Understanding Eating Disorders

million Americans will suffer from an eating disorder at some point in their lives.

Eating disorders as a group are very serious and sometimes fatal. They cause adverse psychological, physical, and social consequences for the person suffering. What’s even more frightening is that they cross all lines: gender, age, socioeconomic class, and race.

The four most common eating disorders are Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, and Other Specified Feeding or Eating Disorders (OSFED). All of these disorders feature serious disturbances in eating behavior and weight reduction.

And while eating disorders, specifically anorexia, have the highest mortality rate of any mental illness, many people don’t often recognize the signs, including doctors. That’s why early detection, intervention and a willingness to talk about it are key to recovery.

Types of Eating Disorders

The American Psychiatric Association identifies three main types of eating disorders: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder. Patients may also suffer from eating disorders classified as Other Specified Feeding or Eating Disorders (OSFED).

Anorexia Nervosa

People with anorexia nervosa see themselves as overweight even though they are dangerously thin. Anorexia nervosa has three key features: less eating, fear of gaining weight or becoming fat, and distorted body image.

Common Symptoms of Anorexia Nervosa

  • Extremely restricted eating
  • Extreme thinness
  • 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
  • Excessive exercise
  • Severe or rigid dieting or very restrictive eating
  • Depression and anxiety

Some of the health concerns caused by anorexia nervosa include:

  • Thinning of the bones
  • Damage to the heart
  • Lethargy
  • Anemia
  • Feeling cold
  • Yellowish skin
  • Growth of fine hair all over the body
  • Brittle nails and hair
  • Amenorrhea
  • Loss of muscle
  • Low blood pressure
  • Constipation

In the most severe cases, patients may experience brain damage, multi-organ failure or even death.

Bulimia Nervosa

People with bulimia nervosa eat unusually large amounts of food (binge eat) and then compensate by purging via vomiting, taking laxatives or diuretics, fasting or excessive exercise. Bulimia is easier to hide than anorexia because people often stay at a normal weight or are overweight when they are bulimic.

Common Symptoms of Bulimia Nervosa

  • Repeated binge eating, while feeling unable to stop
  • Loss of control
  • Repeated unhealthy actions to prevent weight gain, such as vomiting, abuse of laxatives or diuretics, fasting, or excessive exercise
  • Poor body image and low self-confidence

Some of the health concerns caused by bulimia nervosa include:

  • Inflamed sore throat
  • Swollen salivary glands in the neck and jaw area
  • Worn tooth enamel
  • Acid reflux
  • Digestive problems
  • Intestinal distress from laxative abuse
  • Severe dehydration from purging
  • Electrolyte imbalance
  • Anxiety
  • Depression

Binge-Eating Disorder

Considered the most common eating disorder, people with binge-eating disorder binge but do not purge, and they often become overweight or obese.

Common Symptoms of Binge-Eating Disorder

  • Repeated binge eating while feeling distressed and out of control
  • Eating alone due to embarrassment
  • Eating large amounts when not hungry and eating until uncomfortably full
  • Eating more rapidly than normal
  • Feeling guilt, sadness, and disgust after a binge

Some of the health concerns caused by binge-eating disorder include:

  • Weight gain or cycling
  • Bloating
  • Restricted food intake
  • Dehydration
  • Stress
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Anxiety
  • Depression

Other Specified Feeding and Eating Disorders (OSFED)

According to the American Psychiatric Association, a person with OSFED may present with many of the symptoms of other eating disorders such as anorexia nervosa, bulimia nervosa, or binge-eating disorder but will not meet the full criteria for diagnosis of these disorders. The symptoms and health concerns are typically a combination of one or more of the other three eating disorders.

Treating an Eating Disorder

Eating disorders are treatable with individual and group psychotherapy. In extreme cases, in-patient hospitalization is the only way to deliver treatment. But for less serious cases, a combination of outpatient therapy, medical care and monitoring, nutritional counseling, and medication is the first line of defense.

Psychotherapy for Eating Disorders

Otherwise known as “talk therapy,” psychotherapy can help patients with an eating disorder understand their diagnosis and how it impacts their life. The therapist will also work with them to develop strategies that decrease the severity of the symptoms. Cognitive behavioral therapy, which emphasizes the important role of thinking in how we feel and what we do, is an effective form of treatment for eating disorders. Treatment includes individual, group or family psychotherapy.

Antidepressant Medication

Antidepressant medications approved by the U.S. Food and Drug Association have been shown to help certain eating disorders. A physician may recommend an antidepressant, which acts on the brain chemicals that are involved in mood regulation, to help treat bulimia nervosa and binge-eating disorder.


Professional help is the only way to treat an eating disorder, but your health care provider may recommend that you also participate in a self-help or support group.

Finding Treatment for an Eating Disorder

The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains an online Behavioral Health Treatment Services Locator that can help locate eating disorder services and professionals in your area.

Additionally, there are ongoing clinical trials you can participate in that seek to gather information about potential medications and therapies before they are approved by the FDA for treating eating disorders. These clinical trials take place at various hospitals, universities, and clinics all over the country.

Studies are also looking for new ways to identify genetic factors, find genetic and environmental factors that affect risk, and use new preventative and treatment methods that focus on thoughts, emotions, or social interactions.