Eating Disorders: Know The Types, The Signs, and The Questions to Ask
Ask someone to name and describe an eating disorder, and chances are you’ll hear anorexia or bulimia in response. Additionally, it wouldn't be surprising to get simplistic descriptions along with the answers—like “the one where you don’t eat” and “the one where you vomit,” respectively—as well as misguided ideas about the ways an eating disorder looks or behaves.
There is far more to anorexia and bulimia than not eating or vomiting, though, and there is more to eating disorders than these two diagnoses. Eating disorders comprise a diverse set of brain-based conditions with a wide range of psychological, behavioral, and physical symptoms.
In this post, we outline the five primary types of eating disorders as established by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), including common signs and symptoms of each. Learn what to look out for and what questions to ask if you are concerned about yourself, a patient, or a loved one.
What are the most common eating disorders?
An eating disorder is a mental illness that manifests in a pattern of problematic behaviors around food. Unlike dieting, the illness involves a level of preoccupation with food or eating that causes significant impairment to a person’s daily functioning.
No two eating disorders are identical, and signs and symptoms often vary throughout the course of the illness. The following lists provide a general overview of five key diagnoses: anorexia, bulimia, binge eating disorder, Other Specified Feeding or Eating Disorder (OSFED), and Avoidant/Restrictive Food Intake Disorder (ARFID). Excluded here is a sixth category, Unspecified Feeding or Eating Disorder (UFED). This label is reserved for situations where an eating disorder is present, but there is insufficient information to make a specific diagnosis.
Anorexia Nervosa
Inability to consume adequate nutrition, leading to low body weight or failure to meet growth trajectories
Intense fear of food and weight gain
Disturbance in body perception
Warning signs include:
Dramatic weight loss
Obsession with weight, food, calories, fat, and/or dieting
Distortion of body image
Over-exercise
Loss of menstruation
Misuse of diuretics, diet pills, or laxatives
Bulimia Nervosa
Binge eating episodes followed by purging (vomiting, laxatives, diuretics) or a non-purging compensatory behavior
Self-evaluation is unduly influenced by body weight and shape
Warning signs include:
Frequently and repetitively eating large quantities of food, especially sweets
Leaving for the bathroom immediately after eating
Swollen cheeks from self-induced vomiting
Broken blood vessels in the eyes
Misuse of diuretics, diet pills, or laxatives
Binge Eating Disorder
Binge eating episodes accompanied by marked distress
Absence of compensatory behaviors (such as purging)
Warning signs include:
Excessive food consumption without hunger
Frequently eating alone or in secret
Using food to cope with negative emotions, but feeling distressed, disgusted, guilty, or depressed instead
Feelings of loss of control, self-loathing, depression, anxiety, or shame
Avoidant/Restrictive Food Intake Disorder (ARFID)
Failure to meet nutritional/energy needs because of eating or feeding disturbance
Associated with weight loss, nutritional deficiency, or failure to meet growth trajectories
Warning signs include:
Lack of appetite or interest in food
Gastrointestinal issues that seemingly have no known cause
Fear of illness, choking, or vomiting
Menstrual irregularities
No body image concerns
Other Specified Feeding or Eating Disorders (OSFED)
A struggle with food not captured by the criteria of another eating disorder diagnosis.
Warning signs include:
Atypical anorexia nervosa (weight is not below normal)
Bulimia nervosa (with less frequent behaviors)
Binge eating disorder (with less frequent occurrences)
Purging disorder (purging without binge eating)
Night eating syndrome (excessive nighttime food consumption)
Because eating disorders are mental illnesses, the warning signs are not always visible. Conversations about food and eating can help determine whether there may be a problem.
Could you, your client, or someone you love have an eating disorder?
Eating disorders and disordered eating are incredibly complex and multi-faceted.
Because eating disorders are mental illnesses, the warning signs are not always visible. Conversations about food and eating can help determine whether there may be a problem.
If you are concerned about yourself, your patient, or your loved one, it might help to ask the following six questions, adapted from the SCOFF questionnaire (a tool designed to identify eating disorders):
Do you feel like you sometimes lose or have lost control over how you eat?
Do you ever make yourself sick because you feel uncomfortably full?
Do you believe yourself to be fat, even when others say you are too thin?
Do food or thoughts about food dominate your life?
Do thoughts about changing your body and/or your weight dominate your life?
Have others become worried about your weight and/or eating?
If the answer is “yes” to two or more of the questions above, we strongly recommend seeking a comprehensive assessment from a place that specializes in eating disorders, such as The Emily Program.
It is common for people to wonder whether their situation warrants professional support. Though they have eating concerns, they may worry whether it’s “bad enough” to reach out for help. In these cases, we also recommend seeking an assessment. No matter the intensity or nature of your struggle, you deserve support and it’s important that you find support that recognizes your specific needs in making peace with food.
The Emily Program’s vision is a world of peaceful relationships with food, weight, and body image, where everyone with an eating disorder can experience recovery. The Emily Program was founded in 1993 by Dirk Miller, PhD, LP, after his sister Emily recovered from an eating disorder. Recognizing that one size does not fit all, The Emily Program provides exceptional, individualized care leading to recovery from eating disorders, incorporating individual, group, and family therapy, nutrition, psychiatry, medical care, yoga, and more. If you or someone you know is struggling with an eating disorder, call 1-888-EMILY-77 or visit emilyprogram.com.