Many different types of eating disorders exist and affect roughly 20 million women and 10 million men in the United States alone. More than just a peculiar set of rules or conditions surrounding meals and diet, eating disorders are characterized by food choices and behaviors surrounding food that are actively harmful, detrimental, and unhealthy.
Eating disorders, in general, encapsulate eating behaviors that play a role in debilitating a person in their day-to-day life. These are complex physical and mental health conditions that are not always easily categorized.
Different Types of Eating Disorders
Currently, there are over half a dozen different specific types of eating disorders, as well as a catch-all term for cases of eating behavior that does not fit into existing criteria yet is still endangering a patient’s life.
In addition to being relatively common, eating disorders are also incredibly dangerous. Eating disorders have some of the highest mortality rates among mental health conditions and can severely impact a person’s physical health.
Some conditions, like pica, can be immediately fatal. Others can lead to long-term health consequences, such as dental damage caused during bulimia and damage dealt to the heart and other vital organs due to overfeeding/underfeeding for years.
Identifying and treating eating disorders as early as possible is important. What might start out as health-conscious behavior or a fasting diet could be a loved one’s first steps toward disordered eating. Keep an eye out for common signs and symptoms, and contact a professional if you have any concerns for your loved one’s safety and health.
1. Anorexia Nervosa
Anorexia nervosa is one of the three most common eating disorders. It is characterized by severe underfeeding and an obsession with body weight and calorie tracking.
A person struggling with anorexia nervosa will see themselves as overweight even as they approach single digit bodyfat. Patients with anorexia are typically dangerously underweight. Body dysmorphia, or a distorted sense of one’s own body image, is a common element in cases of anorexia nervosa. Other common signs include:
- Very sudden and drastic weight loss.
- Dressing up in many layers to hide weight loss.
- Preoccupied with losing weight, finding ways to lose weight, different exercise regimens, counting calories, counting fat, counting carbs, etc.
- Frequently mentioning being fat despite being skinny.
- Exercising despite fatigue, injury, or worsening health conditions.
- Stopped menstruating.
- Using legal or illegal appetite suppressants (diet pills, over-the-counter drugs, prescription medication, nicotine).
2. Bulimia Nervosa
Bulimia nervosa is another of the three most common eating disorders. Bulimia is characterized by binge eating and subsequent purging. Purges don’t always involve vomiting, although they often do.
Other purging methods include the abuse of laxatives and diuretics to force weight loss. Bulimia nervosa is also characterized by its cyclical nature – a person will go through a period of harsh dieting and fasting before relapsing into a massive binge, and then purging by inducing vomiting or using laxatives to compensate for the binge and lose excess calories.
Patients with bulimia tend to look more physically robust than patients with anorexia, but the cycle of fasting, binging, and purging can still have a drastically negative effect on their health, particularly their throat, teeth, organs, and digestive system. Signs of bulimia nervosa include:
- Frequent food binges, often alone.
- Evidence of food binges (empty wrappers, frequent fast-food orders, large amounts of food disappearing).
- Signs of purging behavior (frequent bathroom visits after meals, signs of frequent vomiting, diuretics, or laxatives)
- Excessive use of mouthwash/mints/gum.
- Calluses on the back of the hand/knuckles of the index and middle fingers.
- Worsening dental health (eroded enamel, cavities, discolored teeth)
3. Binge Eating Disorder
The last of the most common eating disorders is binge eating disorder. This condition is characterized by frequent food binges without purging events. A person with a binge eating disorder may try to control their diet via excessive course correction, such as harsh diets or strict elimination diets, but will continuously lose control over their eating habits, usually in the form of one or several consecutive binges.
Food binges are almost always followed by feelings of shame and distress. Binge eating disorder is the most common eating disorder in the US and can frequently be life-threatening. Signs of binge eating disorder include:
- Frequent eating binges, often in secret.
- Feelings of shame and/or disgust towards oneself, particularly after a binge.
- Food hoarding (keeping food everywhere, including under the bed, in bags, in clothes, in a night desk, etc.)
- Creating rituals around a binge.
4. Avoidant Restrictive Food Intake Disorder
Avoidant restrictive food intake disorder (ARFID) is characterized by similar markers of low body weight and malnutrition as anorexia but without body image or body fat worries. Instead, patients with ARFID are pathologically selective in their food intake and suffer for it, without necessarily tracing their selective eating to some form of fear of fatness. Signs of ARFID include:
- Fear of choking on food.
- Incredibly selective food intake.
- Dramatically low bodyweight.
- Other physical signs of malnutrition (brittle hair and nails, etc.).
Pica is a form of eating disorder that involves the culturally and developmentally inappropriate ingestion of non-food items on a regular basis.
Very young children regularly chew on and mouth objects as they explore their senses. This can lead to accidental ingestion. Certain cultures also ingest non-food items for ritual or medicinal purposes.
Outside of these cases, the frequent ingestion of non-food items is a cause for concern. Unlike most eating disorders, pica is typically caused by an existing mineral deficiency. Usually, correcting this deficiency eliminates the pica. This happens more often in anemic children and pregnant people.
Pica is also more common in patients with a developmental condition or on the autism spectrum. In these cases, behavioral therapy can help teach them to avoid non-food items.
6. Rumination Disorder
Rumination disorder is a type of eating disorder characterized by frequently regurgitating ingested food. It is either spat out or eaten again.
Sometimes, rumination disorder is a result of a viral illness or physical injury. Certain gastrointestinal conditions can also cause the involuntary regurgitation of undigested food. However, rumination disorder can also be a result of anxiety or stress.
Rumination disorder is diagnosed instead of other conditions (such as achalasia or gastroparesis) if a patient only regurgitates their food while they are awake, shortly after mealtimes, without retching, and without responding to treatments for gastroesophageal reflux disease (mild acid reflux).
7. Other Specified Feeding and Eating Disorders
Some cases of an eating disorder are classified as Other Specified Feeding and Eating Disorders (OSFED), previously known as an Eating Disorder Not Otherwise Specified (EDNOS).
This classification is used to describe eating disorders that cannot be classified as anorexia, bulimia, binge eating, or another specific eating disorder due to falling short of the diagnostic criteria. It includes categories such as atypical anorexia, subthreshold bulimia, and subthreshold binge eating disorder.
Patients might not fulfill the criteria needed to be bulimic, anorexic, or binge eaters, but may still show clear signs of an eating disorder in their symptoms, such as an obsession with body image, a fixation around burning off calories, binge eating episodes, cycles of fasting and binging, diet-hopping, and purging behavior.
8. Unspecified Eating Disorders
Unspecified eating disorder is a term applied to cases where an eating disorder is clearly present, but a doctor lacks the time or information to make a proper diagnosis or chooses not to specify the reason that criteria are not met for another disorder.
A patient with an unspecified eating disorder did not meet the criteria for a specific eating disorder, nor did they meet the criteria for another specific feeding and eating disorder. Instead, they presented with clear signs of disordered eating but not enough criteria to clearly classify their disorder.
Eating Disorders Are Incredibly Dangerous
Regardless of what eating disorder you or your loved one is struggling with, seeking help immediately is important. A common characteristic among all eating disorders is that disordered eating cannot be controlled and that it continues to actively cause harm to a person, mentally and physically.
Professional treatment – in the form of talk therapy, medication, dietary supervision, and inpatient or outpatient treatment can help patients learn to adopt a healthier perspective, overcome their intrusive thoughts and physical anxieties, and lead happier longer lives.