Understanding Eating Disorders

We all need to eat, and most of us look forward to eating. More than nourishing our bodies, food is often a big part of getting together with the people we love. Indeed, it’s hard to imagine what life would be like without the many social events we have built around sharing food.

But for people with eating disorders, unhealthy relationships with food and body image can cause major social, emotional, and physical problems. Left untreated, eating disorders can lead to serious consequences like organ failure—or even death.

Common Types of Eating Disorders

There are many different types of eating disorders, and some people may experience symptoms of more than one disorder. The most common eating disorders are:

  • Anorexia nervosa: A condition characterized by deliberate efforts to severely restrict food intake (despite low body weight), often to the point of clinical starvation.
  • Bulimia nervosa: A condition in which someone eats large quantities of food and then purges it via induced vomiting, exercising excessively just after a binge, or using laxatives, diuretics, or enemas.
  • Binge-eating disorder: A condition in which someone eats large quantities of food, often in a very short period of time, to the point of discomfort; they may feel that they “lose control” while this occurs.

What Causes Eating Disorders?

There are many reasons someone might develop an eating disorder—but none of them are purely about vanity. In fact, people with eating disorders often have low self esteem. Some people with eating disorders struggle with past trauma, lack of control over their lives, and feelings of inadequacy, anxiety, or depression. Controlling what they eat is one way to exert control over their lives—even when the challenges they’re struggling with has little or nothing to do with food or eating.

It is not uncommon for individuals with eating disorders to suffer from body dysmorphia—a condition in which someone becomes fixated on perceived flaws in their appearance, even when they are minor or can’t be seen by others.

Outside influences can contribute to someone developing an unhealthy relationship to food or their own body image, as well, like cultural pressures to be thin or “perfect.”

Because eating disorders depend on compulsive thoughts and behaviors—meaning the behavior feels irresistible—it can be difficult for some people to stop even when they know it’s harmful.

Who Develops Eating Disorders?

Eating disorders are common in people of all genders at all stages of life. In fact, 9% of the U.S. population will develop an eating disorder in their lifetime. But they are most common in teenagers and young women: research shows that up to 13% of young people may experience at least one eating disorder by age 20.

Signs and Symptoms of Eating Disorders

Living with an eating disorder can be challenging, especially since food is such a central part of our lives.

It can sometimes be hard to tell the difference between an eating disorder and typical weight concerns or dieting—especially in a culture where dieting is common. It can also be hard to notice an eating disorder, because people who binge, purge, or starve themselves often hide their behavior. If you suspect someone you know is struggling with an eating disorder, check for these warning signs:

Changes in Behaviors Around Food and Body Image

  • Starving themselves or restricting their food intake, like eating significantly below normal daily requirements of calories per day
  • Acting extremely controlling around food and/or wanting to eat in private
  • Exercising excessively
  • Purging, including self-induced vomiting or misuse of laxatives, diuretics or enemas
  • Spending long, unexplained amounts of time in the bathroom, or needing to run to the bathroom right after each meal
  • Consuming a large amount of food very quickly and being unable to stop
  • Exhibiting limited spontaneity around food and/or heightened stress around meal time

Obsessive Thinking About Food and Body Image

  • Preoccupation with being thin
  • Belief they are fat no matter how thin they are
  • Hiding their very thin body with big, bulky clothing
  • Negative body image and frequent negative comments about their body
  • Rigid rules and beliefs about what foods can be eaten and how they should be eaten
  • Setting high standards for how successful they are at controlling their weight

Changes in Mood

  • Exhibiting depression or anxiety
  • Becoming defensive or irritable when approached about their eating habits
  • Acting controlling about letting others see their emotions, or being very restrained in their emotions
  • Feeling guilt, helplessness, or low self-esteem

Changes in Physical Appearance

  • Rapid or excessive weight loss
  • Constantly feeling cold
  • Dry, yellowish skin
  • Fine hair
  • Brittle nails
  • Mouth lesions, chronic sore throat, or “chipmunk cheeks” (when the glands on the sides of the jaw enlarge) caused by frequent purging
  • Girls with very low weight may not get their periods

How to Reach Out to Someone With an Eating Disorder

If someone you know is displaying warning signs of an eating disorder, it is important not to ignore your concerns. Being honest about what you notice and being courageous enough to start a conversation about what you notice could help save your loved one’s life. While it’s important to express your concerns, there are more and less effective ways to start the conversation. Consider the tips below.

Try to:

  • Pick a time when you can speak in private, preferably in person.
  • Express your concerns in a caring, non-judgmental way. Try to remain calm, respectful and positive while you talk.
  • Have concrete examples ready. It’s important to be direct and share what you’ve noticed about the changes in their behavior.

Try to Avoid:

  • Commenting on how the person looks. It may seem counterintuitive, but even a compliment can reinforce the focus on image and weight.
  • Suggesting simple solutions, or saying it will be easy to stop their behavior: “If you’d just stop, everything would be fine!”
  • Criticizing their eating habits.
  • Trying to trick or force them into eating. People with eating disorders are usually using food to gain control over their lives when they feel they don’t have any. Making demands about what they eat will only make things worse.

If your friend or loved one doesn’t want to talk about it or doesn’t respond well, don’t give up. Keep checking in. Let them know that you care and that you’ll be there when they’re ready to talk—and hopefully seek treatment. Seeking treatment for an eating disorder is important. People who develop eating disorders, especially people who have lived with one for a long time, will most likely need support from a mental health professional to change their relationship with food and develop healthier ways to cope.

Seeking Help for An Eating Disorder

Eating disorders tend to get worse the longer over time—and if left untreated, they can cause serious long-term health issues. So if you think that someone you know might have an eating disorder, the sooner you express your concerns, the better their chances at recovery. Or if you think you may be struggling with your relationship with food, it’s never too early to reach out for help.

If you feel you or someone you know needs help with an eating disorder, visit the National Eating Disorders Association (NEDA) website, or call or text the NEDA hotline: 800-931-2237.

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