An eating disorder is a mental health condition characterized by unhealthy relationships with food, eating, exercise, and body image. Understanding what an eating disorder is, symptoms, causes, and potential treatments can help someone take the first step toward getting help.
What is an eating disorder?
Eating disorders are complex and sometimes fatal mental illnesses that can impact a person’s physical and mental health. People who struggle with eating disorders are at increased risk for psychiatric problems, medical complications, and social isolation (NEDC, 2022). Their mood, self-esteem, and general well-being are often directly connected with their body size, weight, and eating habits (Psych Central, 2021). These can have serious emotional and physical consequences (National Alliance for Eating Disorders, 2021).
Causes of eating disorders
The causes of eating disorders vary widely from one person to another. Risk factors for developing an eating disorder include abuse, trauma, low self-esteem, poor body image, bullying, neglect, relationship challenges, and participating in sports or other activities that emphasize weight and size, such as ballet, gymnastics, and wrestling (Kelty Eating Disorders, 2022).
The social pressure to be thin can cause a person to develop an eating disorder, with social media apps such as TikTok promoting diet culture, fatphobic messaging, and unhealthy and unrealistic body images to teens. People can also inherit damaging relationships with food from their parents, affecting them well into adulthood.
While eating disorders occur across the population, some groups are more at-risk. Women are more likely to develop an eating disorder than men (National Alliance for Eating Disorders, 2021). Women with physical disabilities are more likely to develop an eating disorder than those without (ANAD, 2022). Transgender college students report experiencing disordered eating at approximately four times the rate of their cisgender classmates, while athletes are more likely to have an eating disorder than non-athletes (ANAD, 2022).
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Signs and symptoms of eating disorders
Eating disorder symptoms can manifest in emotional, behavioral, and physical changes, including:
- Preoccupation with weight, food, and calories
- Refusal to eat certain foods
- Restrictions against whole categories of foods
- Discomfort eating in the presence of others
- Food rituals
- Skipping meals
- Withdrawal from friends and activities
- Frequent dieting
- Extreme concern with body size, weight, and shape
- Mood swings
- Fluctuations in weight
- Stomach cramps
- Difficulty concentrating
- Problems with sleep
- Muscle weakness
- Impaired immune functioning
Types of eating disorders
Eating disorders can fall into different categories with a range of symptoms. These include:
Anorexia nervosa is characterized by dramatic weight loss, challenges maintaining an appropriate body weight, denial of hunger, and distorted body image. Though anorexia nervosa usually starts during adolescence, an increasing number of children and adults are being diagnosed with the disorder (National Eating Disorders Association, 2018).
- Restricting food intake, leading to significantly low body weight
- Extreme fear of gaining weight and becoming fat
- Distorted or unrealistic body image
Binge eating disorder
Binge eating disorder is the most common eating disorder in the United States. It involves eating large quantities of food, feeling a loss of control while binging, and then feelings of shame and guilt after binging (National Eating Disorders Association, 2018).
- Repeated binge eating at least once a week for three months
- Marked distress about binge eating
- Purging is not associated with binge eating
Avoidant restrictive food intake disorder
Avoidant restrictive food intake disorder, previously referred to as selective eating disorder, is similar to anorexia nervosa as it involves limiting food. However, it does not include distress about a person’s body size or shape (National Eating Disorders Association, 2018).
- Not meeting one’s nutritional needs
- A refusal to eat that is not part of a cultural practice, such as fasting
- A refusal to eat that is not due to a medical condition or other mental health issue
Other eating disorders
Other common eating disorders include bulimia nervosa, which is characterized by binge eating and purging. Orthorexia is an obsession with proper or “healthful” eating.
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How are eating disorders diagnosed?
Often, eating issues don’t fall perfectly into any category. A mental health clinician can diagnose an eating disorder by performing a physical exam, talking with a patient about their symptoms, and ordering lab tests.
Treatments for eating disorders
Treatment plans for eating disorders are typically tailored to the needs of each individual. Treatment options can include:
- Individual, group, and/or family therapy
- Medical care and monitoring
- Nutrition education
Therapy, particularly cognitive behavioral therapy (CBT), can be effective in helping children and adults manage the symptoms of their eating disorders. Therapy can be especially beneficial around the holidays for those in disordered eating recovery.
Eating disorders are occasionally treated with medication. Medications such as antidepressants, antipsychotics, and mood stabilizers can manage symptoms of eating disorders along with other co-occurring illnesses like depression and anxiety.
Many eating disorder treatment plans incorporate dietitians or nutritionists. Nutrition education can help people struggling with eating disorders to:
- Better understand their thoughts and behaviors about food and weight
- Choose food based on nutritional value
- Balance diet with exercise
- Eat without fear, anxiety, guilt, or compensatory behaviors
Dykshoorn, K. L. (2014). Trauma-related obsessive–compulsive disorder: A Review. Health Psychology and Behavioral Medicine, 2(1), 517–528. https://doi.org/10.1080/21642850.2014.905207
Pauls, D. L. (2010). The genetics of obsessive-compulsive disorder: A Review. Dialogues in Clinical Neuroscience, 12(2), 149–163. https://doi.org/10.31887/dcns.2010.12.2/dpauls