Aside from substance use disorders (SUDs), eating disorders comprise the highest mortality rates of all psychiatric disorders, directly causing over 10,200 deaths each year.¹ ² ⁸ ⁹ Even though treatments for eating disorders have advanced over the years, those who received inpatient treatment for anorexia nervosa still have a “more than five times” increased risk of death — giving the disorder an estimated mortality rate of about 5%. Up to 4% of females and 0.3% of males suffer from anorexia nervosa during their lifetime.³ ⁹ ¹⁰ ¹¹
Eating disorders can affect people of any age, sex, gender, race, size, sexual orientation, or family medical history.² The prevalence of eating disorders is generally higher in women than in men, with data also showing increases in eating disorders among BIPOC, LGBTQ+, and other minority populations, including female veterans and those with disabilities.² ¹² Causes for the high rates of mortality with eating disorders are complicated but can include:
This guide examines the causes, symptoms, and available treatments for individuals struggling with eating disorders and disordered eating behaviors.
Here is a handy chart breaking down important details about anorexia nervosa, bulimia nervosa, and binge eating disorder.¹⁹ ²⁰
Eating disorders are mental illnesses characterized by severe and persistent disturbance in eating behaviors with associated distressing emotions and thoughts related to eating. The most common symptoms of eating disorders are:²⁰
The obsessive nature of eating disorders concerning food, weight, and body image often leads to significant psychological distress. Eating disorders are also commonly comorbid with other issues, including depression, anxiety, and substance abuse. Eating disorders may develop during childhood or early adolescence. More rarely, they manifest in adults.
Eating disorders can have many causes and are often a complex interaction of genetic, psychological, and social factors. Social and psychological factors appear to be the leading causes. Many eating disorders relate to feelings of poor body image and low self-esteem.²⁰
Poor body image and low self-esteem often manifest from societal pressure about appearances. Certain personality traits have been linked to eating disorders, such as:²¹
However, determining the exact cause of an eating disorder is not simple, and a wide variety of things may trigger them. Research is ongoing in determining the causes of disordered eating behaviors.
Anorexia and bulimia are the most common eating disorders, followed by binge eating disorder. Other Specified Feeding or Eating Disorders (OSFED) comprise the fourth category for individuals who do not align with the first three disorders.
Disordered eating or diets evolve into eating disorders by degrees. The degree to which a person controls their eating and the motivation behind the behavior can turn a diet into an eating disorder. A diet is an intentional regulation of food intake to modify the body (losing weight, etc.) with a finite objective — losing 10 pounds or adding 15 pounds of muscle, for instance. But strict dieting is rarely necessary and can often become disordered.
Disordered eating refers to abnormal eating behaviors that don’t meet the criteria for an eating disorder. For example, someone who occasionally binges and purges but does not engage in these activities often or in as extreme a fashion may be diagnosed with disordered eating behaviors and not fit the complete diagnosis of bulimia.
Eating disorders take dieting and disordered eating to the extreme. Individuals with eating disorders often find it impossible to let go of their behaviors even after they have met a set goal. Once they complete an objective, a new one replaces it. Eating habits become a compulsion.
Anorexia often involves the desire to consume as few calories as possible through obsessive counting or tracking and sometimes excessive exercise to burn off calories consumed.²²
Bulimia often includes eating regularly or excessively and then purging (vomiting or laxative use) to expel the calories.²³
Binge eating manifests as compulsively eating a large amount of food in one sitting, often consuming excessive calories.²⁴
Other Specified Feeding or Eating Disorders (OSFED) may present as various eating behaviors, such as starving, binging, purging, extreme food aversions, and more. These issues do not fit neatly into bulimia, anorexia, or binge eating categories.²⁵
Eating disorders have both long-term and short-term impacts. In the short term, eating disorders can evoke physical consequences:⁶ ¹⁹ ²⁰
The emotional and psychological impacts of eating disorders can be equally devastating to the sufferer and include issues like depression, anxiety, low self-esteem, social isolation, and more.
In the long-term, eating disorders carry an increased risk for:⁶ ¹⁹ ²⁰
The long-term consequences of eating disorders can severely raise a patient’s mortality rate. Individuals suffering from anorexia have the highest mortality rate for psychological illnesses other than opioid addiction.²
Consider your behaviors and emotions when evaluating your own behavior to determine whether you have an eating disorder. The following are signs of some form of disordered eating:⁶ ¹⁹ ²⁰
When identifying the signs of eating disorders in friends and family, it’s essential to remember that these signs can often be challenging to spot, particularly in the earliest stages. Eating disorders are about shame, and hiding them is often a priority for the sufferer.
However, keeping the disorder hidden as time passes becomes more challenging, especially if the individual begins to lose or gain weight quickly. The following are common physical or emotional signs that may indicate someone you know suffers from an eating disorder:⁶ ¹⁹ ²⁰
As with many subjects, it’s often a challenge to identify factual information about eating disorders in the sea of misinformation. Here we’ll separate reality from myth.² ²⁶
The following statistics give a sense of the magnitude and severity of these disorders.
Anorexia nervosa has the highest mortality rate of all mental illnesses, except for opiate addiction.² ⁶ This disorder is characterized by periods of self-starvation resulting in low body weight. Psychologically, patients with anorexia are motivated by an intense fear of gaining weight or becoming “fat.”
There are two subtypes of anorexia nervosa:²²
Signs of anorexia nervosa develop over time as the condition worsens and may include:⁶ ²²
The impacts of anorexia nervosa are tragic and deadly, as individuals with the disorder have an over 18 times higher risk of dying from suicide than the general population.²⁷
Treatment for anorexia nervosa consists of several elements, depending upon the individual and the severity of their problem. Getting help early on is preferable and often more successful, as with other conditions.
Your doctor will need to address any imminent medical problems first. This may mean getting treatment for related heart issues, osteoporosis, anemia, and malnutrition. Medical evaluations and psychiatric assessments are essential components to help patients normalize their eating and weight control behaviors. They may also refer you to a dietitian.
A dietitian will help you develop a nutritional plan that counters anxieties about eating and gives you practice with consuming a wide variety of foods across regularly spaced meals. You will also be counseled to address body dissatisfaction issues, although these usually take longer to correct than eating behaviors.
In cases of severe anorexia, inpatient treatment or a residential behavioral program may be the best option. Forms of therapy in treating anorexia include cognitive behavioral therapy (CBT), psychotherapy, and medications to assist with comorbid anxiety or depression.²⁸ ²⁹
Understanding that you have a problem with eating is the first step to getting help. If you or someone you know suffers from an eating disorder, look at the resources below for treatment information and advice.
Once you’ve acknowledged the problem, seeing your primary care physician is the best next step. They can help you access mental health resources to begin your path to recovery.
Bulimia is another serious mental health condition with consequences for the digestive system. People who have bulimia and use vomiting as a means of purging can cause long-term physical damage to the esophagus, mouth, and teeth. Those who use laxatives to purge can incur long-term problems with bowel movements.³⁰
Some comorbid physical conditions related to bulimia include:²³ ³⁰ ³¹
Signs of bulimia nervosa develop over time as the condition worsens and may include:⁶ ²³
If you are struggling with bulimia or know someone who is, seeking treatment is imperative for long-term health and wellness. Seeing a medical doctor or mental health professional should be your first step. For more resources on treatment options, see the resources below.
Binge eating is more than simply overindulging on occasion. It becomes a severe disorder driven by uncontrollable urges that disrupt a person’s life. Binge eating can lead to:²⁴ ³⁰ ³¹
A diagnosis of binge eating disorder requires frequent binges associated with feelings of a lack of control. It must also include three or more of the following behaviors:⁶ ²⁴
The most effective treatment for binge eating disorder is cognitive behavioral therapy. Interpersonal therapy may also be effective; your doctor may prescribe antidepressant medications during and after treatment.³² ³³
If a patient has incurred physical health issues due to binge eating, they must also be addressed by their doctor or treatment professional.
Other Specified Feeding or Eating Disorders (OSFED) comprise many lesser-known eating disorders, such as:
Orthorexia is a condition where the sufferer has the compulsion to avoid eating foods they perceive to be impure or unhealthy. It is an unhealthy obsession with eating only healthy foods. This condition limits food selection and can create social isolation due to an intolerance of other eating behaviors. This condition is not recognized as a clinical diagnosis in the DSM-5.³⁴
Avoidant/restrictive food intake disorder (ARFID) involves a disturbance in eating that results in persistent failure to meet nutritional needs. Food avoidance may arise from low appetite and lack of interest in food, extreme avoidance based on sensory characteristics of foods (texture, smell, appearance, etc.), or anxiety about the consequences of eating, like fears of choking, vomiting, constipation, allergic reactions, and more. ARFID is associated with significant weight loss, nutritional deficiency, possible dependence on enteral feeding (tube feeding), and interference with social functioning.³⁵
Weight cycling is a behavior wherein a sufferer repeatedly diets but immediately gains back the weight, leading to more dieting. Yo-yo dieting is an unhealthy behavior that can make you malnourished.³⁶
Diabulimia is a form of bulimia isolated in individuals with diabetes who are dependent on insulin. People with diabulimia purposely restrict insulin to lose weight. Some symptoms include severe weight loss, extreme thirst, and frequent urination. This dangerous disorder can lead to long-term kidney and vision problems, cardiovascular issues, and other complications.³⁷
Rumination disorder involves regurgitating food and then re-chewing and swallowing the regurgitation. It can occur in infancy, childhood, adolescence, or adulthood.³⁸
Over a quarter of college-aged women report binging and purging behaviors, and other eating disorders appear at much higher rates among college students.⁷ There are several theories for this common problem, which are listed below.
One of the first steps you can take if you believe you or someone you know is suffering from disordered eating or an eating disorder is to contact your school’s medical health center for counseling with a professional. Colleges today recognize the problem of eating disorders among college students and will have resources to help them seek treatment on-campus or off.
Browse the following list for valuable resources we can recommend.
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 National Institute of Mental Health. (n.d.). Eating Disorders: About More Than Food. NIMH. Retrieved February 28, 2023, from https://www.nimh.nih.gov/health/publications/eating-disorders.
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