Eating disorders are a group of serious, chronic conditions characterized by extreme issues with food and weight. They can lead to severe emotional and physical problems that may be fatal when left untreated. Eating disorders affect people of any age, race, or gender, but rates are highest among adolescent and young adult women.
Definition of an Eating Disorder
Eating disorders describe disordered behaviors related to food intake and weight loss or gain. There are three main categories of eating disorders grouped by their different characteristics: anorexia nervosa, bulimia nervosa, and binge eating disorder.
Anorexia nervosa is the condition people most often associated with eating disorders. Individuals with anorexia nervosa take drastic measures to maintain abnormally low body weight. When you have anorexia, you have an intense, irrational fear of weight gain and maintain a level of self-starvation to avoid putting on weight. You also tend to have a distorted perception of your body image and weight.
Some of the main methods for avoiding weight gain include:
- Limiting calories to the point of self-starvation
- Obsessive or excessive exercise
- Using diet aids or laxatives
- Vomiting after eating
Bulimia nervosa is the second category of eating disorders, marked by patterns of binging and purging. Some individuals with bulimia also restrict their eating during the day but ultimately end up binging and purging at some point. When you have bulimia nervosa, another distinct feature is your feeling of lack of control over your eating.
An episode consists of a binge and a purge. During the binge, the person eats large amounts of food, often to the point of feeling sick and uncomfortable. This leads to overwhelming guilt, shame, embarrassment, and remorse, coupled with an intense fear of gaining weight. Then they purge, trying to get rid of the extra calories typically by vomiting, using laxatives, or excessive exercise.
Binge Eating Disorder
Binge eating disorder is the third main type of eating disorder. It is similar to the binge portion of bulimic episodes but lacks the purge portion. Individuals with binge eating disorder eat extreme amounts of food but lack the feeling of control over their eating. They tend to feel shame, embarrassment, and disgust after their episodes but do not try to rid themselves of the extra calories.
Some characteristics of binge eating disorder include:
- Eating when not hungry
- Consuming food very fast
- Eating more than originally intended
- Continuing to eat even after uncomfortably full
Symptoms & Signs of an Eating Disorder
Sometimes it can be difficult to notice the signs and symptoms of an eating disorder. The type of ED a person experiences determines their specific symptoms. All eating disorders are characterized by obsessive preoccupation with food, whether restricting it, consuming it, or purging it. Most people with an eating disorder are also highly concerned with their body image and weight.
There are many different signs and symptoms of an eating disorder, such as:
- Skipping meals
- Making excuses for not eating
- Cooking own meals instead of eating with the rest of the family
- Starting an overly restrictive diet, such as vegetarian, vegan, keto, etc.
- Strict adherence to healthy eating
- Leaving mid-meal to use the restroom
- Withdrawing from social events involving food
- Preoccupation with weight loss or weight gain
- Talking about being fat or losing weight
- Regularly checking appearance for potential changes in weight
- Eating large amounts of food, usually high in fats or sugars
- Eating in secret
- Food disappearing from the kitchen with no explanation
- Finding wrappers in the trash can or in their room
- Compulsive or excessive exercise
- Using laxatives or other dietary supplements to lose weight
- Redness, swelling, or calluses on knuckles caused by self-induced vomiting
- Loss of tooth enamel due to vomiting
- Overeating during meals or snacks
- Talking about shame, guilt, or disgust with eating habits
Anorexia Warning Signs & Symptoms
Along with the general signs of an eating disorder, there are some specific anorexia warning signs and symptoms you can look for. Knowing the symptoms increases your chances of noticing whether someone you love is struggling. Their chances of recovery increase the sooner you notice they have a problem.
Behavioral anorexia warning signs and symptoms include:
- Abnormal preoccupation with food, calories, and dieting
- Excessive concern about physical appearance or bodyweight
- Making comments about feeling overweight or fat, even when losing weight
- Avoiding meals with family or friends
- Cooking for others without eating
- Denying feeling hungry
- Seeming concerned about eating around others
- Developing rituals around food, such as eating foods in a particular order
- Maintaining a strict routine around exercise despite illness, injury, fatigue, or weather
- Withdrawing from family and friends
- Becoming closed off and secretive
- Struggling with memory or concentration
- Feeling intense fear around becoming fat or gaining weight
- Expressing an intense need for control
- Displaying extreme rigidity and inflexibility in thinking or behavior
Physical anorexia warning signs and symptoms include:
- Excessive weight loss or maintaining a dangerously low body weight
- Irregularities in menstruation, such as an inconsistent period or complete loss of period
- Unexplained stomach cramps, constipation, acid reflux, or abdominal pain
- Fatigue or lethargy
- Feeling cold
- Problems with sleep
- Dry skin or nails
- Thinning hair, or dry and brittle hair
- Impaired immune system
Bulimia Warning Signs & Symptoms
Eating disorders are characterized by some general symptoms that group the conditions together. Like anorexia, though, there are also some distinct bulimia warning signs and symptoms to keep an eye on. Knowing what to look for can make the difference between someone continuing to hide or getting the help they need.
Behavioral bulimia warning signs and symptoms include:
- Overly concerned with weight loss, dieting, or controlling food
- Evidence of binge eating, such as large amounts of food missing, or empty containers and wrappers found in the trash can
- Evidence of purging, such as using the restroom after eating, signs or smells of vomiting, or finding laxatives or diuretics or their containers
- Developing food rituals, such as eating only certain types of foods
- Skipping meals or eating only small amounts at mealtimes
- Disappearing after eating, usually to the restroom
- Adopting restrictive diets such as vegetarian, vegan, keto, etc.
- Expressing fear of eating around others
- Stealing or hoarding food
- Extreme mood swings
- Drinking abnormal amounts of water or low-/no-calorie beverages
- Using mouthwash, mints, or gum excessively
- Hiding physical appearance under baggy clothes
- Maintaining a strict exercise regimen
- Avoiding friends or family
- Having secret recurring binge eating episodes
Physical bulimia warning signs and symptoms include:
- Noticeable changes in body weight, either gaining or losing
- Complaining about stomach cramps, abdominal pains, or other gastrointestinal issues
- Poor memory or concentration
- Problems sleeping
- Feeling cold
- Dry skin or nails
- Abrasions or calluses on knuckles (from inducing vomiting)
- Dental issues like enamel erosion, tooth sensitivity, or cavities (from inducing vomiting)
- Thinning hair or losing hair
- Irregular menstrual cycle or losing period completely
- Poor immune system
Binge Eating Disorder Signs & Symptoms
Binge eating disorder differs slightly from anorexia and bulimia. While those with anorexia and bulimia are consumed by an intense fear of weight gain, those with binge eating disorder are not. The condition centers more around the person’s behaviors with food than their concern for the physical results of their eating behaviors.
Behavioral binge eating disorder signs and symptoms include:
- Large amounts of food disappearing in short periods
- Empty food containers or wrappers disposed of in the trash
- Expressing discomfort eating around others
- Adopting new fad diets or other food practices (ex. vegetarian, vegan, keto, etc.)
- Stealing or hoarding food
- Acting out in frequent binge eating episodes
- Feeling a lack of control over binge eating episodes
- Creating a schedule or lifestyle conducive to binge eating
- Developing food rituals
- Withdrawing from friends and family
- Eating alone out of shame or embarrassment
- Feeling low self-esteem or self-confidence
Physical binge eating disorder signs and symptoms include:
- Experiencing extreme fluctuations in weight
- Feeling unexplained stomach cramps, constipation, or other gastrointestinal issues
- Difficulties focusing
Other Eating Disorder Signs & Symptoms
Anorexia, bulimia, and binge eating disorder are the three main types of ED. There are a few other types of eating disorders that are more specific and affect smaller portions of the ED problem as a whole.
Otherwise Specified Feeding or Eating Disorder (OSFED)
OSFED includes a variety of disordered eating behaviors displayed in some individuals. Since there is such a range in behaviors, a person may display only some of the following symptoms of OSFED, such as:
- Episodes of consuming large amounts of food followed by behaviors to avoid weight gain (ex. vomiting or excessive exercise)
- Signs of binge eating, such as large amounts of food disappearing or find wrappers and food containers in the trash
- Self-esteem overly tied to body image
- Diet behaviors (reducing the overall amount of food consumed or certain types of foods)
- Taking steps to “burn off” calories taken in
Avoidant Restrictive Food Intake Disorder (ARFID)
ARFID is a newer eating disorder diagnosis, formerly called Selective Eating Disorder. It resembles anorexia in terms of limiting or restricting food but the behaviors are not related to stress about body shape, size, or feelings of being fat. Signs of ARFID include:
- Sudden dramatic weight loss
- Strict diet or food preferences that get progressively smaller over time (i.e. picky eating that becomes more and more restricted)
- No apparent distress about body image or fear of weight gain
Orthorexia is an obsession with healthy eating taken to the extreme. Though it isn’t an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, awareness of the condition is increasing. Individuals with orthorexia are overly fixated on healthy eating to the point that it damages their well-being. Signs of orthorexia include:
- Cutting out significant foods or whole food groups (ex. all carbs, sugar, dairy, meat)
- Expressing excessive concern about the healthiness or quality of ingredients
- Only eating foods that are considered “healthy”, “pure”, or “clean”
- Obsessing about foods that may be served during upcoming events
- Possible concerns about body image or weight
Causes of Eating Disorders
Eating disorders are complex conditions. Despite the stereotype, they affect a wide range of people throughout the country. Current research indicates the causes of eating disorders include a combination of biological, environmental, and cultural causes. The precise combination depends on every individual as the factors interact differently in different people.
This means there is no one-size-fits-all set of causes of eating disorders. The causes and resulting diagnosis are unique to each individual. Similarities exist between cases but every person should still be viewed on a case-by-case basis. How does each of these factors affect whether a person develops an eating disorder?
Biological causes of eating disorders refer to the genetic and physical reasons the condition may manifest. Some of the potential biological causes for ED include:
- A parent or close relative with an eating disorder. If you have a first-degree relative with an eating disorder, your likelihood of developing the condition yourself increases.
- A parent or close relative with another mental health disorder. Eating disorders commonly co-occur with other mental health disorders. Having a close family member with a mental health disorder increases your chances of developing an ED.
- History of an anxiety disorder. Research shows that a significant portion of people with eating disorders also battle an anxiety disorder. Two-thirds of people with anorexia showed signs of an anxiety disorder before developing an ED.
- Type 1 diabetes (insulin-dependent). According to some research, people with Type 1 diabetes are more likely to develop an ED. One study revealed that an estimated 25 percent of women with Type 1 diabetes developed an eating disorder.
Environmental causes refer to the environment a person grows up in. These include things like the behavior of family members and pressure from schoolmates. Some of the potential environmental causes of eating disorders include:
- Hearing negative talk about weight or self-image from a close friend or family member. When young children hear negative commentary about body types from family or friends, they’re more likely to develop an ED.
- Living with high levels of stress. Individuals who deal with excessive stress may be more likely to deal with disordered eating behaviors, whether intentionally or unintentionally.
- Experiencing trauma. People who experience or survive traumatic events may show signs of an eating disorder. Sometimes responses to trauma include seeking control and an ED offers the illusion of control.
- Teasing or bullying. Adolescents who are teased or bullied by their peers for their appearances are significantly more likely to develop an eating disorder.
Cultural causes of eating disorders are one of the biggest factors at play. These include a range of things from societal beauty standards to gender roles, social media, and weight stigma. Some of the cultural causes of EDs include:
- Weight stigma. The media pushes the idea that thinner is better. People who are overweight experience significant shame about their bodies and may develop an ED as a result.
- Social media. Social media has created a serious problem regarding the way people feel about their appearance over the last decade. People develop unrealistic standards and ideals for themselves and false ideas about how they should look.
- Internalizing the false idea of “ideal” appearances. Too many people internalize false ideas of what they “should” look like. Ideal appearances are fallacies that too often lead people to develop an eating disorder.
- Gender roles. Women are expected to maintain a thin but curvy figure while men are expected to sustain a lean, muscular physique. These expectations for the different genders may cause individuals to develop an eating disorder while pursuing them.