What are eating disorders?

Eating disorders are complex medical and psychiatric illnesses that affect a person’s physical and mental health, involving intense emotions and disordered behaviors related to food. These are serious illnesses and can be fatal if left untreated.

There are several types of eating disorders and it’s easy to get them confused because symptoms may overlap. The different types include anorexia nervosa, avoidant/restrictive food intake disorder (ARFID), bulimia nervosa, binge eating disorder, and other specified feeding and eating disorders (OSFED.)

Anorexia Nervosa (pronounced: an–or–rex–e–ah nerve–o–sah) involves significant weight loss, lack of appropriate weight gain or refusal to gain weight, and a distorted body image.  People with anorexia drastically limit their food intake (known as food restriction, which also involves cutting out certain foods/food groups) and have an intense fear of gaining weight, even though they may be underweight or have lost a significant amount of weight. Anorexia nervosa often presents during early adolescence (11–13 years of age) or during the later high school years (17–18 years of age), when a teen is preparing to go to college, but can occur in people of any age. Someone with anorexia may or may not binge and/or purge.

Avoidant/Restrictive Food Intake Disorder (ARFID) is a feeding and eating disorder characterized by limiting intake of food or food groups without a fear of weight gain. This eating style can lead to consequences such as weight loss, inadequate growth, or a significant nutritional deficiency. ARFID often presents during early adolescence, with the average age of onset being 12-13 years old. Unlike people with other eating disorders such as anorexia nervosa, individuals with ARFID do not have significant body image concerns.

Bulimia Nervosa (pronounced: bull–e–me–ah nerve–o–sah) involves cycles of binge eating followed by a purging behavior. People with bulimia will eat an unusually large amount of food in a short period of time and then purge by vomiting, using laxatives, enemas, or diuretics, or by exercising excessively as a way to counteract the binge and avoid gaining weight.

Binge eating disorder involves eating an unusually large amount of food in a short period of time. People with binge eating disorder feel out of control during these eating episodes and often feel intense shame or guilt afterwards. People with binge eating disorder do not purge after bingeing.

Other specified feeding and eating disorders (OSFED) involve some combination of symptoms of the other eating disorders such as an intense fear of weight gain and preoccupation with food (thinking about food or having food related thoughts most of the day) but do not meet full criteria for another eating disorder. Many individuals with OSFED have a variety of eating disorder symptoms.

Disordered eating is a term used to describe the condition when someone doesn’t have all the symptoms of a specific type of eating disorder, but their eating patterns and behaviors put them at risk for developing an eating disorder. For example, extreme dieting or orthorexia (an obsession with healthy eating) can lead to an eating disorder.

Prevalence rates or how often eating disorders occur varies with each disorder and are difficult to pinpoint as many people suffering may never seek treatment and/or be diagnosed. Binge eating disorder and OSFED are typically more common than anorexia nervosa and bulimia nervosa. Roughly 5.4% of adolescents age 13-18 will suffer from anorexia, bulimia, or binge eating disorder at some point, with the rate of OSFED or disordered eating likely higher.