All types of eating disorders can affect people across cultures and genders. Their symptoms vary and can be life threatening in some cases, but each is treatable.
There are eight types of feeding and eating disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Eating disorders can be life threatening if they are not addressed.
Despite common myths, eating disorders can affect anyone, regardless of any demographic. According to the National Association of Anorexia Nervosa and Associated Disorders, eating disorders affect at least 9% of the world’s population.
Every type of eating disorder has its own symptoms and criteria for diagnosis. However, it’s possible to experience symptoms of multiple eating disorders or a combination of many different symptoms. It is also possible to shift from one eating disorder to another over time.
Eating disorders are mental health conditions marked by a persistent disturbance in eating behaviors connected to distressing emotions or thoughts. Effects caused by eating disorders can be:
The typical eating habits of those with an eating disorder can cause significant health issues and even endanger their life if not treated.
Eating disorders are complex mental health conditions that do not have one known cause.
A common misconception is that disordered eating only centers around one’s perception of body image. While body dysmorphia and poor body image can contribute to eating disorders, it is not necessarily always a driving factor.
Many factors can contribute to eating disorders, including:
- genetic predisposition
- cultural pressures
- how you manage food
- trouble coping with stress
- underlying mental health conditions
The DSM-5 identifies eight feeding and eating disorders with specific criteria and symptoms.
People with pica tend to eat nonfood substances that carry no nutritional value. Although it can be developmentally appropriate for children under age 2 to put different objects in their mouth, any similar activity after that age may be a cause for concern.
The types of substances ingested depend on the individual, their age, and their environment. Some things people with pica commonly eat include:
- paint chips
Common contributing factors for pica include:
- mental or developmental disorders
- childhood trauma or neglect
- living in an under-resourced community
- autism spectrum disorder (ASD)
- iron deficiency or anemia
Pica can carry serious health risks related to eating dangerous substances, including lead poisoning.
Those with pica may also have a higher risk of:
- nutritional deficiencies (malnutrition)
- vitamin deficiencies
- electrolyte imbalances
The digestive system may also be seriously impacted by pica. When your body cannot break down nonfood substances, it can lead to injuries that may be life threatening in some cases, such as:
- bowel obstruction (blockage)
- holes in the intestines
The main symptom of rumination disorder is repeatedly regurgitating recently eaten food, followed by spitting out, rechewing, or swallowing the contents.
People with rumination disorder do not typically experience:
- involuntary vomiting urges
- feelings of disgust
Rumination disorder can be diagnosed in infants, children, and adults. However, this condition is easily overlooked or
People with rumination disorder may avoid eating in the presence of others. You may cover your mouth and pretend to cough when regurgitating food. Many people with rumination disorder recognize that this behavior could be seen as rude or socially inappropriate, but they are typically unable to resist the urge to regurgitate.
There is a link between this eating disorder and:
- lack of stimulation
If left untreated, rumination disorder may cause malnutrition and esophageal damage.
Avoidant/restrictive food intake disorder (ARFID)
Avoidant/restrictive food intake disorder (ARFID) is characterized by severely limiting your diet and eating only certain kinds of food. Previously, this condition was called “selective eating disorder.“
However, ARFID isn‘t just extreme picky eating. With ARFID, you may avoid certain foods or entire food groups. You may also seriously restrict the overall amount of food you eat in general.
ARFID often stems from a fear of something bad happening when you eat, like poisoning, choking, or vomiting.
Sometimes, ARFID can be connected to sensory disorders as well as autism spectrum disorder (ASD). People with ARFID might limit their eating to avoid foods with certain features they might be sensitive to, such as:
Other common symptoms of ARFID can include:
- dramatic weight loss
- disinterest in food
- anxiety around eating
- avoiding social events that include food and eating
- difficulty chewing or swallowing
- low energy from inadequate nutrition
- intolerance for cold temperatures
- gastrointestinal issues, like stomach pain or constipation
ARFID can progress to a point where a feeding tube or supplements are necessary to deliver essential, life-sustaining nutrients.
Anorexia nervosa often presents similar external symptoms as ARFID, especially with restrictive eating. However, those with anorexia do not avoid eating because of sensitivity to certain foods.
People with anorexia nervosa typically restrict their eating based on a fear of gaining weight. Sometimes, body image distortions don’t necessarily reflect the reality of how you look, causing significant disturbance in how you see yourself.
Signs and symptoms of anorexia can include:
- significant weight loss
- hair loss or development of fine, downy lanugo hair on the skin
- frequently feeling cold
- dressing in baggy clothes or layers
- dry, brittle skin and nails
- isolating or eating alone
- poor body image
- preoccupation with food, weight, and dieting
- following a strict or excessive exercise schedule
- frequently making negative comments about your size, weight, or appearance
However, not everyone with symptoms of anorexia is underweight or in the low weight range.
“Atypical anorexia“ is when someone loses weight from dietary restriction but is still considered to be at an average or above-average weight. This type of eating disturbance may be diagnosed as other specified feeding or eating disorder (OSFED) and can be just as serious as other eating disorders.
Anorexia treatment can be effective.
According to the DSM-5, a diagnosis of bulimia nervosa is based on regular binge eating and engaging in compensatory behaviors to “undo“ the effects of overeating. Binge eating means eating an unusually large amount while experiencing loss of control over the eating episode.
The most common form of compensatory behavior is vomiting. Someone with bulimia nervosa may eat a large amount of food or binge eat, and then vomit or misuse laxatives, diuretics, or enemas afterward.
People with bulimia may also attempt to compensate for eating large amounts through fasting or exercising excessively after binge eating.
It’s common for people with bulimia to feel out of control or like they can’t stop during binge eating, followed by a feeling of shame and guilt.
Signs of bulimia nervosa can be physical, emotional, or behavioral. They may include:
- broken blood vessels on the face or in the eyes
- frequently feeling cold
- tooth decay
- excessive exercise
- going to the bathroom right after eating
- feeling uncomfortable eating with others
- frequently using mouthwash, mints, or gum
- being overly concerned with body image and weight
Untreated bulimia can lead to severe health issues and can become life threatening. Binge eating and purging can harm the entire body and cause effects such as:
- Cardiovascular: irregular heartbeat (arrhythmia), low blood pressure, heart failure
- Gastrointestinal: esophageal damage, pancreatitis, constipation and bowel obstruction, low blood sugar
- Endocrine: anemia, menstrual irregularities, bone loss, insulin resistance (which can lead to type 2 diabetes), kidney failure
- Neurological: problems focusing and concentrating, seizures, sleep disorders and sleep apnea, stroke
Binge eating disorder (BED)
Like bulimia nervosa, eating large quantities of food in one sitting is a main symptom of binge eating disorder (BED). But unlike bulimia, people with BED do not engage in compensatory behaviors after binge eating.
It’s common to overeat sometimes. However, binge eating may feel uncontrollable to someone with BED.
With BED, you may not show any signs of significant weight loss, or you may experience significant weight gain. Signs and symptoms of BED can include:
- feeling guilt after bingeing
- challenges managing food intake
- eating in secret
- stealing or hoarding food
- the tendency to schedule or create rituals around binge eating
Though all eating disorders are treatable, people with binge eating disorder may respond better to treatment than others.
Other specified feeding or eating disorders (OSFED)
Other specified feeding or eating disorders (OSFED) is typically diagnosed when someone has symptoms of eating disorders but doesn’t meet the criteria for any of the eating disorders listed in the DSM-5.
The OSFED classifications cover a broad range of conditions. Symptoms of OSFED often cause stress, social problems, and affect functioning in other areas of life.
Like all eating disorders, OSFED can become severe and life threatening if left untreated.
Eating disorders that fall under the OSFED classification include:
- Atypical anorexia nervosa: similar to anorexia nervosa with weight loss and potential nutritional and medical side effects, though they are at an average or above-average body weight
- Purging disorder: self-induced vomiting, excessive laxative use, or the use of other medications not following an episode of binge eating
- Night eating syndrome:frequently waking up and eating, or excessive eating in the evenings after dinner
Unspecified feeding or eating disorder (UFED)
Unspecified feeding or eating disorders (UFED) are often diagnosed when the symptoms presented do not meet the specific criteria for a known disorder.
A UFED diagnosis is typically the result of a lack of information. For example, an emergency room doctor might examine an unconscious person, finding significantly low weight and malnutrition. Even if the underlying condition is not known, the doctors might conclude UFED is present.
Every type of eating disorder is treatable with the right support. If you or a loved one might have an eating disorder, help is available.
Many people of all genders, races, and backgrounds recover from eating disorders and build healthy, balanced relationships with food.
Treatment for eating disorders is often tailored to your specific symptoms and triggers. A treatment plan may include:
- monitoring by your doctor
- nutritional counseling
For severe or progressed cases, inpatient or outpatient treatment centers may offer the most help. Everyone is different, and it may take time and effort to find the right treatment plan for you.
If you think you may be dealing with an eating disorder, you’re not alone. Recognizing an unhealthy relationship with food is often the first step toward recovery.
Talking with someone you trust — such as a loved one or friend — can be an important factor in getting help.
However, only a doctor or therapist can diagnose an eating disorder. They can also help you find the best treatment plan for you.
If you’re ready to seek help, you can visit the Psych Central guide to finding mental health care.
You can also contact the National Eating Disorder Association hotline by calling or chatting online with someone who can help.