What is an eating disorder?

An eating disorder is an unhealthy preoccupation with food and body image that interferes with an individual’s everyday life. It is a serious mental and physical illness that, if untreated, can be life-threatening. Anorexia nervosa, bulimia nervosa and binge eating are the most common types of eating disorders. Anorexia nervosa has the highest mortality rates of any psychiatric illness. All of the eating disorders have significant effects on health and wellness.

Who gets an eating disorder?

Eating disorders can occur in people of any age, sex, race, gender, ethnicity, economic status, as well as individuals of all body weights, shapes and sizes.

Eating disorders are commonly seen in adolescents and young adults but can occur in young children as well as in the geriatric population. Although eating disorders are recognized as common in girls and women, more and more boys and men are being diagnosed with eating disorders. Binge eating disorder and avoidant/restrictive food intake disorder are more common in boys with eating disorders than anorexia nervosa or bulimia nervosa.

According to the National Eating Disorder Association, about 20 million women and about 10 million men in the United States will have an eating disorder during the course of their life.

What are the different types of eating disorders?

The four most common types of eating disorders are:

  • Anorexia nervosa is defined as self-starvation in order to maintain an abnormally low body weight. It occurs along with an intense fear of gaining weight, poor body image and lack of recognition of the seriousness of the illness.
  • Bulimia nervosa is defined as episodes of eating a large amount of food in a short amount of time with a perceived loss of control. This is followed by purging behaviors (such as self-directed vomiting, fasting, use of enemas, misuse of laxatives and diuretics, or excessive exercise) to prevent weight gain.
  • Binge eating disorder is defined as episodes of eating a large amount of food in a short amount of time until feeling uncomfortably full (without purging behaviors). These episodes occur at least once weekly for at least three months and are often associated with depression, shame or guilt.
  • Avoidant/restrictive food intake disorder is defined as a lack of interest or avoidance of food due to pain, anxiety, extreme pickiness or other factors that results in significant weight loss and nutritional deficiency.

There are other eating disorders in addition to the four mentioned above. Also, some people have symptoms that shift from one diagnostic category to another, while others have eating patterns that don’t quite meet the criteria of a specific disorder. However, all eating disorders are serious physical and psychological conditions.

What causes eating disorders?

Behavioral, biological, emotional, psychological, and social factors all may play a role in the development of an eating disorder. Research has found that genetics may also play a role for some but not all individuals. People with a family member who has or had an eating disorder are more likely to develop one.

Media plays a large role in our view of body image. Research has shown that social comparison and time spent on social media can negatively impact body image and self-esteem.

Eating disorders can also be seen or used as an unhealthy coping strategy. Binge eating disorder may develop out of “emotional eating,” or eating excessively when bored, sad, mad or experiencing other emotion. The starvation and self-restriction of anorexia nervosa may give a person a sense of control over one aspect of their life. Many individuals slide into an eating disorder after making a healthy lifestyle change, but unintended brain starvation leads to "hard-wiring" of unhealthy eating disorder attitudes and behaviors.

What are some of the symptoms of eating disorders?

The physical, psychological and emotional symptoms of eating disorders vary from person to person and by type of eating disorders. The following list of symptoms is seen in one or more eating disorders:

General physical symptoms

  • Significant weight loss/gain, fluctuations or unexplained changes from normal growth curve and weight range for still developing children, adolescents and young adults.
  • Feeling weak, tired, cold.
  • Dizziness.
  • Fainting or near-fainting.
  • Sweating/hot flashes.
  • Dehydration.

Heart / lung symptoms

  • Slow or irregular heart beat.
  • Chest pain.
  • Heart attack.
  • Heart failure.
  • Low blood pressure.
  • Out of breath.
  • Swelling of hands, feet, or other dependent areas.

Dental / neck and face symptoms

  • Tooth decay, erosion of tooth enamel.
  • Swollen parotid glands (cheek and jawline).
  • Sore throat.
  • Bloodshot eyes.

Stomach / bowel symptoms

  • Stomach ulcers.
  • Heartburn, indigestion, bloating.
  • Abdominal pain.
  • Tears in stomach and esophagus.
  • Constipation with or without intermittent diarrhea.
  • Hemorrhoids.

Endocrine symptoms

  • Irregular menstrual periods or loss of periods.
  • Loss of sex drive.
  • Stress fractures due to low bone mineral density/osteoporosis.
  • Seizures (from low blood sugar).

Neuropsychiatric symptoms

  • Depression, anxiety, mood swings.
  • Memory loss.
  • Poor concentration.
  • Sleeping problems.
  • Suicidal thoughts.
  • Self-harm.

Skin / hair / nails symptoms

  • Hair loss, thinning hair, brittle hair.
  • Brittle nails.
  • Poor wound healing.
  • Carotenoderma (yellow/orange skin).

Other symptoms

  • Electrolyte levels (chloride, potassium other chemical levels) outside normal range.

Emotional and behavioral signs and symptoms

  • Intense fear of gaining weight or becoming fat.
  • Preoccupation with and/or distorted view of body image.
  • Feeling out of control while eating.
  • Feeling guilt, shame or disgust about eating.
  • Withdrawing socially from friends and family; not enjoying life any more.
  • Lack of awareness of the seriousness of the eating disorder.
  • Sudden change in eating behaviors (eating huge amounts of food in a short period of time, limiting certain foods or food groups, becoming vegetarian/vegan, lactose-free, gluten-free).
  • Vomiting, abusing laxative or diuretics, fasting, excessive exercising or extreme physical training to prevent weight gain.
  • Strange eating habits or routines, such as eating in secret, eating foods in a certain order, rearranging foods on a plate.
  • Using the bathroom frequently after meals.
  • Purposely not taking insulin (in people who have diabetes) to lose weight.
  • Inappropriate use of nutritional supplements marked for weight loss.

Last reviewed by a Cleveland Clinic medical professional on 05/15/2020.

References

  • Rome ES, Strandjord SE. Eating Disorders. Pediatrics in Review 2016;37(8);323-336. Accessed 5/15/2020.
  • Dickstein LP. Franco KN, Rome ES, Auron M. Recognizing, managing medical consequences of eating disorders in primary care. Cleve Clinic J Med 2014;81(4):255-263. Accessed 5/15/2020.
  • Academy for Eating Disorders. Eating Disorders. A Guide to Medical Care. AED Report 2016. 3rd edition. Accessed 5/15/2020.
  • National Eating Disorder Association. What are eating disorders? Accessed 5/15/2020.
  • National Alliance on Mental Illness. Eating Disorders. Accessed 5/15/2020.
  • National Institute of Mental Health. Eating Disorders: About More than Food. Accessed 5/15/2020.
  • American Psychiatric Association. Help with Eating Disorders. Accessed 5/15/2020.
  • The Eating Disorder Foundation. About Eating Disorders. Accessed 5/15/2020.
  • American Psychological Association. Eating Disorders. Accessed 5/15/2020.
  • National Association for Anorexia and Associated Disorders. Eating Disorder Statistics. Accessed 5/15/2020.
  • Lock J, Le Grange D, eds. Help Your Teenager Beat an Eating Disorder. 2nd ed. New York: The Guilford Press; 2015. Accessed 5/15/2020.

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