Eating disorders are serious mental health conditions characterized by a distorted relationship with food, body image, and weight. These behaviors go far beyond typical diet concerns, significantly disrupting daily life and potentially leading to severe physical and psychological complications.
While not every food-related issue qualifies as an eating disorder, any persistent difficulty around eating that negatively affects a person's well-being may be cause for concern.
In Western countries, the most commonly diagnosed eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. However, many individuals suffer from other clinically significant yet lesser-known conditions such as OSFED (Other Specified Feeding or Eating Disorder), ARFID (Avoidant/Restrictive Food Intake Disorder), pica, rumination disorder, and insulin manipulation disorders associated with type 1 diabetes (often referred to as “diabulimia”).
Anorexia nervosa involves extreme food restriction and an intense fear of weight gain, often rooted in deep psychological distress rather than a mere desire to be thin. Although commonly associated with dieting, anorexia is more accurately understood as a complex emotional and behavioral condition linked to issues of control, perfectionism, and self-worth.
Women are disproportionately affected, with lifetime prevalence rates ranging from 0.9% to 4.3% in females compared to 0.2% to 0.3% in males. High-risk groups include teenagers, university students, dancers, athletes, and medical students—where some global studies report prevalence as high as 10%.
Individuals with anorexia may obsess over food, calories, and weight, engage in rigid eating routines, hide or discard food, and compulsively exercise. Physically, it can result in dramatic weight loss, amenorrhea, fatigue, hair thinning, osteoporosis, and even sexual dysfunction. In extreme cases, anorexia has one of the highest mortality rates among psychiatric disorders.
Bulimia nervosa is marked by cycles of binge eating followed by compensatory behaviors such as vomiting, laxative misuse, or excessive exercise. These cycles are often fueled by guilt, shame, and anxiety. Despite common misconceptions, those with bulimia often maintain a normal weight, making the disorder harder to detect. Prevalence estimates indicate 1.0%–1.5% of women and 0.1%–0.5% of men are affected, with roughly 1% of adult women in Europe and the US meeting the diagnostic criteria.
UK boxer Jack Fincham publicly revealed his 19-year battle with bulimia, which began in adolescence and caused significant damage to his teeth and digestive tract. Emotional struggles typically include body hatred and secrecy, while physical symptoms range from dehydration and throat irritation to severe gastrointestinal issues and cardiac complications.
Binge eating disorder (BED) is the most common eating disorder and involves frequent episodes of uncontrollable overeating without purging behaviors. Individuals often use food as a coping mechanism to manage stress, sadness, or anxiety, which can result in intense feelings of shame and helplessness. In the U.S., the 12-month prevalence of BED is approximately 1.2%, with a lifetime prevalence of around 2.8% in women.
In Europe, estimates suggest a lifetime prevalence below 4%. Individuals may binge in secret, eat past fullness, and struggle with dieting attempts. Physically, BED is associated with weight gain, type 2 diabetes, hypertension, acid reflux, and sleep apnea. Notably, about 40% of BED sufferers are men, challenging the stereotype that eating disorders only affect women.
OSFED, formerly known as EDNOS (Eating Disorder Not Otherwise Specified), includes individuals with significant eating-related issues that don't meet full criteria for anorexia, bulimia, or BED. Despite the lack of a “classic” label, OSFED is the most commonly diagnosed eating disorder and carries the same risks as other types.
It encompasses a range of behaviors such as atypical anorexia, purging disorder, night eating syndrome, and subthreshold presentations of bulimia or BED. Estimates suggest that OSFED affects over 6% of the population.
ARFID is a recently recognized disorder, added in 2013, and is primarily characterized by extreme food aversion due to taste, texture, smell, or fear of choking or vomiting. Unlike other eating disorders, ARFID is not driven by concerns over body image but rather by anxiety around the act of eating itself. It is common in children and adolescents but can persist into adulthood.
Prevalence estimates are around 3.2%. Individuals with ARFID may rely on a very narrow range of “safe” foods and avoid entire categories of food, leading to nutritional deficiencies and developmental delays.
Pica involves the compulsive consumption of non-food items such as dirt, paper, chalk, or metal for at least one month. It is most commonly observed in children, pregnant women, and individuals with intellectual disabilities. Though underreported, studies suggest up to 23% of pregnant women may experience pica, which poses risks such as poisoning, parasitic infections, and intestinal blockages.
Rumination disorder refers to the repeated regurgitation of food without an underlying medical cause. The regurgitated food may be re-chewed, re-swallowed, or spit out. While it is more commonly identified in infants, it can also affect older children and adults, often co-occurring with other psychiatric disorders.
A lesser-known but extremely dangerous condition affecting individuals with type 1 diabetes is diabulimia—an unofficial term describing the deliberate restriction of insulin to prevent weight gain.
Although not formally recognized in diagnostic manuals, diabulimia is acknowledged within diabetes communities and represents a deadly intersection of chronic illness and disordered eating. By avoiding insulin, the body is unable to absorb glucose, leading to rapid weight loss at the cost of severe medical risks including ketoacidosis, organ failure, and death.
The causes of eating disorders are multifactorial, involving genetic, psychological, and socio-cultural components. Studies suggest that about 50% of the risk may be genetic. Psychological risk factors include low self-esteem, perfectionism, anxiety, and unresolved trauma.
Western beauty standards—glorifying thinness and muscularity—play a significant role, especially in youth and social media users. High-risk communities include dancers, athletes, fashion models, and LGBTQ+ individuals.
During the COVID-19 pandemic, eating disorder diagnoses surged globally, particularly among adolescent females. However, male eating disorders are increasingly recognized. Up to 20% of men aged 15 to 35 may experience disordered eating behaviors, with many going undiagnosed due to stigma.
The physical consequences of eating disorders can be life-threatening. Anorexia is associated with bradycardia, hypothermia, amenorrhea, osteoporosis, and multi-organ failure. Bulimia may cause electrolyte imbalance, esophageal rupture, and chronic gastrointestinal problems. BED is linked to obesity, cardiovascular disease, diabetes, and joint pain.
Disorders like ARFID and pica can lead to malnutrition, infection, and digestive injuries. Mental health comorbidities are common; over 70% of patients have a co-occurring condition such as anxiety, depression, OCD, or substance use. Anorexia nervosa remains the deadliest mental illness, with mortality rates five to ten times higher than the general population.
Effective treatment typically involves a multidisciplinary approach, including psychotherapy, nutritional counseling, medical monitoring, and medication where appropriate. Cognitive Behavioral Therapy (CBT) is the gold standard for bulimia and BED, while Family-Based Treatment (FBT) is recommended for adolescents with anorexia. Dialectical Behavior Therapy (DBT) and Interpersonal Therapy (IPT) are also effective, depending on individual needs.
Registered dietitians assist in developing safe and sustainable eating plans, while psychiatrists may prescribe SSRIs (like fluoxetine) for bulimia or FDA-approved medications like lisdexamfetamine for BED. Support organizations such as the National Eating Disorders Association (NEDA) in the U.S. and Beat in the U.K. offer helplines, peer support, and resources for both patients and families.
According to the National Institute of Mental Health (NIMH), 1.2% of U.S. adults meet the criteria for BED annually. Anorexia and bulimia have lower prevalence but higher risk for long-term health consequences. Despite growing awareness, eating disorders remain underdiagnosed, especially in marginalized populations.
Addressing this hidden crisis requires not only clinical intervention but also cultural change. Promoting body neutrality, improving early detection, and reducing stigma are essential steps in reversing the tide.
As more public figures, including athletes and celebrities, share their recovery stories, the conversation is becoming more inclusive. Yet, much work remains to ensure all individuals—regardless of gender, background, or diagnosis—can access compassionate, effective care.