Eating Disorders

When you become so preoccupied with food and weight issues that you find it harder and harder to focus on other aspects of your life, it may be an early sign of an eating disorder. Without treatment, eating disorders can take over a person’s life and lead to serious, potentially fatal medical complications.

What are Eating Disorders?

Eating disorders are a group of related conditions that cause serious emotional and physical problems. Each condition involves extreme food and weight issues; however, each has unique symptoms that separate it from the others.

From the DSM-5

What causes Eating Disorders?

The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes, such as:

  • Genetics and biology. Certain people may have genes that increase their risk of developing eating disorders. Biological factors, such as changes in brain chemicals, may play a role in eating disorders.
  • Psychological and emotional health. People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may have low self-esteem, perfectionism, impulsive behavior and troubled relationships.

Risk Factors

Certain factors may increase the risk of developing an eating disorder, including:

    • Family history. Eating disorders are significantly more likely to occur in people who have parents or siblings who've had an eating disorder.
    • Other mental health disorders. People with an eating disorder often have a history of an anxiety disorder, depression or obsessive-compulsive disorder.
    • Dieting and starvation. Dieting is a risk factor for developing an eating disorder. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. There is strong evidence that many of the symptoms of an eating disorder are actually symptoms of starvation. Starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.
    • Stress. Whether it's heading off to college, moving, landing a new job, or a family or relationship issue, change can bring stress, which may increase your risk of an eating disorder.

    How to Recognize Eating Disorders

    Symptoms vary, depending on the type of eating disorder. Anorexia nervosa, bulimia nervosa and binge-eating disorder are the most common eating disorders. Other eating disorders include rumination disorder and avoidant/restrictive food intake disorder. Red flags that may indicate an eating disorder include:

    Skipping meals or making excuses for not eating
    Adopting an overly restrictive vegetarian diet
    Excessive focus on healthy eating
    Making own meals rather than eating what the family eats
    Withdrawing from normal social activities
    Persistent worry or complaining about being fat and talk of losing weight
    Frequent checking in the mirror for perceived flaws
    Repeatedly eating large amounts of sweets or high-fat foods
    Use of dietary supplements, laxatives or herbal products for weight loss
    Excessive exercise
    Calluses on the knuckles from inducing vomiting
    Problems with loss of tooth enamel that may be a sign of repeated vomiting
    Leaving during meals to use the toilet
    Eating much more food in a meal or snack than is considered normal
    Expressing depression, disgust, shame or guilt about eating habits
    Eating in secret

    Know the Facts

    30 million

    30 million people in the U.S. have an eating disorder.

    95% of people with eating disorders are between the ages 12 and 25.


    Eating disorders have the HIGHEST risk of death of any mental illness.

    Common Forms of Eating Disorders

    Anorexia nervosa

    Often simply called anorexia, is a potentially life-threatening eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape. People with anorexia use extreme efforts to control their weight and shape, which often significantly interferes with their health and life activities.

    Bulimia nervosa

    Commonly called bulimia, is a serious, potentially life-threatening eating disorder. When you have bulimia, you have episodes of bingeing and purging that involve feeling a lack of control over your eating. Many people with bulimia also restrict their eating during the day, which often leads to more binge eating and purging.

    Binge-eating disorder

    The essential feature of binge-eating disorder is regularly (at least once every week for more than 3 months) eat too much food (binging) and feel a lack of control over your eating. You may eat quickly or eat more food than intended, even when you're not hungry, and you may continue eating even long after you're uncomfortably full.

    Rumination disorder

    Rumination disorder is repeatedly and persistently regurgitating food after eating, but it's not due to a medical condition or another eating disorder such as anorexia, bulimia or binge-eating disorder. Sometimes regurgitated food is re-chewed and re-swallowed or spit out.

    Avoidant/restrictive food intake disorder

    Avoidant/restrictive food intake disorder is characterized by failing to meet your minimum daily nutrition requirements because you don't have an interest in eating; you avoid food with certain sensory characteristics, such as color, texture, smell or taste; or you're concerned about the consequences of eating, such as fear of choking. Food is not avoided because of fear of gaining weight.

    Treatment Options

    Treatment of an eating disorder generally includes a team approach. The team typically includes primary care providers, mental health professionals and dietitians — all with experience in eating disorders.Treatment depends on your specific type of eating disorder. But in general, it typically includes nutrition education, psychotherapy and medication. If your life is at risk, you may need immediate hospitalization.


    Psychotherapy is a vital part of bipolar disorder treatment and can be provided in individual, family or group settings. Several types of therapy may be helpful. These include:

    • Family-based therapy (FBT). The focus is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones. CBT can help identify what triggers your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations. 
    • Cognitive behavioral therapy (CBT). CBT is commonly used in eating disorder treatment, especially for bulimia and binge-eating disorder. You learn how to monitor and improve your eating habits and your moods, develop problem-solving skills, and explore healthy ways to cope with stressful situations.


    Medication can't cure an eating disorder. However, certain medications may help you control urges to binge or purge or to manage excessive preoccupations with food and diet. Drugs such as antidepressants and anti-anxiety medications may help with symptoms of depression or anxiety, which are frequently associated with eating disorders.

    Healthy Eating

    No matter what your weight, the members of your team can work with you to design a plan to help you achieve healthy eating habits.


    If you have serious health problems, such as anorexia that has resulted in severe malnutrition, your doctor may recommend hospitalization. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.

    Lifestyle Changes

    To improve your chances of success in overcoming your eating disorder, try to make these steps a part of your daily routine:

    From the Mayo Clinic

    Stick to your treatment plan.

    Don't skip therapy sessions and try not to stray from meal plans. Follow your doctor's recommendations on physical activity and exercise.

    Talk to your doctor.

    Talk to your doctor about appropriate vitamin and mineral supplements. If you're not eating well, chances are your body isn't getting all of the nutrients it needs, such as vitamin D or iron. However, getting most of your vitamins and minerals from food is typically recommended.

    Resist urges to weigh yourself.

    Resist urges to weigh yourself or check yourself in the mirror frequently. This may simply fuel your drive to maintain unhealthy habits.

    Don't isolate yourself.

    Don't isolate yourself from caring family members and friends who want to see you get healthy and have your best interests at heart.

    Although there's no sure way to prevent eating disorders, here are some strategies to help your child develop healthy-eating behaviors:

    Avoid dieting around your child.

    Family dining habits may influence the relationships children develop with food. Eating meals together gives you an opportunity to teach your child about the pitfalls of dieting and encourages eating a balanced diet in reasonable portions.

    Talk to your child.

    For example, there are numerous websites that promote dangerous ideas, such as viewing anorexia as a lifestyle choice rather than an eating disorder. It's crucial to correct any misperceptions like this and to talk to your child about the risks of unhealthy eating choices.

    Cultivate and reinforce a healthy body image.

    Cultivate and reinforce a healthy body image in your child, whatever his or her shape or size. Talk to your child about self-image and offer reassurance that body shapes can vary. Avoid criticizing your own body in front of your child. Messages of acceptance and respect can help build healthy self-esteem and resilience that will carry children through the rocky periods of the teen years.

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