Various eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), avoidant restrictive food intake disorder (ARFID), and binge eating disorder (BED), are described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the record of all officially recognized mental health disorders.
Still, there are many other types of eating disorders that may not fit into any of these categories. The DSM-5—the latest version of the manual—refers to these conditions as either:
- Other specified feeding and eating disorders (OSFED)
- Unspecified Feeding or Eating Disorder (UFED)
And more is being discovered about these conditions all the time.
What are Eating Disorders?
Despite their name, eating disorders involve many factors not directly related to food. Instead, the term describes a group of mental health conditions, which manifest as a range of disordered eating patterns.
These behaviors can include:
- Binge eating or compulsive eating.
- Restriction (of amount of food, type of food, or both).
- Purging and other compensatory behaviors.
- Copious, rigid rules about food and exercise.
Often, these food-related behaviors are accompanied, or maintained, by certain social tendencies or psychological conditions. Many people with different types of eating disorders simultaneously struggle with one or more co-occurring mental health disorders, and may experience or exhibit: (12)
- Anxiety disorders.
- Autism.
- Depression.
- Social isolation.
- Discomfort or erratic behavior around mealtimes.
And while science is increasingly finding that genetics play a big role in who develops an eating disorder, a person’s life experiences and environment both contribute to the expression of nearly every type of eating disorder.
The Most Common Types of Eating Disorders
Whether they’re more clearly recognizable or have been studied for longer, there are some types of eating disorders that occur—or are diagnosed—more commonly than others.
Bulimia nervosa is a condition that affects people of all genders which is characterized by a cycle of binging and purging/compensating. Unfortunately, not enough research has been collected around eating disorders among the transgender and nobinary populatons.
“Binging” is considered any episode where someone eats, within a two hour period, an amount of food much larger than normal and beyond what is needed to meet the body’s requirements. These episodes are accompanied by the sense of a loss of control. (2)
“Purging” describes a compensatory behavior someone partakes in after a binge, which may involve vomiting or misusing laxatives. Non-purging compensatory behaviors include misusing other medications or engaging in excessive exercise.
To be considered part of an official BN diagnosis, these behaviors must occur, on average, at least once a week over the course of three months. A person must also have inaccurate ideas about their own body weight, shape, and size to fit the criteria.
If left unchecked, this dangerous disorder can lead to a number of digestive and dental complications, issues with electrolytes that can lead to heart health irregularities, and, eventually, death.
Thankfully, certain treatments have proved particularly effective at helping people recover from BN. A type of psychotherapy called Cognitive Behavioral Therapy (CBT) has been found especially helpful. Using this technique and others, up to 74% of people with bulimia nervosa are able to make a full recovery after seeking treatment. (3)
Anorexia nervosa is described in the DSM-5 as including both severe food restriction and an intense fear of gaining weight.
To officially qualify under the manual’s criteria, a person must have a body weight that’s significantly low compared to the normal requirements for their age, sex, physical health, and developmental trajectory. Their fear of gaining weight will interfere with any attempt to change their disordered eating patterns. And these behaviors must persist for at least three months to be part of an official diagnosis.
Due to the inclusion of weight criteria in the DSM-5 definition of AN, many people struggling with this disorder have difficulty being diagnosed because of genetic differences which mean that their bodies may not reach a low weight or even lose weight at all in response to severe restriction. Regardless of current weight or history of weight loss, people with AN may exhibit the following symptoms:
- A preoccupation with food, be it calories, nutritional information, or types of diets.
- A fixation on body shape, size, and weight.
- Food rituals, including eating foods in certain orders, rearranging foods on the plate, or excessive chewing.
- Consistent avoidance of shared mealtimes.
When left untreated, AN it can be one of the most dangerous—and, unfortunately, deadly—types of eating disorders.
Recovery from AN is possible. A technique called Cognitive Remediation Therapy (CRT) has been found especially effective at helping people put this disorder behind them. This type of psychotherapy focuses on building mental flexibility and confidence in one’s own ability to take care of themselves.
Binge eating disorder is less well known than AN or BN but has impacted an estimated 2.8 million people since its official recognition by the DSM in 2013. (4)
The condition is similar to bulimia nervosa, consisting of the same type of binging episodes (defined the same way in the DSM-5). Occurring at least once a week for at least three months, these episodes are marked by the sense of a loss of control, and characterized by:
- Rapid eating.
- Eating when not hungry.
- Eating until uncomfortable.
- A feeling of embarrassment or disgust related to the amount consumed.
Unlike those with BN, however, people struggling with BED do not experience a purging cycle. BED can result in a variety of physical health complications including weight cycling, gastrointestinal issues, and the risk of gastric rupture. And people with BED are sadly also at a higher risk of suicidal ideation, suicide attempts, and substance use. (5)
A number of causes have been attributed to the development of BED, including a person’s sensitivity to stress. (6) As with other types of eating disorder behaviors, the cycle of binging (which may be a response to stressful life events, difficult emotions, and/or physical and mental food restriction) can become compulsive over time. (6)
Once again, cognitive behavioral therapy has been found to be a useful tool for helping people struggling with this condition. The method helps people recognize their own unhelpful thought and behavioral patterns, and teaches them new, healthier strategies for coping with these hurtful feelings and thoughts.
Other Types of Eating Disorders
In addition to AN, BN, and BED, there are many other types of eating disorders, both specified and unspecified. OSFED (Other Specified Feeding or Eating Disorder) is thought to impact as much as 6% of the population, while UFED (Unspecified Feeding or Eating Disorder) is used to describe one of every 150 eating disorder patients. (7)
These “umbrella” conditions still represent serious, yet treatable, mental health disorders, even though they can encompass a greater variety of behaviors. Some other common types of eating disorders include:
- Orthorexia: An unhealthy and obsessive fixation on eating only “healthy” foods.
- Exercise addiction disorder: A disruptive dependency on an excessive exercise routine.
- Pica: Eating substances other than food.
- Night eating syndrome: Eating after waking up in the middle of the night, and consuming a majority of calories at night.
- Avoidant/Restrictive Food Intake Disorder: A strong aversion to certain textures, smells, or other sensory characteristics of food, a fear of physical consequences such as choking from eating food, or an overall lack of interest in eating.
Yet while OSFED and UFED can take any number of forms, as their names may suggest, there are a number of general signs and symptoms that may point to these types of eating disorders, including: (7)
- An unhealthy fixation on food, calories, health, or nutrition.
- Self-consciousness when eating in front of others.
- Irritability and mood swings.
- Poor body image or a fixation on body size, shape, and weight.
- Low confidence or self-esteem.
- Strange or erratic behavior around mealtimes.
And just like people with defined types of eating disorders, people struggling with any disordered eating pattern can find help in many different types of therapy.
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Who is At Risk of Getting an Eating Disorder
Eating disorders impact all types of people, no matter their age, race, gender, or body shape. However, some people may be more predisposed to developing an eating disorder than others.
Some factors that put someone at a higher risk of developing an eating disorder include: (8)
- Having a close relative with an eating disorder.
- Having a close relative with a mental health condition.
- Struggling with a mood disorder, especially depression or anxiety.
- Having a negative body image or poor self-esteem.
- Experiencing perfectionism.
- Exhibiting behavioral inflexibility.
- Being teased or bullied, especially over weight.
- Experiencing trauma, including sexual, physical, and mental abuse.
- Being lonely or isolated from social groups.
It’s important to remember that a complex combination of biological, social, and environmental factors often work together when it comes to the development of an eating disorder.
Some people are born with a predisposition to develop certain disorders but never experience a combination of environmental and life experience factors that trigger an eating disorder to develop.
Eating Disorder Statistics
Eating disorders are the second-most deadly type of mental health disorder, following only opioid addiction. (1) Yet, unfortunately, universally agreed-upon statistics on the conditions are hard to come by.
Most factors dealing with different types of eating disorders are taken piecemeal from particular studies, or collected by various organizations using different questions or qualifiers.
Thanks to years of testing and investigation, some general numbers can be fairly applied:
- An estimated 9% of the U.S. population—or 28 million people—will experience an eating disorder in their lifetime. (1)
- Less than 6% of eating disorder patients are at very low body weights. (1)
- More than 50% of eating disorders are related to genetic inheritance. (9)
- Of these cases, up to 50% are triggered by changes during puberty. (10)
- Up to 95% of eating disorder patients have experienced potentially traumatic events in their life. (11)
- An estimated 26% of people struggling with eating disorders will attempt suicide. (1)
Increasing attention has also been paid recently to historically underserved groups, including BIPOC, the LGBTQ+ community, and people with disabilities, and emerging research is finding that these groups may experience eating disorders at higher rates and suffer from underdiagnosis.
95% of those with eating disorders have experienced traumatic events.
Although eating disorders are complex and destructive conditions, recovery from them remains possible and help is available.
Within Health offers personalized remote eating disorder treatment backed by years of experience.
Within’s IOP and PHP programs offer meal kit deliveries, a numberless scale, a convenient app to attend therapy sessions and view your schedule, and so much more.
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Resources
- Eating disorder statistics: General & Diversity stats: Anad. National Association of Anorexia Nervosa and Associated Disorders. (2022, June 8). Retrieved June 24, 2022, from https://anad.org/eating-disorders-statistics/
- Bulimia nervosa. National Eating Disorders Association. (2018, February 22). Retrieved June 24, 2022, from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bulimia
- Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biological Psychiatry, 61(3), 348–358. https://doi.org/10.1016/j.biopsych.2006.03.040
- Shining a light on binge eating disorder (B.E.D.) in adults. National Eating Disorders Association. (2018, February 21). Retrieved June 27, 2022, from https://www.nationaleatingdisorders.org/blog/shining-light-binge-eating-disorder-bed-adults
- Conti, C., Lanzara, R., Scipioni, M., Iasenza, M., Guagnano, M. T., & Fulcheri, M. (2017). The relationship between binge eating disorder and suicidality: A systematic review. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.02125
- Mathes, W. F., Brownley, K. A., Mo, X., & Bulik, C. M. (2009). The biology of binge eating. Appetite, 52(3), 545–553. https://doi.org/10.1016/j.appet.2009.03.005
- Ekern, B., Ekern, B., About Baxter EkernBaxter is the Vice President of Ekern Enterprises, & View all posts by Baxter Ekern →. (2016, March 8). Unspecified feeding or eating disorder (UFED): Signs and symptoms. Eating Disorder Hope. Retrieved June 27, 2022, from https://www.eatingdisorderhope.com/blog/unspecified-feeding-or-eating-disorder-ufed-signs-and-symptoms
- Risk factors. National Eating Disorders Association. (2018, August 3). Retrieved June 27, 2022, from https://www.nationaleatingdisorders.org/risk-factors
- Berrettini W. (2004). The genetics of eating disorders. Psychiatry (Edgmont (Pa. : Township)), 1(3), 18–25.
- Person. (2007, May 9). MSU research uncovers genetic risk factors for eating disorders. MSUToday. Retrieved June 27, 2022, from https://msutoday.msu.edu/news/2007/msu-research-uncovers-genetic-risk-factors-for-eating-disorders
- Tagay, S., Schlottbohm, E., Reyes-Rodriguez, M. L., Repic, N., & Senf, W. (2014). Eating disorders, trauma, PTSD, and psychosocial resources. Eating disorders, 22(1), 33–49. https://doi.org/10.1080/10640266.2014.857517
- Dual diagnosis & co-occurring disorders. Eating Disorder Hope. (2022, May 5). Retrieved June 24, 2022, from https://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring-dual-diagnosis