Anorexia, bulimia and binge-eating disorder affect physical and mental health. Learn about symptoms, causes, risk factors, diagnosis and treatment options.
Eating disorders are serious health conditions that affect both your physical and mental health. These conditions include problems in how you think about food, eating, weight and shape, and in your eating behaviors. These symptoms can affect your health, your emotions and your ability to function in important areas of life.
If not treated effectively, eating disorders can become long-term problems and, in some cases, can cause death. The most common eating disorders are anorexia, bulimia and binge-eating disorder.
Most eating disorders involve focusing too much on weight, body shape and food. This can lead to dangerous eating behaviors. These behaviors can seriously affect the ability to get the nutrition your body needs. Eating disorders can harm the heart, digestive system, bones, teeth and mouth. They can lead to other diseases. They're also linked with depression, anxiety, self-harm, and suicidal thoughts and behaviors.
With proper treatment, you can return to healthier eating habits and learn healthier ways to think about food and your body. You also may be able to reverse or reduce serious problems caused by the eating disorder.
Symptoms vary, depending on the type of eating disorder. Anorexia, bulimia and binge-eating disorder are the most common eating disorders. People with eating disorders can have all different body types and sizes.
Anorexia (an-o-REK-see-uh), also called anorexia nervosa, can be a life-threatening eating disorder. It includes an unhealthy low body weight, intense fear of gaining weight, and a view of weight and shape that is not realistic. Anorexia often involves using extreme efforts to control weight and shape, which often seriously interfere with health and daily life.
Anorexia may include severely limiting calories or cutting out certain kinds of foods or food groups. It may involve other methods to lose weight, such as exercising too much, using laxatives or diet aids, or vomiting after eating. Efforts to reduce weight can cause severe health problems, even for those who continue eating throughout the day or whose weight isn't extremely low.
Bulimia (buh-LEE-me-uh), also called bulimia nervosa, is a serious, sometimes life-threatening eating disorder. Bulimia includes episodes of bingeing, commonly followed by episodes of purging. Sometimes bulimia also includes severely limiting eating for periods of time. This often leads to stronger urges to binge eat and then purge.
Bingeing involves eating food — sometimes an extremely large amount — in a short period of time. During bingeing, people feel like they have no control over their eating and that they can't stop. After eating, due to guilt, shame or an intense fear of weight gain, purging is done to get rid of calories. Purging can include vomiting, exercising too much, not eating for a period of time, or using other methods, such as taking laxatives. Some people change medicine doses, such as changing insulin amounts, to try to lose weight.
Bulimia also involves being preoccupied with weight and body shape, with severe and harsh self-judgment of personal appearance.
Binge-eating disorder involves eating food in a short amount of time. When bingeing, it feels like there's no control over eating. But binge eating is not followed by purging. During a binge, people may eat food faster or eat more food than planned. Even when not hungry, eating may continue long past feeling uncomfortably full.
After a binge, people often feel a great deal of guilt, disgust or shame. They may fear gaining weight. They may try to severely limit eating for periods of time. This leads to increased urges to binge, setting up an unhealthy cycle. Embarrassment can lead to eating alone to hide bingeing. A new round of bingeing commonly occurs at least once a week.
Avoidant/restrictive food intake disorder includes extremely limited eating or not eating certain foods. The pattern of eating often doesn't meet minimum daily nutrition needs. This may lead to problems with growth, development and functioning in daily life. But people with this disorder don't have fears about gaining weight or body size. Instead, they may not be interested in eating or may avoid food with a certain color, texture, smell or taste. Or they may worry about what can happen when eating. For example, they may have a fear of choking or vomiting, or they may worry about getting stomach problems.
Avoidant/restrictive food intake disorder can be diagnosed in all ages, but it's more common in younger children. The disorder can result in major weight loss or failure to gain weight in childhood. A lack of proper nutrition can lead to major health problems.
An eating disorder can be difficult to manage or overcome by yourself. The earlier you get treatment, the more likely you'll make a full recovery. Sometimes people can have problem eating behaviors that are similar to some symptoms of an eating disorder, but the symptoms don't meet the guidelines for a diagnosis of an eating disorder. But these problem eating behaviors can still seriously affect health and well-being.
If you have problem eating behaviors that cause you distress or affect your life or health, or if you think you have an eating disorder, seek medical help.
Many people with eating disorders may not think they need treatment. One of the main features of many eating disorders is not realizing how severe the symptoms are. Also, guilt and shame often prevent people from getting help.
If you're worried about a friend or family member, urge the person to talk to a health care provider. Even if that person isn't ready to admit to having an issue with food, you can start the discussion by expressing concern and a desire to listen.
Red flags that may suggest an eating disorder include:
If you're worried that you or your child may have an eating disorder, contact a health care provider to talk about your concerns. If needed, get a referral to a mental health provider with expertise in eating disorders. Or if your insurance permits it, contact an expert directly.
The exact cause of eating disorders is not known. As with other mental health conditions, there may be different causes, such as:
Anyone can develop an eating disorder. Eating disorders often start in the teen and young adult years. But they can occur at any age.
Certain factors may increase the risk of developing an eating disorder, including:
Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely it is that serious complications may occur. These may include:
There's no sure way to prevent eating disorders, but you can take steps to develop healthy eating habits. If you have a child, you can help your child lower the risk of developing eating disorders.
To develop healthy eating habits and lifestyle behaviors:
For more guidelines on food and nutrition, as well as physical activity, go to health.gov.
Talk to a health care provider if you have concerns about your eating behaviors. Getting treatment early can prevent the problem from getting worse.
Here are some ways to help your child develop healthy-eating behaviors:
If you notice a family member or friend who seems to show signs of an eating disorder, consider talking to that person about your concern for their well-being. You may not be able to prevent an eating disorder from developing, but reaching out with compassion may encourage the person to seek treatment.
Eating disorders are diagnosed based on symptoms and a review of eating habits and behaviors. You may see both your health care provider and a mental health professional for a diagnosis.
To get a diagnosis, you may need:
The best treatment for an eating disorder involves a team approach. The team commonly includes your primary health care provider, a mental health professional and sometimes a registered dietitian. Look for professionals with experience in treating eating disorders.
Treatment depends on your specific type of eating disorder. But in general, it includes:
If your life is at risk, you may need to go into a hospital right away.
Certain behavioral therapies can be effective in treating eating disorders. These include:
Medicine can't cure an eating disorder. No medicines have been shown to help with weight gain or to treat anorexia. For bulimia or binge-eating disorder, certain medicines may help manage urges to binge or purge or help manage an extreme focus on food and diet.
If you have serious health problems related to your eating disorder, your health care provider may recommend that you stay in the hospital for a time. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than a stay in the hospital. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.
To improve the chances of success in overcoming an eating disorder:
Alternative medicine is a popular name for health care practices that traditionally are not part of well-researched standard medicine. Complementary and integrative medicine, when based on solid research, may sometimes be used along with standard medicine — but they are not substitutes for standard medical care.
Most often when people turn to alternative or complementary medicine, it's to improve their health. But dietary supplements and herbal products designed to dampen the appetite or aid in weight loss may be unsafe and misused by people with eating disorders. Such products can have dangerous interactions with other medicines.
Weight-loss and other dietary supplements don't need approval by the U.S. Food and Drug Administration (FDA) to go on the market. The FDA maintains an online list of tainted weight-loss products, some of which can cause serious harm, such as irregular heartbeats, increased blood pressure, stroke and even death.
Talk with your health care provider before trying any alternative or complementary medicine. Natural doesn't always mean safe. Your provider can help you understand possible risks and benefits before you try a treatment.
Some complementary treatments and approaches may help reduce stress and anxiety. They can promote relaxation and increase a sense of well-being. Examples include:
It's difficult to manage an eating disorder when you get mixed messages from the media, culture, and sometimes family or friends. Whether you or your loved one has an eating disorder, ask your health care provider or a mental health professional for advice on coping and emotional support.
Learning effective coping strategies and getting the support you need from family and friends are vital to successful treatment.
Here's some information to help you get ready for your appointment. You may want to ask a relative or friend to go with you for support and to aid your memory. A family member may be able to give your provider a more complete picture of your home life.
Before your appointment, make a list of:
Some questions you might ask include:
Feel free to ask other questions during your appointment.
Your health care provider or mental health provider is likely to ask you several questions, such as:
Your provider may ask other questions based on your answers, symptoms and needs. Be ready to answer questions so you have time to discuss whatever is most important to you.