Eating Disorders

Eating disorders are not just about food, weight, vanity or willpower, but are serious and potentially life-threatening mental disorders. Most eating disorders occur when a person has distortions in thoughts and emotions relating to body image, leading to marked changes in eating or exercise behaviors that interfere with the person’s life.

The median age of onset for eating disorders ranges from 18 to 20 years (50% have onset before these ages). A high proportion of people with eating disorders also have another mental disorder, particularly anxiety, mood or substance use disorders. However, less than one-third of people with eating disorders received treatment for a mental health problem in the past 12 months. Eating disorders have the highest mortality rate of any mental illness. 

Behavioral:

• Dieting behaviors, such as fasting, counting calories, avoidance of food groups or types
• Evidence of binge eating
• Evidence of vomiting or laxative use
• Excessive, obsessive or ritualistic exercise patterns
• Changes in food preferences
• Development of rigid patterns around food selection, preparation, and eating such as cutting food into small pieces, or eating very slowly
• Avoidance of eating meals
• Lying about amount or type of food consumed, or evading questions about eating and weight
• Behaviors focused on body shape and weight
• Development of repetitive or obsessive behaviors relating to body shape and weight, such as pinching waist or wrists, repeated weighing or excessive time spent looking in mirrors
• Social withdrawal or avoidance of previously enjoyed activities

Physical:

• Weight loss or weight fluctuations
• Sensitivity to cold or feeling cold most the time, even in warm temperatures
• Changes in menstruation
• Swelling around cheeks or jaw, calluses on knuckles, or dental discoloration from vomiting
• Fainting

Psychological:

• Preoccupation with food, body shape, and weight
• Extreme body dissatisfaction
• Distorted body image, such as complaining of being, feeling, looking fat when actually having a healthy weight or being underweight
• Sensitivity to comments or criticism about exercise, food, body shape, or weight

• Assess for risk of suicide or harm
• Listen nonjudgmentally
• Give reassurance and information
• Encourage appropriate professional help
• Encourage self-help and other support strategies

• Mental Health America
• National Association of Anorexia Nervosa and Associated Disorders
• National Council for Behavioral Health
• National Eating Disorders Association
• National Institute of Mental Health
• Substance Abuse and Mental Health Services Administration