Eating disorders are behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions. They can be very serious conditions affecting physical, psychological and social function. Types of eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorder, pica and rumination disorder.
Taken together, eating disorders affect up to 5% of the population, most often develop in adolescence and young adulthood. Several, especially anorexia nervosa and bulimia nervosa are more common in women, but they can all occur at any age and affect any gender. Eating disorders are often associated with preoccupations with food, weight or shape or with anxiety about eating or the consequences of eating certain foods. Behaviors associated with eating disorders including restrictive eating or avoidance of certain foods, binge eating, purging by vomiting or laxative misuse or compulsive exercise. These behaviors can become driven in ways that appear similar to an addiction.
Anorexia nervosa is characterized by self-starvation and weight loss resulting in low weight for height and age. It has the highest mortality of any psychiatric diagnosis other than opioid use disorder and can be a very serious condition. Dieting behavior in anorexia nervosa is driven by an intense fear of gaining weight or becoming fat. Although some individuals with anorexia will say they want and are trying to gain weight, their behavior is not consistent with this intent. Some persons with anorexia nervosa also intermittently binge eat and or purge by vomiting or laxative misuse.
There are two subtypes of anorexia nervosa:
Individuals with bulimia nervosa typically alternate dieting, or eating only low-calorie “safe foods” with binge eating on “forbidden” high-calorie foods. Binge eating is defined as eating a large amount of food in a short period of time associated with a sense of loss of control over what, or how much one is eating. Binge behavior is usually secretive and associated with feelings of shame or embarrassment. Binges may be very large and food is often consumed rapidly, beyond fullness to the point of nausea and discomfort.
Binges occur at least weekly and are typically followed by what are called "compensatory behaviors" to prevent weight gain. These can include fasting, vomiting, laxative misuse or compulsive exercise. As in anorexia nervosa, persons with bulimia nervosa are excessively preoccupied with thoughts of food, weight or shape which negatively affect, and disproportionately impact, their self-worth.
As with bulimia nervosa, people with binge eating disorder have episodes of binge eating in which they consume large quantities of food in a brief period, experience a sense of loss of control over their eating and are distressed by the binge behavior. Unlike people with bulimia nervosa however, they do not regularly use compensatory behaviors to get rid of the food by inducing vomiting, fasting, exercising or laxative misuse. Binge eating disorder can lead to serious health complications, including obesity, diabetes, hypertension and cardiovascular diseases.
Psychological symptoms of eating disorder include:
Physical symptoms of eating disorders may include:
Certain behaviors are common in people living with eating disorders. People are often secretive about their behaviors around food and body image. These behaviors can make people feel increasingly isolated or guilty. Behavioral symptoms can include: