The Three Most Common Eating Disorders and How They’re Diagnosed
Eating disorders represent the extremes in thought and behavior patterns surrounding eating. They can lead to serious medical problems, and they can be fatal. According to the National Association of Anorexia Nervosa and Associated Disorders, up to 20 percent of people who don’t seek treatment for an eating disorder will die.
If you’re worried that you or someone you love might have an eating disorder, you may be wondering what your next steps should be. You probably have a lot of questions and just as many worries, but it’s hard to know where to begin. This primer will help you better understand the most common eating disorders, what causes them, how they’re treated and what you can do to promote long-term recovery.
The three most common eating disorders are binge eating disorder, anorexia nervosa, and bulimia nervosa.
Binge Eating Disorder
Binge eating disorder is the most common eating disorder in the U.S., according to the National Eating Disorders Association.2 It’s characterized by episodes of eating large amounts of food, often quickly and to the point of discomfort. Binge eating disorder is not associated with compensatory behaviors like excessive exercise or purging.
An episode of binge eating is characterized by:
- Eating a larger amount of food in one sitting than most people would eat in a similar time period under similar circumstances
- Feeling a lack of control over eating during the episode
A formal diagnosis of binge eating disorder requires at least one episode of binge eating a week for at least three months. Additionally, at least three of the following must be true during a typical binge eating episode:
- Eating faster than normal
- Eating until you’re uncomfortably full
- Eating large amounts of food even though you’re not hungry
- Eating alone because you feel embarrassed about how much you’re eating
- Feeling depressed, guilty or disgusted with yourself afterward
Anorexia nervosa is a serious, life-threatening eating disorder that has the highest mortality rate of all psychiatric disorders. An estimated two percent of American women and 0.3 percent of American men have a lifetime history of anorexia, according to NEDA.3
Anorexia is diagnosed using the following criteria:
- Extreme restriction of calories relative to one’s daily energy requirements
- Low body weight for one’s age, sex and height
- Intense fear of weight gain, even in those who are underweight
- A distorted body perception, which includes denial of the seriousness of extremely low body weight
- An undue influence of body weight on self-perception and self-evaluation
Although anorexia nervosa is commonly associated with being underweight or emaciated, not everyone who has anorexia experiences extreme weight loss. Atypical anorexia is diagnosed in those who meet the criteria for anorexia except for low body weight.
Common signs and symptoms of anorexia include:
- Constant dieting and an obsession with the calorie and fat content of food
- Engaging in ritualistic eating patterns, including hiding food, cutting food into tiny pieces or eating alone
- Disrupted or absent menstruation
- Social isolation
- Depression or lethargy
- Thinning hair or hair loss
- Soft, fine hair known as lanugo growing on the face and body
Bulimia nervosa is a potentially life-threatening eating disorder characterized by a cycle of bingeing and engaging in behaviors to compensate for a binge. According to NEDA, 1.5 percent of American women and 0.5 percent of American men have a lifetime history of bulimia.
Bulimia is diagnosed using the following criteria:
- Recurrent episodes of binge eating
- A sense of a loss of control over eating during the binge
- Engaging in unhealthy behaviors to compensate for the binge, such as self-induced vomiting or purging, heavy laxative or diuretic use, fasting between binges or excessive exercise
- A heavy influence of body weight on self-perception
- Bingeing and purging at least once a week for at least three months
Signs and symptoms of bulimia include:
- Eating in secret
- Using the bathroom immediately after eating
- Sores on the knuckles or fingers or damage to the teeth and gums from self-induced vomiting
- An excessively negative body image
Read part two of this series, Eating Disorders 101, Part II: The Causes of Eating Disorders, or download the entire series as an eBook.