8 Different Types of Eating Disorders

What Are Eating Disorders?

Eating disorders are illnesses characterized by harmful behaviors or compulsive practices around eating. While eating disorders are serious, they are treatable. People of all ages, genders, and socio-economic statuses can develop eating disorders. The impact of eating disorders can include significant shame, body changes, medical issues, and social difficulties. Severe eating disorders can be life threatening.

People often believe that all individuals with an eating disorder are thin, or developed an eating disorder because they wanted to meet a perceived societal standard. However, there are a plethora of reasons why someone may develop a specific eating disorder.

What Causes Eating Disorders?

The three most common factors that cause eating disorders are biological tendencies, mental health conditions, or social environment. Eating disorders are more common in women and girls, but there are a growing number of men and boys being diagnosed with eating disorders as well.¹

Possible causes of eating disorders include:

• Genetic factors: Having a close family member with an eating disorder increases the likelihood of developing an eating disorder.²
• Body image ideals: Fixating on an “ideal” body image can lead to unhealthy expectations for a person’s body shape. A person may develop an eating disorder while they are attempting to achieve their society’s ideal body image.
• Weight stigmas: When a person doesn’t meet a specific weight ideal, they can experience shame, bullying, and social stigma. A person may develop an eating disorder due to these distressing emotions and experiences.
• Poor coping skills: A lack of healthy coping skills can lead to bad habits around food that contribute to disordered eating. Over time, this can become a consistent and harmful pattern that results in an eating disorder.³
• Limited peer support: A lack of friends and social support can contribute to and deepen isolation. When a person experiences isolation they may turn to an eating disorder to bring control into their lives.
• Anxiety or Depression: It’s common to have depression and eating disorders at the same time. Research indicates that people with major depressive disorder or anxiety disorders are more likely to have eating disorders.⁴

8 Types of Eating Disorders

Eating disorders involve a group of behaviors that are very broad, and so it is necessary to place the varying symptoms into categories of similar behaviors. The different categories help clinicians to better understand the unique disorder a person is dealing with. Some diagnoses, such as anorexia or bulimia, are more common, whereas diagnoses like rumination syndrome are far less common.

Here are eight types of eating disorders:

1. Anorexia Nervosa

Anorexia nervosa, often simply called anorexia, is characterized by an obsession with weight gain and a distorted body image that leads to harmful behaviors such as restrictive food intake and over-exercising. The person’s beliefs about body image are held tightly, and so when a loved one expresses concern, it will often be dismissed. Anorexia is one of the most commonly diagnosed eating disorders, and is mostly diagnosed in women.

Emotional and behavioral symptoms of anorexia include:

• Obsessing with diet, weight, counting calories and nutritional information
• Dressing in layers to hide weight loss or stay warm
• Frequently  talking about about being “fat” or overweight despite weight loss
• Denying being hungry
• Food rituals, such as chewing a certain number of times or arranging food rigidly
• Consistently making excuses to avoid eating around others
• Exercising without regard to time needs, illness, or injury
• Isolation from friends and family
• Inability to recognize their body image accurately
• Placing unreasonable importance on body image or an unacquirable ideal

Physical symptoms of anorexia include:⁵

• Inability to maintain body weight appropriate for age or height
• Stomach cramps or other non-specific gastrointestinal complaints, such as constipation or acid reflux
• Dizziness
• Fainting
• Menstrual irregularities or loss of menstrual periods
• Dried-out skin
• Dry, brittle nails
• Lanugo, which is fine hair on body
• Thinning of hair on head or dry and brittle hair
• Muscle weakness

2. Bulimia Nervosa

Bulimia nervosa, or bulimia, is characterized by a cycle of binging and then purging, usually by self-induced vomiting or laxative abuse. The compensatory behavior of purging is often used as an attempt to prevent weight-gain. A person suffering from bulimia may have fluctuations in weight, or maintain their normal body weight. Bulimia is one of the most commonly diagnosed eating disorders, and is mostly diagnosed in women.

Emotional and behavioral symptoms of bulimia include:

• Evidence of binge eating, such as large amounts of food disappearing in short periods of time or wrappers left in hidden spaces
• Evidence of purging behaviors, such as frequent trips to the bathroom after meals or a smell of vomit
• Disappearing after eating, often to the bathroom
• Stealing or  hoarding food in strange places
• Drinking excessive amounts of water or other no-calorie drink
• Using excessive amounts of mouthwash or breath mints
• Appearing bloated from fluid retention
• Extreme concern with body weight and shape
• Frequent checking in the mirror for perceived flaws in appearance
• Extreme mood swings

Physical symptoms of bulimia include:⁵

• Noticeable fluctuations in weight
• Cuts and calluses across the top of finger joints due to forced vomiting
• Swelling around salivary glands
• Thinning of hair on head, dry and brittle hair
•  Lanugo, fine hair on body
• Cavities or discolored teeth due to vomiting
• Menstrual irregularities or loss of menstrual periods
• Self-injury, such as cutting or other forms of self-harm in the absence of suicidal intention

3. Binge-Eating Disorder

Binge-eating disorder is characterized by regular episodes of binge eating accompanied by a feeling of being out of control. People who suffer from binge-eating disorder are likely to experience feelings of guilt and shame about their eating. It is common for people dealing with binge-eating disorder to go to great lengths to hide their behavior.

Signs and symptoms of binge-eating disorder include:⁵

• Evidence of binge eating, such as large amounts of food disappearing in short periods of time or wrappers left in hidden spaces
• Being uncomfortable eating around others
• Stealing or  hoarding food in strange places
• Showing extreme concern with body weight and shape
• Fixation on flaws in appearance
• Feeling a lack of control over ability to stop eating
• Eating alone out of embarrassment about the quantity of food being eaten
• Feelings of disgust, depression, or guilt after overeating
• Significant distress about binge-eating

When comparing binge-eating versus bulimia, the primary difference is that people with binge-eating disorder don’t typically participate in purging or compensatory behaviors after overeating.

4. Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/restrictive food intake disorder, or ARFID, is characterized by a persistent avoidance or restrictive intake of food. People who suffer from ARFID are not just picky eaters, rather their food restrictions are so severe it can lead to an interference in psychosocial functioning, and nutritional deficiency. ARFID is most commonly diagnosed in male adolescents and children.⁶

Emotional and behavioral symptoms of ARFID include:

• Low energy
• Dressing warmly to hide weight loss or feeling cold
• Pickiness with food based on texture or flavor, becoming narrower over time
• Absence of body image issues or fear of weight gain

Physical signs and symptoms of ARFID include:⁵

• Significant weight loss
• Stomach cramps
• Menstrual irregularities, including loss of periods
• Difficulties concentrating
• Dizziness
• Fainting
• Feeling cold all the time
• Insomnia
• Dry skin
• Dry, brittle nails
• Fine hair on body (lanugo)
• Thinning hair, dry and brittle hair
• Muscle weakness
• Impaired immune functioning

5. Pica

Pica is characterized by an irresistible urge to eat non-food items, with no nutritional value. People suffering with pica may eat items such as dirt, paper, soap, or hair. Initially, they may feel pleasure or relief when eating these items, but this feeling is often replaced by guilt or shame. Pica can lead to serious health complications, such as intestinal blockages.⁸

Research studies show that people suffering with pica often have a deficiency in certain vitamins or minerals, such as iron or zinc. It is not uncommon for the non-food items consumed by those with this type of eating disorder to contain nutrients they are lacking.⁷

Signs and symptoms of pica may include:^7,8

• Persistent eating of items of no nutritional value
• A willingness to eat food
• Anemia (low iron)
• Constipation
• Electrolyte imbalance
• Lead poisoning
• Intestinal obstruction/blockage

6. Rumination Syndrome

Rumination syndrome is characterized by repeated regurgitation of food after it has been swallowed. Once regurgitated, the food is re-chewed and swallowed. Regurgitation is typically done after every meal, soon after eating. Some of the dangers of rumination syndrome are significant weight loss, malnutrition, and isolation due to the stigma associated with this condition. Rumination syndrome is relatively uncommon, and is mostly diagnosed in people with intellectual disabilities.⁵

Signs and symptoms of rumination syndrome may include:⁵

• Repeated regurgitation of food  over a duration of at least one month
• Bad breath
• Damaged and yellow teeth
• Signs of malnutrition, especially when regurgitation leads to restricted food intake
• Coughing or covering mouth while eating may occur to disguise the behavior
• The behavior isn’t better explained by a different type of eating disorder

7. Other Specified Feeding or Eating Disorder (OSFED)

Other specified feeding or eating disorder (OSFED) is diagnosed by a clinician when an individual has an eating disorder that does not meet the criteria for another diagnosis. An OSFED diagnosis does not indicate that a person’s eating disorder causes less distress or needs to be taken less seriously, but their treatment process may look different. OSFED diagnoses are generally less common than other disorders.

Subtypes of eating disorders included in OSFED are:

• Purging Disorder: Purging disorder is characterized by regular episodes of purging, such as self-induced vomiting or laxative abuse. Purging disorder differentiates itself from bulimia because no binging is involved.
• Atypical Anorexia Nervosa: A diagnosis for individuals who have symptoms of anorexia nervosa, but are still within their medical weight requirements.
• Binge-eating disorder (of low frequency/limited duration): A diagnosis for people who have symptoms of binge-eating disorder, but the compensatory behaviors are infrequent or occurring for less than three months.
• Bulimia nervosa (of low frequency/limited duration): A diagnosis for people who have symptoms of bulimia nervosa, but the compensatory behaviors are infrequent or occurring for less than three months.
• Night Eating Syndrome: When a person wakes up multiple times in the middle of the night so that they can eat. Night eating syndrome differs from binge eating disorder because the individual is not necessarily consuming an abnormal amount of food, or losing control over their ability to stop eating.

8. Unspecified Feeding or Eating Disorder (UFED)

Unspecified feeding or eating disorder (UFED) is diagnosed when there is not enough information present to give an individual a proper diagnosis. It is usually given when a person is in the ER, or if they are receiving an unrelated medical treatment, and the doctor has concerns, but does not have enough time to give the person a full evaluation.

How Do I Know If I Have an Eating Disorder?

Worrying about body image and struggling with diet culture can be entirely normal. However, if these worries begin to become obsessive and lead to harmful behaviors in an attempt to fix the perceived issues, you may want to consider speaking to your doctor or a therapist.

Signs that you may be developing an eating disorder could include:

• Obsession with body image or weight loss that controls how you eat
• Rigid refusal to eat certain types of food, to the extent where it impacts your life
• Reflexive justification of eating disorder compensatory behaviors
• Feeling unable to control binge episodes
• Desire to eat non-food objects
• Regular purging behaviors

Treatment for Eating Disorders

There are multiple levels of care for treating an eating disorder, and it is important to have a doctor assess the severity of the disorder to help decide which level of care is appropriate. If the eating disorder is just developing, initial treatment may begin with outpatient therapy, where a therapist can help with developing coping skills for the eating disorder and explore what is driving the condition. If a person’s functioning is more severely impaired, partial hospitalization, residential or an inpatient hospital stay may be recommended in order to ensure the individual’s health is stable and monitor behaviors more closely.

When looking for proper eating disorder care, it is important to find professionals who have a lot of experience with eating disorders. There are online therapist directories that can help to sort for therapists who specialize in treating eating disorders. Additionally, it may be helpful to speak with an online psychiatrist to begin exploring whether medications can help. You could also access care online through a program like Equip Health.

Treatment options for eating disorders include:

• Outpatient therapy: Outpatient therapy is the lowest level of care for eating disorders, and is appropriate when the eating disorder is very minor and stable. It typically involves addressing core beliefs and expectations surrounding disordered eating and body image, as well as mental health concerns.
• Family therapy: The psychological dynamics of eating disorders can be complicated and often impacts the entire family. Family therapy options like the Maudsley method can be useful to help parents gain an understanding of the needs of their child who is suffering from an eating disorder. It can be helpful to have a trusted therapist to help navigate.
• Nutritional counseling: Nutritional education can help a person to understand the harmful myths surrounding diet culture, and help them to become an intuitive eater.
• Medication: Medication is typically given when there are co-occurring disorders, such as obsessive compulsive disorder (OCD), anxiety, or depression. A reduction of any co-occurring symptoms can have a positive impact on the eating disorder symptoms as well. Some medications may also help to reduce binging and purging behaviors.
• Group therapy: Group therapy for eating disorders can help a person connect with others who are suffering from similar disorders. Group therapy can reduce internalized stigma and help someone develop a support network.
• Intensive outpatient program (IOP): IOP typically involves attending 3-5 hours of eating disorder programming at a treatment center, typically 3-5 times per week. Programming involves both individual, group, and nutritional treatment.
• Partial hospitalization program (PHP): PHP typically involves attending 8 hours of eating disorder programming at a treatment center 5-7 times per a week. Programming involves both individual, group, and nutritional treatment.
• Residential treatment: Residential treatment for eating disorders involves staying in a treatment facility where someone attends programming during the day and sleeps in a supervised setting at night. Residential treatment is a high level of care for individuals  with impaired function because of eating disorders.
• Inpatient hospitalization: Inpatient care is a 24/7 stay at an inpatient unit in the hospital. The individual is monitored the entire time as a team of specialists attempt to get them back to a medically stable place.

How to Help a Loved One With an Eating Disorder

Support from one’s family and friends is vital when dealing with an eating disorder. If your loved one’s eating disorder is severe, your intervention can save their life. If their symptoms are not yet life-threatening, your support can help prevent their eating disorder from spiraling out of control.

Below are some tips for supporting a loved one with an eating disorder:

• Be patient: The ideas your loved one has surrounding their eating and body may not make sense to you, but they deeply believe them to be true. Deconstructing these beliefs can take time. Be patient and supportive of them, no matter how long it takes for them to recover.
• Practice listening: Every person experiences their eating disorder in a unique way. Instead of making assumptions about what your loved one is experiencing, listen closely to what they are sharing with you and take them seriously.
• Build their self-esteem: Working to build self-esteem can help your loved one recognize the incorrect beliefs about their body image. Your encouragement can help counter the negative internal thoughts they may have.
• Keep an eye on them: Even without talking with them, noticing the eating behaviors of your loved one can help you stay ahead of the development of disordered practices.
• Examine your own habits: Do you exhibit troubling signs in the way you eat or talk about body image? Your unhealthy habits around food and body image will likely exacerbate your loved one’s eating disorder.
• Don’t be afraid to ask for help: You may feel that you have reached the limit for what you can do. Remember that you are not a professional and you are not expected to have all the answers. Reaching out for support can set a good example for your loved one as well.