Eating Disorders: What They Are, Why They Happen and What to Do

Because an eating disorder affects how your feel about yourself and how you interact with others, the condition impacts so much more than your physical health. Treatment comes in many forms. Here’s your quick guide.
African American female

American media is overcome with its obsession to fitness and beauty, and the message has always been clear: to be valuable, you have to be thin and attractive. And that point is modeled in magazines, pinned to social media feeds and broadcast to living rooms every second of every day. That's a really sad message, and it's without an ounce of truth. Unfortunately, as with any message that gets repeated often enough, we start to believe it, and it absolutely affects the way we see and treat ourselves.

So let's take a closer look at eating and feeding disorders: the different types and symptoms, who it affects and why, and what we can do to find peace within our own bodies.

A Quick Look at Eating Disorders

  • An estimated 30 million people in the United States are affected by eating disorders, with tens of millions more affected around the world.
  • Eating disorders refer to a grouping of symptoms related to body image, eating behaviors, and physical and psychological well-being.
  • There are several types of eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, pica, rumination disorder, avoidant/restrictive food intake disorder and more.
  • Feeding and eating disorders affect all ages, genders and ethnicities.
  • Men are often underrepresented in treatment settings and statistics for both anorexia nervosa and bulimia (10 females to one male for both).
  • Each disorder has its own set of symptoms, and varies in terms of who it affects, when it affects them and how.

The most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder. As with all eating disorders, their signs, symptoms and behaviors most often begin to appear during someone's teenage years and might coincide with other disorders like depression, anxiety or substance misuse.

But there are many things that contribute to an eating disorder, including:

  • Biological factors: how the brain is wired and how the body functions
  • Psychological factors: how someone sees themselves and the world around them, along with any related coping strategies
  • Environmental factors: family and social messaging about body image and eating, or other activities that promote certain body types or involve specific diet or exercise

Eating disorders take a great toll on someone's mental, physical and relational health, and family members may feel completely lost when trying to help.

What Is an Eating Disorder?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes eating disorders as an ongoing disturbance to eating or related behaviors that results in a significant change to food intake, and has a clear effect on physical health and psychological well-being. Eating disorders can:

  • Appear at any time in someone's life, from infancy into adulthood
  • Include preoccupation with how one looks
  • Produce misperceptions about one's own body
  • Create fears of having certain body types and behaviors to control their appearance

Those attempts to control one's appearance, like controlled eating or purging, are generally the outward signs and symptoms of an eating disorder that friends or family might notice.

What Are the Signs and Symptoms for Eating Disorders?

As previously mentioned, the signs, symptoms and risks for eating disorders will vary by diagnosis.

Anorexia Nervosa Symptoms

  • Intense fear of gaining weight
  • Significant limitations to what someone eats
  • Extreme weight loss and thinness
  • Use of weight-loss supplements like laxatives
  • Self-worth highly connected to one's body weight and thinness
  • Difficulty recognizing the severity of behaviors related to appearance and food
  • Weakening and thinning of bones
  • Brittle hair and nails
  • Yellowing of skin
  • Infertility
  • Heart problems
  • Low energy
  • Organ failure

Anorexia nervosa is a very serious mental illness and often goes hand-in-hand with other mental health diagnoses like depression, anxiety, substance use and bipolar disorders. When compared to their peers without the diagnosis, adolescents and young adults diagnosed with anorexia nervosa have a ten times greater risk of dying.

In addition to the physical effects, someone diagnosed with anorexia might experience relational damages from:

  • Secretive behavior and weight control
  • Ongoing stress due to health complications
  • Negative self-perception and a resulting disconnection from friends and family

Bulimia Nervosa Symptoms

  • Eating large amounts of food very quickly
  • Feeling out of control with food intake
  • Frequently engaging in body weight control measures like vomiting, fasting or excessive exercise
  • Cycling between restriction of food intake and compensatory binging
  • Tying self-worth to one's physical appearance
  • Stomach problems with digestion or acid reflux
  • Chronic sore throat
  • Severe dehydration
  • Sensitive or decaying teeth

Much like anorexia, people with bulimia nervosa will often experience other mental health issues like depression, bipolar disorder, anxiety and substance misuse.

Binge Eating Disorder Symptoms

  • Patterned loss of control over food intake
  • Eating large amounts of food very quickly
  • Eating to the point of discomfort
  • Eating when not hungry
  • Eating alone for fear of being judged by others
  • Feelings of guilt and shame after eating

Binge eating affects men, women and many ethnicities at similar rates across the United States, and the disorder puts someone's physical health at risk because of the increased likelihood of weight gain, obesity and associated medical concerns.

Who Do Eating Disorders Affect and Why?

As mentioned previously, eating disorders are common and affect millions of people around the world. It's worth noting, though: the data for eating disorders are sometimes skewed by the varied access to treatment services around the world, and different cultures have different conceptions of eating disorders like binge eating and bulimia. But the following factors generally put someone at an increased risk for an eating disorder:

  • Diagnosed with an anxiety disorder
  • Showed anxious or obsessional traits in early childhood
  • Low self-esteem
  • Diagnosed with a depressive disorder
  • Live in a culture where body weight is highly scrutinized
  • Engage in athletics or other occupations where thinness is emphasized
  • Experienced trauma like childhood sexual or physical abuse
  • Family history of eating disorders
  • Childhood obesity or early puberty

Why Do Mental Health Conditions Often Precipitate an Eating Disorder?

Mental health conditions like depression, anxiety and bipolar disorder increase the risk for eating disorders because they affect how a person feels about themselves and how they interact with others. For those diagnosed with depression, it can influence the way a person sees and treats themselves physically. Someone with an anxiety disorder might try to assert control or alleviate tension through eating. And cultural messages about beauty might reinforce any existing insecurities or negative beliefs about self-worth and body image. Then you add any genetic history of eating disorders or family beliefs about body appearance, and it all adds up and contributes to a person's relationship to food and self.

The Help You Deserve

There are a range of treatment options for eating disorders, depending on the severity and urgency of the diagnosis, that can involve a family support system if desired. Consider getting an assessment to figure out the best choice for you:

  • Nutrition therapy and support
  • Counseling and therapy to regulate emotions, thinking and behavior
  • Family therapy or other family interventions
  • Outpatient treatment services
  • Hospitalization or inpatient treatment programs

There is always hope for recovery. If you or a loved one are experiencing signs or symptoms that suggest an eating disorder or unhealthy body image and related behaviors, contact a mental health center or specialist to schedule an assessment. They can help you determine whether you meet the criteria for an eating disorder and get you on track to happiness, health and high self-esteem.

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. 

Brewerton TD, Perlman MM, Gavidia I, Suro G, Genet J, Bunnell DW. The Association of Traumatic Events and Posttraumatic Stress Disorder With Greater Eating Disorder and Comorbid Symptom Severity in Residential Eating Disorder Treatment Centers. International Journal of Eat Disorders. 2020;1–6.

Fichter, M. M., & Quadflieg, N. (2016). Mortality in eating disorders – Results of a large prospective clinical longitudinal study. International Journal of Eating Disorders, Epub ahead of print. 

Garcia SC, Mikhail ME, Keel PK, et al. Increased rates of eating disorders and their symptoms in women with major depressive disorder and anxiety disorders. International Journal of Eating Disorders. 2020;1–11. 23366

National Alliance on Mental Illness.

National Eating Disorders Association (2018).

National Institute of Mental Health (2016).

Smink, F. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406-414

World Health Organization (2005). Gender in Mental Health Research Series