Eating Disorders: Types, Symptoms, Causes, and Treatment

Eating disorders are critical mental health conditions that are characterized by abnormal eating patterns. This negatively impacts a person’s physical and emotional well-being. These conditions are associated with disturbing emotions and feelings related to food and body image. They usually lead to severe physical and mental health problems that require immediate treatment. 

There are several types of eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/Restrictive food intake disorder (ARFID), and other specified feeding or eating disorders.

Common symptoms of an eating disorder can range from excessive weight loss, faulty body image, consciousness around food, over-eating, compensatory behavior, and obsession with body weight to regular binge eating, no self-control, no compensation behavior, food avoidance, malnutrition, atypical anorexia nervosa, less frequency bulimia nervosa, and night eating syndrome.

Some of the leading causes of eating disorders include brain chemistry, genetics, hormone levels, and traumatic events.

Treatment options for addressing eating disorders can be psychotherapy, medication, nutritional counseling, and hospitalization. 

What Are Eating Disorders?

Eating disorders are serious mental health conditions that lead to severe disturbances in eating behaviors and patterns. Dealing with such disorders can have a damaging impact on a person’s physical and physiological health.

According to the National Institute of Mental Health, eating disorders can be a fatal illness that causes disruptions in a person’s normal eating patterns. 

As per The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), eating disorders are mainly classified into certain diagnostic criteria, including Anorexia nervosa, bulimia nervosa, binge eating disorder, other specified feeding and eating disorder, pica, rumination disorder, unspecified feeding or eating disorder. 

Based on research by the National Association of Anorexia Nervosa and Associated Disorders (ANAD), 9% of people all over the world are affected by eating disorders. In the United States, almost 28.9 million people, which makes up 9% of the population, have suffered from this disorder. 

What Are the Types of Eating Disorders?

The types of eating disorders are anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/Restrictive food intake disorder (ARFID), and other specified feeding or eating disorders.

The common types of eating disorders are listed below.

Anorexia Nervosa

Anorexia Nervosa is a type of eating disorder where people have an intense fear of gaining weight and body image. This fear leads them to severely cut down their food intake and engage in excessive exercise. It can lead to significant malnutrition, osteoporosis, muscle wasting, and, in severe cases, even death.  As per the National Institute of Mental Health, anorexia nervosa is among the most common causes of high mortality rates due to a mental disorder. A study showed that almost 20% of people suffering from anorexia nervosa die from a severe condition.

Bulimia Nervosa

Bulimia Nervosa is a form of disorder that involves episodes of binge eating and then compensating it with self-induced vomiting, aggressive exercise, and the use of medications in order to prevent weight gain. Suffering from this disorder can lead to dehydration, electrolyte imbalance, and several stomach issues. As per the American Psychological Association (APA), patients with this disorder have uncontrolled consumption of abnormal amounts of foods, leading to aggressive measures for weight loss. 

Binge-eating Disorder

Binge-eating disorder is an eating disorder where people eat large quantities of food rather quickly and even to the point that it starts causing discomfort. Unlike bulimia nervosa, there is no compensatory behavior involved in this. This can lead to health complications like type-2 diabetes, obesity, and high blood pressure. There can be psychological distress as well, like feelings of guilt and shame. As per the National Eating Disorders (NEDA), people with binge-eating disorder usually avoid eating in public and feel embarrassed by the amount of food consumed. 

Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive food intake disorder (ARFID) is characterized by the avoidance of food especially due to having sensory trouble with it. This leads to major weight loss and nutritional insufficiency. There is a severe lack of interest in food and this leads to unhealthy weight loss. As per NEDA, patients with this complication are usually then dependent on medications and even tube feeding. This disorder is found to be more common in children and adolescents. 

Other Specified Feeding or Eating Disorders

Other Specified feeding or eating disorders are the types of eating disorders that have the potential to cause distress and impairment. However, they do not meet the criteria for other specified eating disorders. Some examples of this disorder are atypical anorexia nervosa and low-frequency bulimia nervosa. Symptoms of this disorder are similar to other disorders, but severity varies. 

What Are the Symptoms of Eating Disorders?

The Symptoms of Eating Disorders include abnormal eating patterns, psychological distress, and physical health complications that vary across different types of disorders. While each condition presents unique characteristics, they commonly involve distorted relationships with food, body image concerns, and compensatory behaviors. 

The following table outlines the specific symptoms across five major types of eating disorders: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant/Restrictive Food Intake Disorder (ARFID), and Other Specified Feeding or Eating Disorders.

Symptoms of Eating Disorders
Anorexia Nervosa	Bulimia Nervosa	Binge Eating Disorder	ARFID	Other Specified Disorders
• Excessive weight loss from extreme dieting and exercise	• Over-eating episodes with loss of control	• Regular binge eating until discomfort	• Food avoidance due to sensory characteristics	• Atypical anorexia: Similar to anorexia but less weight loss
• Faulty body image perception	• Compensatory behavior (self-induced vomiting, aggressive exercise)	• No self-control over food quantity	• Significant weight loss	• Less frequent bulimia: Fewer binge-eating and compensatory behaviors
• Fear of food consumption and calories	• Obsession with body weight	• No compensatory behaviors	• Malnutrition	• Night eating syndrome: Excessive eating at night
• Pale skin	• Thyroid issues	• Health issues (obesity, diabetes)	• Social avoidance	• Significant distress and impairment
• Brittle nails and hair	• Stomach problems	• Distress	• Stunted growth
• Denial of hunger	• Guilt	• Shame	• Fatigue
• Irritability	• Shame	• Guilt	• Anxiety
• Depression	• Anxiety

What Are the Causes of Eating Disorders?

The causes of eating disorders include brain chemistry, genetics, hormone levels, and traumatic events.

Some of the leading causes of eating disorders are listed below:

• Brain Chemistry: This is the imbalance of neurotransmitters in the brain especially involving serotonin, dopamine, and norepinephrine. These chemicals play a crucial role in managing mood and appetite. Abnormalities within these brain chemicals can result in the development of eating disorders. It has a major impact on the perception of hunger and the feeling of fullness. 

• Genetics: Genetics can lead to a person having varying eating disorders. If a close family member or relative has any relation with some form of eating disorder, there are high chances for other family members to develop a disorder as well. As per NIMH, Genetics contribute to 50-80% of the causes related to eating disorders. 

• Hormone levels: Hormone imbalances especially during the time of puberty can trigger the development of various types of eating disorders. Estrogen and cortisol are found to be the main hormones that can influence the development of disorders. These hormones can have a major impact on mood and metabolism, further impacting eating patterns. 

• Traumatic events: Any traumatic events in life, be it physical, emotional, or sexual, can disrupt normal body functioning and lead to the development of eating disorders. Such events can leave a person feeling like using food as some type of copy technique. Usually, people with eating disorders have shown past relations with some sort of trauma in life. 

How Is an Eating Disorder Diagnosed?

Diagnosing an eating disorder involves a comprehensive approach where patients’ physical and psychological health factors are taken into account. Initially, the patient’s physical health is assessed in order to identify if there are any underlying factors related to weight and growth. This can include an assessment of body mass index (BMI), heart rate, and blood pressure. 

Moreover, lab tests are performed to rule out any other causes that might be influencing the condition. This might include tests for electrolyte imbalances, liver and kidney function tests, and nutritional deficiencies. Thyroid and vitamin D levels are also assessed to check for underlying factors.

An important part of the diagnosis is psychological evaluation. For this, a mental health professional has a detailed discussion with the patient. They inquire about their mental well-being, feelings, and any emotions related to food, weight, body image, and eating patterns. This helps to further assess the issue’s cause.

The final diagnosis is made based on the criteria outlined in DSM-5 in order to ensure the type, severity, and treatment required for the eating disorder. 

“Diagnosing an eating disorder involves evaluating both physical and psychological health. Initially, physical assessments like BMI, heart rate, and lab tests for electrolyte imbalances are conducted. A mental health professional then assesses the patient’s attitudes toward food, weight, and body image. The final diagnosis follows DSM-5 criteria to determine the type, severity, and appropriate treatment for the disorder.”

Dr Michael Olla

What Is the Difference Between Eating Disorders vs. Food Addiction?

The difference between Eating Disorders and Food Addiction lies in their core characteristics and medical recognition. Eating disorders are clinically recognized mental health conditions focused on overall eating behaviors and body image, while food addiction is a behavioral condition specifically centered on the compulsive consumption of certain foods, particularly those high in sugar, fat, and salt.

Aspect	Eating Disorders	Food Addiction
Definition	Mental health conditions with severe disturbances in eating behaviors	Behavioral addiction to consuming specific foods
Focus	Overall eating patterns and body image	Compulsive consumption of particular foods
Types	Anorexia nervosa, bulimia nervosa, binge eating disorder	Single condition focusing on addictive eating
Influences	Genetic, biological, psychological, and social factors	Brain reward pathways similar to substance addiction
Recognition	Clinically recognized in DSM-5	Not universally recognized as a distinct disorder
Treatment	Comprehensive medical, nutritional, and psychological interventions	Behavioral therapies and support groups
Key Feature	Disturbances in eating behaviors, thoughts, and emotions	Loss of control over eating specific foods

What Are the Complications of Eating Disorders?

The complications of eating disorders encompass severe physical, mental, and emotional impacts that can be life-threatening if left untreated. These complications fall into two main categories:

Physical Complications:

• Malnutrition leads to weakened bones, muscles, and immune system
• Irregular heart rates and blood pressure
• Electrolyte imbalance causes heart arrhythmias (especially in bulimia)
• Development of non-communicable diseases:
  • Obesity
  • Diabetes
  • Heart disease

Mental and Emotional Complications:

• Anxiety
• Depression
• Emotional distress
• Negative thoughts about:
  • Food
  • Weight
  • Body image

Both categories of complications require immediate medical attention to prevent the condition from worsening and to ensure effective treatment outcomes.

“Eating disorders place extreme stress on the body, leading to severe physical and psychological consequences. Physically, they can cause significant weight fluctuations, heart issues, electrolyte imbalances, and organ damage. Psychologically, they often result in intense anxiety, depression, and a distorted body image. The chronic stress from these disorders can profoundly impact overall health and quality of life.”

Dr. Michael Olla

What Are the Treatment Options for Eating Disorders?

The treatment options for eating disorders include psychotherapy, medication, nutritional counseling, and hospitalization. 

Treatment options for eating disorders are listed below:

1. Psychotherapy: Involves talk therapy with a mental health professional, focusing on emotional and psychological factors. Key types include cognitive behavioral therapy (CBT) and family-based therapy (FBT). Recovery can take months to years.
2. Medication: Antidepressants and mood stabilizers help manage symptoms. Recovery time ranges from weeks to months, but potential side effects must be monitored.
3. Nutritional Counseling: Registered dietitians provide advice to create a balanced eating relationship. This can take months to years and is beneficial for long-term healthy eating patterns but may not address psychological aspects.
4. Mental Health and Eating Disorder Centers: These centers offer multidisciplinary treatment plans, including medical care, psychological support, and nutritional counseling. Recovery time varies based on individual needs and severity.
5. Hospitalization: Provides intensive care in a controlled environment, with recovery time from weeks to months. It offers 24/7 medical attention but can be costly and time-consuming.
6. Support Groups and Counseling: Community support through groups like Eating Disorders Anonymous helps individuals share experiences and emotions. This is a long-term recovery approach, but may not suffice in severe cases. For more information on support groups, visit this 12-step program.

Can You Prevent an Eating Disorder?

While it’s complicated to prevent an eating disorder, there are certainly some precautions that can be taken to reduce the risks. Early education on healthy food patterns and promoting self-esteem can prove to be helpful.

Can Stress Lead to An Eating Disorder?

Yes, stress can lead to the development of an eating disorder. Stressful events in life, like trauma or life challenges, can influence the triggering of certain eating disorders. Stress impacts hormonal balance, which further deteriorates appetite and health.

Are Eating Disorders Genetic?

Yes, eating disorders can be caused by genetic factors. However, genetics is among other factors that can have an influence on the onset of eating disorders. 

According to Donato, K.’s 2022 study, ‘Gene variants in eating disorders. Focus on anorexia nervosa, bulimia nervosa, and binge-eating disorder’, eating disorders have a strong genetic component, contributing to 33-84% of the risk for anorexia, 28-83% for bulimia, and 41-57% for binge eating.