Condition Center: Eating Disorders

Photo Illustration by Becky Jiras
Photo Illustration by Becky Jiras

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this condition: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

"Eating disorders are a public health crisis," says Kamryn Eddy, PhD, codirector of Massachusetts General Hospital's Eating Disorders Clinical and Research Program. There are several types of EDs, all of which can take a devastating toll on one's physical, mental, and emotional health. And the illnesses don't discriminate by gender, age, race, sexual orientation, and body size; they'll affect roughly 20 million women and 10 million men at some point in their lives, according to the National Eating Disorders Association (NEDA). Being able to recognize dangerous behavior and seek help early can be the key to avoiding the most serious consequences.

Understanding Eating Disorders

Of the eight eating disorders listed in the DSM-5, a manual of mental health conditions used for psychiatric diagnoses, three are the most common among adults.

  • Anorexia nervosa, which is characterized by restricted eating, often paired with compulsive exercise and vomiting or taking laxatives after eating.
  • Bulimia nervosa, which is defined by recurrent episodes of binge eating (eating a large amount of food in a short amount of time), followed by vomiting, using laxatives, exercising excessively, or other behaviors intended to "undo" the binge.
  • Binge-eating disorder, which has several hallmark signs, including eating large amounts of food in a short amount of time, feeling a loss of control during the episodes, and feeling ashamed, depressed, or guilty afterward.

The other five eating disorders include pica, avoidant/restrictive food intake disorder (ARFID), rumination disorder, other specified feeding or eating disorders (OSFED), and unspecified feeding or eating disorder (UFED).

While not listed in the DSM-5, two other EDs are common as well: orthorexia, defined as an extreme obsession with healthy eating, and compulsive exercise, according to the National Eating Disorders Association (NEDA).

"Most eating disorders develop in adolescence or early adulthood, but there is no age when women are immune," Eddy says. The health implications of eating disorders range from physical issues, including bone loss, heart problems, hormone abnormalities, and electrolyte imbalances, to emotional issues, such as depression, anxiety, obsessive-compulsive disorder, and substance abuse. Eating disorders are also associated with premature death, from both physical health problems and suicide.

Causes of Eating Disorders

"Eating disorders are biopsychosocial illnesses, meaning their causes are multifactorial," Eddy explains. Some contributing factors include:

  • Biology. This includes having a genetic predisposition or a family history of eating disorders or other mental health problems, reports the Mayo Clinic. Personality traits, such as perfectionism and inflexibility, are also associated with an increased risk of developing an ED, according to NEDA.
  • Involvement in certain sports that emphasize body size, including gymnastics or diving, per NEDA. Behaviors like dieting may also be risky. In one small study, people who dieted "at a moderate level" were five times as likely as nondieters to develop an ED.
  • Societal pressures. Exposure to fatphobia and societal body standards, as well as notions around what it means to look or be masculine or feminine, can increase dissatisfaction with your body — a key component of most eating disorders, Eddy says.

Most Effective Treatments For Eating Disorders

"The first active ingredient of treatment is to interrupt the restrictive eating, binging, and purging behaviors," Eddy says. This sort of change may require inpatient treatment at a hospital, intensive outpatient treatment, or residential therapy at an eating-disorder clinic. Recovery also typically involves nutrition counseling, medical and psychiatric monitoring, and psychological counseling (often cognitive behavior therapy). Many people in recovery from EDs find it useful to continue with therapy after they've finished the more intensive stages of treatment.

ED treatment will look different from person to person. But Eddy emphasizes that recovery is possible. A 2016 study coauthored by Eddy followed the recovery process of women with anorexia nervosa or bulimia nervosa over 22 years and found that around two-thirds will recover. Some of the study participants relapsed during this time period. But as Eddy said in a statement when the study first came out, "These findings challenge the notion that eating disorders are a life sentence."

If you or someone you know is struggling with an eating disorder, the National Eating Disorder Association (NEDA) has resources available including a 24/7 helpline at (800) 931-2237. For a 24-hour crisis line, text "NEDA" to 741741 or use its click-to-chat help messaging system.