Eating disorders are serious mental and physical illnesses that involve circuitous and dissentious relationships with food, eating, exercise, and body image. These disorders impact approximately 20 million women and ten meg men in the U.s. and are found in all populations regardless of age, ethnicity, socioeconomic status, faith, sex, gender, etc.

Eating Disorder Definition from the DSM-5

The DSM-five (Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition) lists eating disorders under the category of "Feeding & Eating Disorders" and describes that they are "characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of nutrient that significantly impairs physical health or psychosocial functioning [ane]."

This category specifies diagnostic criteria for the disorders of "pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and rampage-eating disorder [1]."

Woman on Weight Scale

Eating Disorder Facts

Eating disorders are complicated and nuanced disorders and vary from person to person. However, in that location are some overall eating disorder facts that inquiry has been able to clearly delineate regardless of the private.

  • Eating disorders do non discriminate and are observed in "people of all ages, racial/ethnic backgrounds, trunk weights, and genders [two – NIMH]."
  • Eating disorder onset typically occurs in adolescence or young adulthood but is not limited to these life stages.
  • In that location is no one distinct cause of eating disorders. Research has found a number of "genetic, biological, behavioral, psychological, and social factors" that can increase the run a risk of eating disorder development [2].
  • Eating disorders can be life-threatening and have the highest bloodshed rate of any mental disease.
  • While eating disorders do not have a "phenomenon cure," at that place are numerous evidence-based practices proven to support eating disorder recovery.

Types of Eating Disorders

Equally mentioned above, in that location are many more eating disorder diagnoses than the three nearly commonly heard virtually (Anorexia Nervosa, Bulimia Nervosa, & Binge Eating Disorder). Each diagnosis has specific criteria differentiating it from other mental illnesses and eating disorders. Recognizing the distinct difference in disorders tin can help to better treatment and recovery outcomes.

Anorexia Nervosa

For Anorexia Nervosa to be diagnosed, the DSM-5 specifies that the individual must engage in persistent energy intake restriction, have an intense fear of gaining weight or becoming fat, or be engaging in a persistent beliefs that interferes with weight gain, and the individual has a disturbance in their own perception of their trunk weight or shape [1].

These individuals often present with a bodyweight that is "below a minimally normal level for age, sex, developmental trajectory, and physical wellness," but this is not ever the instance. You cannot decide if someone struggles with anorexia based on their body appearance lone.

Learn About Anorexia Nervosa

Bulimia Nervosa

Bulimia Nervosa is characterized by three essential features: "recurrent episodes of rampage eating, recurrent inappropriate compensatory behaviors to prevent weight gain, and self-evaluation that is unduly influenced by body shape and weight [1]."

An individual must engage in these behaviors at least in one case per calendar week for three months to see the criteria for diagnosis [ane].

Referring to the start feature, a rampage is characterized by an individual "eating, in a discrete period of fourth dimension, an amount of food that is definitely larger than what most individuals would eat in a similar period of time nether like circumstances" and that the individuals feel "a sense of lack of control over eating during the episode [1]."

Learn Nigh Bulimia Nervosa

Binge Eating Disorder (BED)

Rampage Eating Disorder, commonly referred to as BED is the nearly common eating disorder diagnosis among all others. The DSM-5 specifies that BED involves rampage eating episodes divers as mentioned above in the Bulimia Nervosa diagnosis.

BED differs from Bulimia Nervosa in that BED involves no recurrent use of inappropriate behaviors to compensate for binge episodes and does not occur exclusively during anorexia or bulimia episodes

BED also does not include an private'due south perception of torso shape and weight in diagnostic criteria.

Acquire About Binge Eating Disorder

Pica

Pica involves an private eating one (or more) not-nutritive, nonfood substance on a persistent basis for at least one month [1]. Pica is diagnosed when this behavior occurs, ofttimes plenty to warrant clinical attention [1].

The DSM-5 specifies that the eating of non-nutritive, non-nutrient substances must exist inappropriate to the developmental level of the individual and "not part of a culturally supported or socially normative practice [1]."

Rumination Disorder

Rumination Disorder is characterized past "repeated regurgitation of food occurring later feeding or eating over a period of at least one calendar month [1]." Those with Rumination Disorder regurgitate previously swallowed nutrient with no apparent symptoms of nausea, involuntary retching, or disgust [ane].

Diagnostic criteria of Rumination Disorder specifies that information technology should not be diagnosed if behaviors can exist better explained by a gastrointestinal or medical status or if they occur exclusively during an anorexia, bulimia, BED, or ARFID episode [i].

Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant Restrictive Food Intake Disorder, often shortened to ARFID, replaced the previous DSM-5 diagnosis of "feeding disorder of infancy or early on childhood." One reason for this is that ARFID occurs predominantly, only not exclusively, in infants or children.

An essential diagnostic feature of ARFID is "abstention or restriction of food intake manifested by clinically significant failure to meet requirements for nutrition or bereft energy intake through oral intake of food [1]." This restriction does non occur every bit a event of another eating disorder diagnosis, and there should exist no evidence of disturbance in body weight or shape perception.

Individuals that struggle with ARFID oftentimes experience nutrient-related distress based on sensory characteristics of qualities of food. ARFID behaviors may as well exist based on a conditioned negative response associated with certain foods, such as a trauma.

Other Specified Feeding or Eating Disorder (OSFED)

This category is intended for cases wherein symptoms of a feeding or eating disorder are present and cause clinically meaning distress or impairment simply do not come across the full criteria for the above-specified disorders.

OSFED Disorders include:

  • Singular Anorexia Nervosa: An individual meeting all criteria for anorexia are met except the individual's weight is inside or above the normal range.
  • Bulimia Nervosa (of low frequency and/or limited duration: Every bit the individual meets, all criteria for bulimia except binge eating and compensatory behaviors occur less than once a week and/or for less than three months.
  • Binge-Eating Disorder (of depression frequency and/or limited duration): An individual meets all criteria for BED except binge eating episodes occur less than in one case/week and/or for less than 3 months.
  • Purging Disorder: An individual engages in regular purging beliefs to influence body weight or shape only does not engage in rampage eating behaviors.

Unspecified Feeding or Eating Disorder

This category, as with OSFED, includes disorders that are symptomatic of an eating disorder diagnosis merely practice not run into full criteria.

UFED duffers from OSFED in that information technology is used "in situations in which the clinician chooses not to specify the reason that the criteria are not met" for a specific disorder or "there is insufficient information to make a more specific diagnosis" such as emergency room settings [1].

Further Reading

  • Weight & Body Image
  • Orthorexia, Excessive Practice & Nutrition
  • Addictions & Eating Disorders
  • Eating Disorder Statistic
  • Eating Disorder Research, Studies, and Tests
  • Eating Disorders in Men
  • What is Too Skinny
  • What to Know About BMI
  • General Symptoms of Eating Disorders
  • Testing for an Eating Disorder
  • What Causes Eating Disorders
  • Demographic Statistics for Eating Disorders

getting help in therapy

Eating Disorder Symptoms

Eating disorders manifest in varying ways as they are complicated disorders that impact psychological, physical, and sociological health. Determining whether someone is struggling with an eating disorder is not an exact scientific discipline due to the many manifestations of these disorders, only, there are some symptoms that tin present every bit warning signs.

Emotional & Behavioral ED Symptoms

Our physical bodies, psychological, operation, cognitive wellness, and choices and behaviors are all deeply intertwined and impactful of i another. Below are a few emotional and behavioral symptoms that may indicate an private is struggling with eating disorder beliefs or behaviors.

  • Beliefs/patterns/choices that indicate a focus on weight loss, dieting, food rules, or eating patterns.
  • Farthermost mood swings.
  • Difficulty
  • Checking in the mirror ofttimes.
  • Withdrawing from others, decreased socializing, especially when nutrient is involved.
  • Presenting as hyper-focused on weight, food, calories, nutritional content of nutrient.
  • Eating solitary or hiding food.
  • Skipping meals.
  • Intense fear of gaining weight.
  • Distorted body epitome.
  • Tangential thought process and difficulty concentrating.

Physical Alert Signs of Eating Disorders

A starved brain and body cannot part optimally. Therefore, an individual struggling with an eating disorder will present with at least some, if not all, of the concrete signs beneath:

  • Weight fluctuations (both upwards and down) that occur rapidly.
  • Severe constipation.
  • Low claret pressure
  • Slowed breathing and pulse.
  • Lethargy, lethargy, or consistent reports of feeling tired.
  • Brittle hair and nails.
  • Dry, yellow pare.
  • Loss of menstrual cycle (amenorrhea).
  • Growth of soft hair all over body (lanugo).
  • Stomach/gastrointestinal issues.
  • Dizziness/fainting/lightheadedness.
  • Muscle weakness.
  • Impaired immune system functioning.

Risk Factors for Eating Disorders

It is unsurprising with all of the concrete, emotional, and behavioral symptoms of eating disorders above that the long-term consequences can be astringent. The malnourishment that results from disordered eating impacts all organ systems in the body including the brain as well every bit the cardiovascular, endocrine, and gastrointestinal systems.

Due to malnourishment, the trunk breaks down its own tissues, including the heart, which leads to a lack of energy to pump blood through the body, lowering pulse and blood pressure and increasing the risk of heart failure. The electrolyte imbalance acquired past vomiting or laxative use or excessive water intake can also increment the risk of heart failure.

Lack of fatty and cholesterol through matted eating impacts functions of the endocrine system, such equally the production of sex activity and thyroid hormones. For this reason, individuals may experience loss of or irregularities in the menstrual cycle. This likewise impacts os density, metabolic rate, and issues regulating core torso temperature (which tin can result in hypothermia).

It is difficult for the brain to function when it is not receiving proper and consequent nourishment. This leads to difficulty concentrating, sleeping, or staying asleep, sleep apnea, and dizziness or fainting. The electrolytes mentioned above are as well used to create signals in the brain, meaning malnourishment disrupts the ability of the brain to communicate effectively to the body.

Finally, gastrointestinally, eating disorders impact stomach emptying and absorption of nutrients which tin atomic number 82 to severe tummy problems. Consistent vomiting can wear downwards the esophagus causing it to rupture, which is life-threatening. Binge eating tin can also cause a life-threatening emergency in that information technology can lead to a tum rupture. Substantially, all of the organs and gastrointestinal functions are severely disturbed in eating disorder behaviors and can result in many life-threatening illnesses and issues.

Eating a Tiny Portion on a Plate

What Causes Eating Disorders?

There are many genetic, environmental, and sociological factors that contribute to eating disorder development.

Biological Factors

Biological take chances factors for eating disorders include many genetic factors such equally predispositions to medical and mental illness.

Individuals that have a family history of mental illness diagnoses are more likely to experience mental illness themselves. Even if the predisposed mental illness is not an eating disorder, eating disorders unremarkably co-occur with diagnoses such as depression, anxiety, or substance use issues, to proper name a few.

An individual'south medical history tin can likewise increment eating disorder take chances, as inquiry indicates that sure illnesses, such as Blazon 1 Diabetes, are associated with increased take a chance for eating disorder development.

Psychological Factors

Psychological factors for eating disorders include a co-occurring diagnosis of another disorder, as mentioned to a higher place.

Additionally, in that location are specific personality traits that inquiry indicates can increment the likelihood of developing an eating disorder, such every bit perfectionism, low self-worth, distorted trunk epitome, or impulsivity.

Experiencing a by or present trauma likewise increases one's likelihood of developing a disordered eating conventionalities or blueprint.

Environmental Factors

Environmental factors include the dynamics that surround an private.

This tin include family dynamics, as family-related beliefs and discussions around weight, nutrient, and self-view are shown to be associated with eating disorder diagnoses.

The social views one absorbs via peers, social media, television/movies, and consumer culture are also related to the increased development of eating disorders.

How to Treat Eating Disorders

Due to the insidious ways in which eating disorders pervade all aspects of one'southward body, mind, and life, receiving the advisable treatment is of import. There are diverse levels of care designed to treat specific stages of eating disorder severity—these range from inpatient at a medical facility downwardly to outpatient. Whatever eating disorder treatment middle can assess a struggling individual to determine the appropriate level of intendance.

Exterior of receiving treatment in general, it is also important to ensure the facility uses testify-based practices, as these can pb to better long-term outcomes.

In that location are many evidence-based treatments that can support eating disorder recovery; the nearly well-known and most commonly used is Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Family-Based Treatment (also known every bit "The Maudsley Method").

Do non be afraid to ask whatsoever questions that arise if yous or a loved one are searching for the handling that volition best back up recovery.

References

[1] American Psychiatric Clan. (2013). Diagnostic and statistical manual of mental disorders (fifth ed.)

[two] Unknown (2021). Eating disorders: about more than food. National Constitute of Mental Health. Retrieved from https://www.nimh.nih.gov/wellness/publications/eating-disorders/eatingdisorders_148810.pdf.

Author: Margot Rittenhouse, MS, LPC, NCC
Page Last Reviewed and Updated By: Jacquelyn Ekern, MS, LPC on June 14, 2021

ED Articles

1. Anorexia kills people. In fact, this disease enjoys the highest fatality rate of any psychiatric disorder. In the case of a glory death, the media provides coverage. Maybe the first recognized case was that of Karen Carpenter in the early 8Os. An anorexic who relied on ipecac for airsickness, she died of middle failure. Years later, she was followed by Christina Renee Henrich, a world-class gymnast who died in 1994.

2. Female Athlete Triad Syndrome is a dangerous affliction that can crusade women who are extreme in their sports to take lifelong wellness concerns. Their coaches, friends, and family need to pay attention and help forestall the athlete from developing Female person Athlete Triad Syndrome.

3. Major life changes can exist a trigger to those fighting an eating disorder. Kickoff college is no exception. The young man or adult female is leaving home, friends and family to venture off into the unknown. College can exist challenging and hard for all students, simply more than then for others. This progression into adulthood is often a significant life altering event, and higher can sadly trigger or lead to an eating disorder.

4. Eating disorders are more commonly associated with Caucasian females who are well-educated and from the upper socio-economical class. Eating disorders are also viewed as a western earth disease and not unremarkably related to other ethnic groups. This is not an accurate assumption. Eating disorders are prevalent in many different cultures and have been for a long fourth dimension. This just continues to prove there are no barriers when it comes to disordered eating. Males, females, Caucasians, African Americans, Asian Americans, Mexican Americans and other ethnic minorities all can struggle with eating disorders.

v. According to the National Eating Disorders Association, people who are lesbian, gay, bisexual and transgender (LGBT) are at a higher adventure of developing eating disorders including anorexia and bulimia. Gay and bisexual men who are single tend to feel more pressure level to exist thin and resort to restrictive EDs while those in a relationship turn to bulimia. Women in the lesbian and bisexual customs all the same struggle with eating disorders similar to most heterosexual women with eating disorders, simply lesbian and bisexual women are more likely to have mood disorders.

vi. In that location is no such matter as the perfect dancer. Female person ballet dancers work very difficult at their craft merely oftentimes discover themselves in the throes of an eating disorder. Ballet dancers accept long been known to develop eating disorders, and this tin, to a degree, be understood considering the dancer stands in front of a big mirror during practice and compares herself to all of her peers. In addition, it does not aid that the manufacture of ballet dancing is extremely obsessed with weight.

vii. Is vegetarianism contributing to matted eating? Currently, just about five pct of Americans define themselves every bit a vegetarian (a person who removes meat and beast products from their diet). This percent does non include those who consider themselves to exist "quasi-vegetarians" (people who eat some animal-based products merely primarily rely on a plant-based diet). Vegetarianism is much more prevalent for those who struggle with eating disorders. Nigh half of the patients fighting an eating disorder practice some course of vegetarian diet.

eight. In addressing the many medical complications of an eating disorder, the more than urgent concerns typically take priority, such as undernourishment or an unstable heartbeat. However, some of the health consequences related to disordered eating affect the private in the long term, even if they aren't more credible or obvious. Bone loss, or osteoporosis, is a silent but debilitating condition that commonly impacts women with EDs, such as Anorexia Nervosa. If yous or a loved one is struggling with an eating disorder, read this article to learn more most ways you lot tin prevent and treat os density loss and eating disorders

9. With the mass corporeality of misguided information about eating disorders, it is common for these serious illnesses to be misunderstood, oversimplified, or greatly generalized. The truth of the affair is that Eating Disorders are circuitous diseases caused by a multitude of factors. Men or women who struggle with disordered eating have a serious mental illness with potentially life-threatening consequences. Understanding the implications of disordered eating can help increase awareness nigh ways to get help. Read this article to larn the myths vs. facts about eating disorders, which are serious mental weather condition.

10. In the rapid evolution of our social club today, advances in technology have dictated the form of human interactions. The way we interface with one another is largely hinged on the capacities that have adult throughout the years. Confront-to-face up connections are frequently pushed aside for text messaging, emails, and the like. What has been lost and sacrificed in the proper noun of convenience and expediency? Read more hither.

eleven. The media can be a culprit for generating images that falsify the reality of man bodies, but what drives an individual to idealize the representation of torso perfection? As scientists unfold the blueprint of our genetic make-upward, it is axiomatic that both surround and genetics play an integral role in the formation of trunk image. Read more here.

12. While the transition to college is an heady time for young adults, full of opportunities for independence and self-discovery, it also comes with an array of stressors. It's often the beginning time a young adult lives apart from their primary support organization. Learn most how college life (and especially as an athlete) can put people at gamble for eating disorders.

thirteen. Anyone who has whatever experience with doing battle with an eating disorder knows the claiming of wrestling with their "demons" and regaining control of their lives. I can't think of whatsoever fourth dimension more than difficult than the complimentary time from work or college, aka summer vacation. This is when nearly of us can detect ourselves fifty-fifty more focused on trunk image and hear our ED talking loudest to u.s..

14. For individuals struggling with an eating disorder spurred from pressures or dysfunctions in their family, this summertime break readjustment is exacerbated. For virtually, domicile is a loving and safe environment. However, for some, dwelling may accept been different.

15. In the handling of eating disorders, mirror neurons play an interesting role. Ofttimes those with a disorder such equally anorexia tend to feel rigidity and inflexibility in their thoughts and actions. The manner they acquit their lives is ofttimes through a very black and white perspective. This is particularly evident in their perceptions of nutrient and food consumption.

xvi. Most higher students have been primed on how not to proceeds the "freshman 15." But they likely oasis't been primed on merely how dangerous it can exist to attempt and avoid gaining those 15 pounds as a freshman or primed on the red flag alarm signs of an eating disorder.

17. There is a close human relationship between anxiety and all types of disordered eating. One study plant that 64% of the 674 anorexic and bulimic participants had a diagnosable anxiety disorder at some point in their lives.

xviii. Eating disorders accept the highest mortality rate of any mental illness, which is why treatment is often and then critical. In ED treatment, those with anorexia, bulimia or rampage eating disorder are given the tools and skills to get well. These strategies are designed to help them cope with uncomfortable feelings or distress; they are intended to supervene upon the need for matted eating and foreclose a relapse. Because the truth is, an eating disorder is an unhealthy, maladaptive coping technique.

19. Anyone, from a princess to a pauper, tin can fall victim to these life-altering—and life-threatening—mental illnesses. Friends, relatives, lovers, acquaintances—even celebrities, the people nosotros adore every bit stars, the nearly powerful, or the most beautiful among us, are or take been afflicted.

20. Interview with Dr. Thomas Britton, DrPH, LPC, LCAS, CCS, ACS: "I was very fortunate that my own journeying to recovery didn't include the pain and isolation of disordered eating, merely the patterns and hurting experienced in my early years shared many parallels and gave me great empathy for those with eating disorders. Back so, there was merely i treatment center in my surface area that provided hospital-based intendance and no outpatient therapists existed that were trained in ED."

21. Many individuals work diligently and tirelessly to brand college a reality, and can abruptly interfere with these goals and dreams. Is it possible to both attend college while receiving treatment for disordered eating?

22. If you've also had a pre-existing fright about food and a pre-occupation (or full-blown obsession) with your weight, shape, and size then higher can be an extremely difficult fourth dimension. In improver, there can be whole new levels of social pressure around being sparse that you're just not used to dealing with.

23. Your loved 1 cannot be in a position to communicate effectively with you until that stabilization and maintenance have occurred. Later on that stabilization of eating patterns occurs, the real family piece of work can develop. It is important to recognize that your loved one yet needs patience from y'all as they proceed to learn how to communicate their emotions in a healthy style.

24. As a spousal relationship and family therapist, I have treated numerous families where a son or daughter is recovering from these debilitating disorders. Moms and Dads and brothers and sisters are on the front lines with the one struggling to recover from anorexia or bulimia. They are also vital members of the treatment squad whose support is crucial in helping someone fully recover from their eating disorder. And one thing I reiterate to all of the families I work with during counseling is that no one is to blame for the disorder but everyone tin help in the recovery.

25. Nearly eating disorders are abomination to those who do not accept one, simply certain food-related illnesses are particularly alarming and baffling to the public at large. PICA is certainly 1 of them.

26. This led me to wonder- how hard must mindfulness be for those that wait toward these holidays with dread rather than joyous anticipation? While there are many reasons that the vacation flavour is challenging for people, for the purposes of this article, I will focus on those individuals whose difficulty around the holidays is related to their eating disorders.

27. We all take well learned that while there is excitement about beingness with family unit and friends during the Vacation season, there is also a sure amount of stress. For those who are feeling "pretty good" emotionally, the holidays tin can enhance those positive emotional and relationship experiences.

28. The holidays can be a stressful time for anyone, regardless of whether an eating disorder is involved in your life. Commonly, in that location are plans to exist made, family members and loved ones to visit with, parties and social gatherings to attend, gifts to purchase, meals to make, and often flood with nutrient.

29. Thyroid problems are extremely common population-wide and are an issue for some in recovery from eating disorders as well. However, the type of dysfunction that occurs in the general population and those with a history of an eating disorder are not usually the same.

30. Today, we are bombarded with photos of today's "cute women" in magazines, commercials, TV shows, movies and online photos. These women that represent today's standard of beauty expect very different from women of the by. The women displayed on the nationally broadcasted Victoria's Cloak-and-dagger runway shows each year epitomize the extreme standards the media portrays as "sexy" and "cute."