Signs and Treatments for Eating Disorders

Eating disorders are mental health conditions that involve disturbances in eating behaviors, including eating too much or too little. People with eating disorders often have a poor self-image. They may have negative thoughts about their food choices, weight, and body shape.

Some people mistakenly believe that eating disorders are lifestyle choices. However, they are serious medical conditions—and if left untreated, they can be fatal. With treatment, most people with eating disorders can recover.

Understanding the symptoms of eating disorders can help you find resources and support, whether for yourself or a loved one. Learn more about eating disorders, including types, signs, causes, and treatment options.

How to Tell If I Have an Eating Disorder

There are several types of eating disorders, each of which involves different signs and symptoms. Learn more about how to tell if you or a loved one has one of these disorders.

Signs

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), some of the most common eating disorders include:

• Anorexia nervosa (AN)
• Bulimia nervosa (BN)
• Binge eating disorder (BED)
• Avoidant/restrictive food intake disorder (ARFID)

Anorexia nervosa, usually called anorexia, involves an intense fear of gaining weight. People with anorexia go to extreme lengths to lose weight, such as severely restricting their food intake. 

Anorexia signs and symptoms include:

• Rapid, extreme weight loss
• Being underweight
• Having an extremely low body mass index (BMI)
• Eating very slowly 
• Cutting food up into very small pieces
• Avoiding social situations that involve food
• Hiding body shape with baggy clothes
• Lying about food intake 
• Blotchy skin
• Brittle nails
• Hair loss
• Dizziness
• Fatigue
• Confusion

Bulimia nervosa, often simply called bulimia, involves both binging (eating a large amount of food in a short amount of time) and purging (“compensating” for binge eating by vomiting, exercising, or using laxatives). 

The most common signs of bulimia are:

• Rushing to the bathroom immediately after eating
• Buying and/or eating unusually large amounts of food 
• Eating in secret
• Exercising excessively
• Purchasing laxatives or diuretics (water pills) frequently
• Having bad breath
• Having dental problems
• Seeing food “disappear” within a short time
• Swollen cheeks
• Having dizziness and/or fainting
• Experiencing frequent diarrhea
• Having a chronic sore throat

Binge eating disorder is an eating disorder that involves eating very large amounts of food on a regular basis. People with BED often experience feelings of helplessness or being “out of control” while binging, followed by feelings of guilt, disgust, and shame. 

Some red flags of binge eating disorder are:

• Eating a large amount of food in a short time and/or very frequently
• Eating when not hungry
• Eating very quickly
• Continuing to eat well past the point of feeling full
• Frequently eating alone
• Feeling embarrassed about eating habits
• Keeping “secret stashes” of food
• Throwing away food wrappers or containers frequently

Avoidant/restrictive food intake disorder is when a person severely restricts the number, amount, or types of food they eat. However, they don’t alter their eating habits because of problems with body image, self-esteem, or weight.

Some people with ARFID are very selective about the foods they eat because of low appetite, a lack of interest in eating, fears of choking, or concern about nausea and indigestion. Others have food aversions related to sensory processing issues, such as disliking certain textures or smells.

If you notice any of these signs in yourself or a loved one, reach out to a healthcare provider or mental health therapist about your concerns. Eating disorders are common and treatable. Help is available.

Diagnosis

Your healthcare provider can use the criteria in the DSM-5 to diagnose you with an eating disorder. In addition to asking you about your eating habits, exercise habits, and medical history, they may also perform a physical exam, blood tests, and/or psychological assessments.

If you meet many, but not all, of the criteria for an eating disorder, you may be given a diagnosis of other specified feeding and eating disorder (OSFED). For example, someone who severely restricts the amount of food they eat may be diagnosed with OSFED if their BMI is not low enough to meet the criteria for anorexia.

Why Do People Develop Eating Disorders?

Anyone can develop an eating disorder, regardless of race, age, sex, weight, background, or body shape. While there is no particular known cause of eating disorders, risk factors may include:

• Genetics: Studies show that some eating disorders (especially anorexia, bulimia, and binge eating disorder) may be passed down in families.
• Cultural factors: Many researchers believe that cultural standards of beauty, peer pressure, and media imagery often impact body image and eating disorders. For example, people who grow up in a cultural environment where extreme thinness is highly valued are more likely to develop anorexia. 
• Occupation: People involved in certain occupations or activities—such as modeling, dance, or sports—have a higher risk of eating disorders.
• Trauma: Around 50% of people with eating disorders have experienced at least one type of childhood trauma, such as sexual, emotional, and/or physical abuse.
• Personality traits: Eating disorders are strongly linked to certain personality traits, such as perfectionism, sensation-seeking, impulsivity, harm avoidance, neuroticism, dependence on reward, and passivity.
• Brain function: Imaging tests have revealed that people with eating disorders have abnormal activity levels in the areas of the brain involved in decision-making, planning, and reward processing. These differences may alter someone’s relationship with food.
• Medical history: A history of certain medical conditions, especially during childhood or adolescence, may increase the likelihood that someone will develop an eating disorder later in life. For example, research suggests that many people with ARFID experienced a gastrointestinal disorder early in life.
• Comorbid mental health conditions: Many people with an eating disorder have at least one other mental health condition. Mood disorders, substance use disorders (SUD), major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and anxiety disorders are especially common comorbid conditions.
  

How Do I Get Help If I Have an Eating Disorder?

Many people feel ashamed or afraid to seek help for an eating disorder, but treatment is available and effective.

Your healthcare provider can refer you to a therapist or eating disorder specialist who can help you find the support you need. You can also find local resources by contacting the National Eating Disorders Association (NEDA) Helpline at 800-931-2237 for yourself or a loved one.

Eating disorders often require a combination of multiple kinds of treatment from a specialized medical team. Treatment options for eating disorders may include lifestyle changes, psychotherapy, medication, and/or hospitalization.

Lifestyle Changes

Healing physically is a crucial part of eating disorder treatment. However, it’s also important to build your self-confidence, improve your body image, and find the love, joy, and support you deserve. 

Here are some ways that you can start to address your eating disorder symptoms from the inside out:

• Find a support or self-help group, whether in person or online.
• Read self-help books to learn how to improve your eating habits.
• Repeat positive affirmations to build your self-esteem.
• Practice mindfulness techniques, such as meditation and yoga.
• Take care of your body in healthy ways, like staying hydrated and getting enough sleep.
• Manage stress with relaxation techniques and deep breathing exercises.
• Develop new interests or pick up a fun hobby to keep your mind off of food and weight.
• Remind yourself to eat regularly with a self-monitoring app.
  

Psychotherapy

Many people with eating disorders change the way they eat as a way of dealing with negative emotions, stress, or trauma. Psychotherapy—including both individual and group therapy—can help you improve your decision-making skills, develop healthier coping methods, and address any comorbid mental health conditions.

Some effective forms of psychotherapy for eating disorders include:

• Cognitive behavioral therapy (CBT): Research indicates that CBT can help people with eating disorders reduce targeted, unwanted patterns of thinking and behavior, such as an obsessive focus on weight and body shape. 
• Dialectical behavioral therapy (DBT): Originally designed to treat borderline personality disorder (BPD), DBT is a type of psychotherapy that combines aspects of CBT with mindfulness techniques in order to help people learn to manage emotional distress. Studies suggest that DBT is effective in treating anorexia and bulimia, binge eating disorder, and ARFID.
• Family-based treatment (FBT): Family-based treatment, which equips parents with the skills and resources they need to stop the eating disorder “cycle,” has been shown to be especially helpful for adolescents with anorexia.
• Acceptance and commitment therapy (ACT): Acceptance and commitment therapy, which aims to help people accept their emotions and thoughts without shame or resistance, has been found to be effective in increasing self-esteem and improving overall quality of life among people with eating disorders.
• Cognitive remediation therapy (CRT): Cognitive remediation therapy focuses on improving cognitive flexibility (i.e., increasing open-mindedness and reducing rigid thinking patterns), which can be helpful for some patients with anorexia.
  

Medication

Along with psychotherapy, medications are sometimes prescribed to treat eating disorders and comorbid mental health conditions. These may include:

• Prozac (fluoxetine) for bulimia
• Vyvanse (lisdexamfetamine) for binge eating disorder
• Hormonal treatments, proton pump inhibitors, and prokinetic drugs for certain anorexia symptoms
• Antianxiety medications for comorbid anxiety 
• Antidepressants for comorbid depression

Hospitalization

In severe or complex cases, short-term or long-term hospitalization may be needed to get you on the road to full eating disorder recovery. A multimodal residential treatment plan can be tailored to meet your specific physical, mental, and/or emotional needs. 

For example, residential treatment for anorexia typically involves:

• Weight gain under the supervision of your medical team
• Medical monitoring and treatment for physical symptoms, such as dehydration and electrolyte imbalances
• Nutrition counseling from a trained dietitian 
• Psychotherapy in individual and/or group settings

Inpatient treatment may seem overwhelming or scary, but it’s often effective. Research shows that most people who go through residential treatment for an eating disorder report significant improvements in their mood, eating habits, weight, and overall quality of life.

Summary

Eating disorders are serious mental health conditions that involve disturbed eating behaviors, such as eating too much or too little. If left untreated, eating disorders can lead to severe medical consequences and even death.

The most common types of eating disorders are anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and avoidant/restrictive food intake disorder (ARFID).

People who don’t meet all the criteria for one of the eating disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) may be given a diagnosis of “other specified feeding and eating disorder” (OSFED).

Some of the most common signs and symptoms of eating disorders are extreme weight loss or gain, frequently visiting the bathroom after eating, eating very slowly or very quickly, lying about eating habits, and refusing to eat with other people.

Eating disorders are typically treated with a combination of psychotherapy, self-help programs, and medication. In some cases, treatment may require hospitalization.

A Word From Verywell

If you think you have an eating disorder, it’s important to seek help right away. Your therapist or healthcare provider can point you to valuable resources and support. They can help you improve your confidence, protect your health, and improve your quality of life.