despite being underweight, frequently check their weight, and fear gaining weight. Additional signs include:

  • Extremely low body weight

  • Excessive exercise

  • Intense preoccupation with food, weight, and appearance

  • Distorted body image

  • Ritualistic eating behaviors similar to obsessive-compulsive disorder, such as cutting food into tiny pieces

Due to inadequate nutrition, anorexia can lead to various health problems such as muscle loss, low blood pressure, infertility, brittle nails and hair, and eventual multi-organ failure.

Bulimia Nervosa

Bulimia nervosa is more prevalent than anorexia. Individuals with bulimia consume large quantities of food quickly and feel a loss of control during these episodes. To prevent weight gain, they may vomit, use laxatives or diuretics, fast, or over-exercise.

Common symptoms from purging include:

  • Inflamed or sore throat

  • Swollen glands in the neck and jaw

  • Tooth decay or sensitivity due to vomiting

  • Digestive issues like acid reflux

  • Severe dehydration and electrolyte imbalances

Unlike anorexia, weight in people with bulimia can vary significantly.

Binge-Eating Disorder (BED)

BED is the most common eating disorder in the United States. It is marked by eating large quantities of food in a short time and feeling a lack of control. Unlike bulimia, individuals with BED do not purge, fast, or over-exercise afterward.

Many with BED have larger body sizes, and over one-third are male. Common signs include:

  • Consuming large amounts of food quickly

  • Eating when full or until uncomfortably full

  • Feeling out of control during binges

  • Hiding eating habits due to shame

Avoidant Restrictive Food Intake Disorder (ARFID)

ARFID involves limiting the variety or amount of food eaten, leading to weight loss or failure to grow appropriately in children. While common in children under seven, it may persist into adulthood.

ARFID differs from typical picky eating as it causes malnutrition and weight loss. It is not related to cultural or personal food restrictions, such as vegetarianism.

Symptoms include:

  • Disinterest in eating or food

  • Poor appetite

  • Aversion to specific textures, tastes, smells, or food colors

  • Persistent picky eating

  • Noticeable weight loss

  • Stomach issues like nausea or discomfort

Other Eating Disorders

Two additional disorders include pica and rumination disorder.

Pica involves craving and consuming non-food items like dirt or paper. It’s more common in children and pregnant individuals and may persist in those with intellectual disabilities.

Rumination disorder is characterized by regurgitating, re-chewing, and either re-swallowing or spitting out food. It often resolves in infancy but can continue into later life.

Other conditions are grouped under "Other Specified Feeding and Eating Disorder (OSFED)," including:

  • Purging disorder: Purging behaviors without binge-eating

  • Night eating syndrome: Eating excessively after waking up at night

  • Orthorexia: An obsession with eating “clean” or “healthy” food, often involving reading labels obsessively and avoiding entire food groups. While not an official diagnosis, it often overlaps with OCD.

Possible Signs of an Eating Disorder

Signs of eating disorders vary by individual but commonly include:

Physical signs:

  • Dry skin, thinning hair, brittle nails

  • Fine hair on the body (lanugo)

  • Muscle weakness

  • Dizziness

  • Swelling in the feet

Psychological and behavioral signs:

  • Obsession with food or body weight

  • Avoiding certain foods

  • Odd food rituals

  • Compulsive exercising

  • Purging after eating

  • Shame about eating

  • Avoiding social eating

  • Mood changes

Many with eating disorders may not appear underweight. People with higher BMIs can still suffer from serious eating disorders and face added weight stigma in medical settings.

What Causes an Eating Disorder?

Causes are complex and may involve biological, psychological, and social factors:

  • Family history of eating disorders

  • Hormonal imbalances, such as serotonin levels

  • Dieting or prolonged negative energy balance

  • Personality traits like perfectionism or impulsivity

  • Early trauma, bullying, or abuse

  • Cultural assimilation and exposure to body image ideals

Risk Factors

Certain groups face higher risk:

  • Women are five times more likely to be diagnosed

  • Asian American college students report more restrictive behaviors

  • LGBTQ+ individuals are about three times more likely to experience eating disorders

  • Transgender students are four times more likely to be diagnosed

  • Athletes may adopt harmful behaviors to control weight, but stigma may delay treatment

Weight Stigma

Weight stigma negatively affects self-image and can encourage disordered eating. It can occur among peers, families, and within the healthcare system. Reducing weight-focused narratives can support healthier relationships with food.

Eating Disorder Treatment

Treatment goals include improving nutrition, reducing unhealthy behaviors, and addressing co-occurring mental health or substance issues.

Psychotherapy

Psychotherapy is a primary treatment method. Options include:

  • CBT: Reframes negative thinking patterns

  • CBT-E: Tailored CBT for eating disorders

  • Family-Based Treatment: Engages family in treatment, effective for youth

  • Interpersonal Therapy: Focuses on social and relationship issues

  • DBT: Combines cognitive therapy with mindfulness and emotional regulation

Nutritional Counseling

Nutritional therapy aims to restore healthy eating and proper nourishment. For anorexia, this may involve gradual refeeding and vitamin/mineral replenishment. Combined with psychotherapy, it helps prevent relapse.

Medical Care

In severe cases, inpatient care may be necessary—especially with extreme weight loss or lack of outpatient improvement. Medical monitoring is often needed during refeeding.

Medication

Medication can be used for eating disorders and related mental health conditions. Fluoxetine (Prozac) is FDA-approved for bulimia and BED. Other medications are still under study.

How To Support Someone With an Eating Disorder

Support from loved ones is essential. You can:

  • Educate yourself

  • Listen without judgment

  • Speak honestly and kindly

  • Observe and document worrying behaviors

  • Share meals supportively

  • Help locate treatment providers

Respect their boundaries, stay fact-focused, and encourage professional help if needed.

Looking for Support?

Contact the National Eating Disorders Association (NEDA) Helpline at 1-800-931-2237 for support. The SAMHSA Treatment Referral Helpline is available at 1-800-662-HELP (4357).

Possible Risks and Complications

Eating disorders can lead to:

  • Heart conditions

  • Digestive problems

  • Anemia

  • Cognitive difficulties

  • Type 2 diabetes

  • Delayed growth and puberty in youth

  • Missed menstrual periods and bone density loss

  • Fertility issues

  • Life-threatening organ failure

Anorexia carries the highest mortality risk. Prompt treatment and strong support are crucial.

Preventing Eating Disorders

Prevention starts early. Programs in schools can promote self-worth and reduce harmful dieting behaviors. Preventive measures include:

  • Choosing nutrient-rich foods over low-calorie ones

  • Exercising for strength, not appearance

  • Modeling balanced eating at family meals

  • Avoiding weight-based teasing

  • Practicing intuitive eating—honoring hunger and fullness cues without restriction

Intuitive eating has been linked to reduced disordered eating, while dieting increases risk.

When to Contact a Healthcare Provider

If you suspect an eating disorder, consult a healthcare provider promptly. Early treatment reduces the risk of complications. NEDA offers a screening tool and treatment locator online.

A Quick Review

Eating disorders are serious mental health issues involving abnormal eating habits. Symptoms vary, but treatment often includes therapy, nutrition guidance, and sometimes medication. Recovery is possible, especially with early intervention and strong support.