Eating Disorders: Types, Symptoms, Causes & Treatments

By Paula Holmes LCSW

Eating disorders can affect anyone regardless of age, gender, race or socioeconomic status. Eating disorders often emerge in adolescence, when people are more vulnerable about body image and self-esteem as the brain continues to develop. There are many types of eating disorders, and each has its own set of risk factors for physical and emotional health. If left untreated, eating disorders can be deadly. It is important to recognize the signs and symptoms of eating disorders early to establish effective treatment. 

What Are Eating Disorders?

People who struggle with eating disorders have a complicated relationship with food. The primary component of most eating disorders is the ineffective consumption of food, whether it’s characterized by overeating or deprivation. These behaviors are driven by a desire to self-soothe, establish a sense of control over one’s life and body, or manage emotions. The pervasive nature of eating disorders makes them a significant risk due to the potential impact on physical health. 

Several types of eating disorders are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Additional disorders are also included in the DSM-5 that are related to eating but not classified as eating disorders. Eating-related conditions that emerge during early childhood may be a part of the developmental experience, but may not become a lasting issue. Symptoms of all disordered eating should be monitored and treated, whether it is considered a short-term early childhood condition such as pica, or a longer-term issue like anorexia. 

See Related: Songs About Eating Disorders

Types of Eating Disorders

Eating disorders are classified by their intensity, frequency, duration and distinct symptoms. Each type of eating disorder is challenging to manage in its own way — it is often difficult to change a well-established behavior. There are many factors involved in developing an eating disorder, including self-esteem and self-soothing, as well as environmental factors that contribute to someone’s perception of body image. 

Anorexia Nervosa

Anorexia nervosa is characterized by severely limiting food intake or engaging in excessive behavior to lose weight or prevent weight gain. A hallmark of anorexia is the distortion of one’s body image. When someone with anorexia loses weight, they are often dissatisfied and continue to pursue additional weight loss even if their weight is far below what is considered healthy. 

Anorexia affects around eight in 100,000 people annually. It can become dangerous quickly, with serious health implications for multiple bodily systems. 

Symptoms of anorexia nervosa often include: 

• Extreme fear of weight gain
• A distorted image of one’s body, focusing excessively on their size or shape
• In women, missing three or more menstrual cycles 
• Severe, unhealthy and ongoing restriction of food intake for the purpose of weight loss
• Engaging in extreme behaviors to lose weight or prevent weight gain
• Exercising excessively
• Taking pills to suppress appetite, to urinate, or to have frequent bowel movements
• Blotchy, dry, sometimes yellowed skin 
• Fine hair covering skin on the body
• Dry mouth
• Loss of bone strength
• Wasting away in muscle and fat stores
• Confusion
• Memory loss

Bulimia Nervosa 

People with bulimia nervosa experience a loss of control when eating and eat a large amount in a short period of time, known as binge eating, and then experience intense feelings of shame and regret. In a desire to eliminate the food and prevent weight gain, someone with bulimia purges after binging, either through vomiting or taking large amounts of laxatives. Additional behaviors include excessive exercise or fasting in an attempt to reverse the effects of binging cycles. 

According to the National Eating Disorders Association (NEDA), the prevalence of diagnostic criteria for bulimia at any point is around 1.0% for young women and 0.1% for young men. Because someone with bulimia typically maintains an average weight, they may be able to hide their condition for a longer period of time compared to other eating disorders. 

Some symptoms of bulimia nervosa include:

• A pattern of consuming large amounts of food in a short period of time
• Feeling a loss of control over eating patterns
• Engaging in purging behaviors, like intentional vomiting or taking excessive laxative products
• Exercising excessively 
• Obsessing about weight and size
• Feeling shame and guilt about eating
• Mood changes, like increased anxiety
• Spending long periods of time in the bathroom after eating

Binge Eating Disorder (BED)

Binge eating disorder is characterized by periods of excessive food consumption coupled with a feeling of loss of control and distress about eating. Binge eating disorder does not involve purging or excessive attempts to control weight. Binge eating disorder often results in significant weight gain. Binge eating disorder occurs in 1.2% of U.S. adults. 

Common symptoms of binge eating disorder include:

• Eating excessive amounts of food over a short period of time, such as a couple of hours
• Loss of control over one’s eating 
• Consuming food until feeling uncomfortably full
• Eating more quickly than normal
• Consuming large amounts of food regardless of hunger
• Not eating in front of others due to shame
• Feelings of guilt or shame about overeating

Avoidant/Restrictive Food Intake Disorder (ARFID)

ARFID is a condition that often occurs in pediatric patients, though teens and adults can also develop the disorder. ARFID is characterized by restricted eating patterns or avoiding certain foods or categories of food that the person perceives as problematic in some way. People with ARFID may avoid certain textures due to sensory issues or a fear of choking or vomiting. One study showed that 20% of children with ARFID had a co-occurring autism spectrum diagnosis. 

ARFID can be risky due to the risk of nutritional deficiencies, especially if food is limited so much that entire food groups are removed from one’s diet. Insufficient food and nutritional intake cause the body’s inability to grow properly or maintain its normal processes. 

Common symptoms of ARFID include:

• Severe restriction of food
• Fear of choking and/or vomiting that results in food refusal
• Elimination of certain food groups
• Abdominal pain, constipation and other digestive complaints
• Dizziness
• Fainting
• Low immunity
• Muscle weakness
• Dry nails and skin
• Lab work that indicates nutritional deficits 

Pica

Many eating disorders are food-related, but pica involves non-food items. People with pica eat items that don’t have nutritional value, such as dirt, hair and other things that are not considered edible. To be diagnosed with pica, the consumption of non-food items must persist for at least a month. Additional testing is often done when assessing and monitoring pica to make sure there aren’t any negative effects from non-food items being consumed, especially in the case of toxic substances such as paint or other chemicals. Pica cannot be diagnosed under the age of two years due to the normalcy of mouthing items in general during that time. Iron deficiency is a common contributing factor to this condition, and iron levels are routinely checked when someone is being assessed for pica. 

Symptoms of pica may include:

• Consumption of non-food items for a minimum of one month
• Consumption of non-food items in addition to normal eating patterns
• Iron deficiency or other types of malnutrition
• Co-occurring conditions such as intellectual disability, skin-picking or hair-pulling disorders, like excoriation or trichotillomania

Unspecified Feeding or Eating Disorder (UFED)

If one has symptoms of an eating or feeding disorder but does not meet full criteria for diagnosis, they may be diagnosed with Unspecified Feeding or Eating Disorder. UFED is a way for medical professionals to address eating disorder symptoms and any issues they may cause, even if one does not meet diagnostic criteria. UFED is also used in settings where someone is referred to another level of care since extensive assessment cannot be completed, such as in an emergency room. Someone with a variety of symptoms related to eating or feeding may be diagnosed with UFED. 

How Common are Eating Disorders?

Eating disorders affect eight million Americans, with an estimated 95% of those affected being between the ages of 12 and 25. While eating disorders are more prevalent in women, they can affect anyone and are the deadliest type of mental health condition. It is crucial to understand the signs and symptoms so that people struggling with an eating disorder can access treatment. 

What Causes Eating Disorders?

There is no specific cause of eating disorders, as each person has a unique life experience and genetic makeup. Some people may be more prone to eating disorders than others, but this is affected by many different factors. 

Risk Factors for Eating Disorders

Depending on the person, there may be several present risk factors that contribute to the development of an eating disorder, including psychological, environmental and interpersonal risk factors.

Psychological Risk Factors

Some psychological health factors can make someone more likely to have an eating disorder.

Psychological risk factors for eating disorders include:

• Low self-esteem
• Anxiety, depression
• Feelings of isolation and loneliness
• Unresolved anger
• Feeling out of control of one’s life
• Disliking one’s own body

Environmental Risk Factors

Environmental factors also contribute to the likelihood of someone developing an eating disorder. 

Environmental risk factors for eating disorders include:

• Cultural norms and values of being thin
• Media pressures to be a certain weight or size
• Family and friends being highly focused on body size or weight loss
• Family history: First-degree relatives of someone with an eating disorder are ten times more likely to also develop an eating disorder 

Interpersonal Risk Factors

Interpersonal factors revolving around personal history and emotional makeup also play a part in the development of an eating disorder.

Interpersonal risk factors for eating disorders include:

• Challenges in relationships with family and friends
• History of being bullied about weight
• Abuse history
• Difficulty expressing feelings

Eating Disorder Symptoms

Each type of eating disorder has unique symptoms, but there are overall signs that show someone may be struggling. Talking about eating-related issues can be difficult, and this may cause people to avoid sharing their experiences. 

If you notice several symptoms together, seeking additional help or offering support might be beneficial:

• Changes in eating patterns
• Weight loss or gain
• Spending excessive time in the bathroom after meals
• Consistent consumption of laxatives, diet pills or diuretics 
• Self-critical comments about weight
• Preoccupation with one’s size or weight

Health Risks Associated with Eating Disorders

Eating disorders can lead to health problems, including heart conditions, organ failure, infertility and severe constipation. Other issues include brittle nails and hair, low blood pressure and pulse, brain damage, anemia, weakness, dry yellow skin, fine hair growth on one’s body and a decrease in bone strength. 

Eating Disorder Hotlines

People struggling with eating disorders can find support through multiple hotline options. The benefit of using a hotline is that someone can talk through difficult thoughts and feelings in the moment and access support and care. Whether on a support hotline or in a therapy setting, it is healthy to freely talk about your challenges with someone who is not in your everyday life. 

Hotlines for eating disorders include:

• The National Eating Disorder Association: 1-800-931-2237, or text NEDA to 741-741
• National Alliance on Mental Illness: 1-800-950-6264, or text NAMI to 741-741
• National Suicide Prevention Hotline: 1-800-273-8255
• Anorexia Nervosa and Associated Disorders Hotline: 1-630-577-1130
• Substance Abuse and Mental Health Services Administration (SAMHSA): 1-800-662-HELP (4357)

Eating Disorder Treatment

Seeking professional help for an eating disorder is the best way to overcome it and manage symptoms as they arise. When considering treatment, the most important thing is choosing the right resources for support. This could start with a conversation with your doctor, or talking to someone at a hotline about your experiences. Reviewing treatment options may feel daunting, but healing begins with that first step.

Therapy for Eating Disorders

Talk therapy is a great resource for people struggling with eating disorders. Therapy is a safe, confidential setting to explore thoughts and feelings. It can also promote the development of additional skills in emotion regulation, coping strategies and managing triggers. 

CBT for Eating Disorders

Cognitive behavioral therapy or CBT is frequently used to treat eating disorders. This treatment method helps identify underlying triggers, thoughts and feelings that impact the way you eat. Together with a therapist, you can explore these factors and learn new ways to think about yourself and your relationship with food. 

Medications for Eating Disorders

Depending on your unique situation, your doctor may suggest or prescribe medications to help manage challenges with an eating disorder. While there are no medications specifically created to treat eating disorders, many medications can help reduce or control symptoms. 

Certain types of antidepressants and anxiety medications may be used to reduce bulimia symptoms, anticonvulsants can reduce incidences of binge eating episodes, and nausea medication has also been known to help reduce the occurrence of binging and purging cycles. Consult with your doctor to learn which medications may be best suited for your specific situation and needs. 

Eating Disorder Resources

An eating disorder can have a profoundly negative effect on one’s life. Fortunately, there are many resources available that can help. Whether you reach out to a hotline, talk with your doctor, or consult a therapist or treatment facility, there is no wrong way to get started. Therapeutic resources can help you begin your healing journey toward gaining control over your eating disorder. 

Getting Help for Eating Disorders

One simple step to take as you explore healing from an eating disorder is to learn more about easily-accessed mental health management tools, like Nobu. Nobu is a free app that features a series of mental health tools to help you process thoughts and feelings, and adopt healthy coping strategies. User-friendly apps like Nobu can help you think about your circumstances in a different way and learn new methods to manage your feelings. Download Nobu on the App store or Google Play store and get started on the road to better mental wellness.