Eating disorders are serious and often fatal illnesses that are associated with severe disturbances in people’s eating behaviors and related thoughts and emotions.
Eating disorders are not a choice. These disorders can adversely affect a person’s physical and mental health, and in some cases, they can be life-threatening. With treatment, however, people can recover from eating disorders.
Who is at risk for eating disorders?
Eating disorders can affect people of all ages, racial and ethnic backgrounds, body weights, and genders. Even people who appear healthy can have eating disorders and be extremely ill. People with eating disorders can be underweight, average weight, or overweight.
The exact cause of eating disorders is not fully understood. Research suggests a combination of genetic, biological, behavioral, psychological, and social factors can raise a person’s risk.
What are the common types of eating disorders?
Common types of eating disorders include:
- Anorexia nervosa: People with anorexia nervosa severely avoid or restrict food intake due to a distorted self-image or an intense fear of gaining weight. Even when dangerously underweight, they may see themselves as overweight. Some people with anorexia nervosa may also have binge eating and purging episodes.
- Binge-eating disorder: People with binge-eating disorder regularly lose control of their eating and eat unusually large amounts of food. People with binge-eating disorder are often overweight or obese.
- Bulimia nervosa: People with bulimia nervosa regularly binge eat and then engage in unhealthy behaviors to prevent weight gain, such as forced vomiting or the use of laxatives. People with bulimia nervosa may maintain an average weight or be overweight.
- Avoidant restrictive food intake disorder (ARFID): People with ARFID limit the amount and variety of food they eat due to their anxiety or fear of the consequences of eating (such as choking or vomiting) or dislike of a food’s characteristics (such as its appearance or texture). People with ARFID are frequently underweight.
People exhibiting any combination of these symptoms may have an eating disorder and should talk to a health care provider.
What are the signs and symptoms of anorexia nervosa?
Symptoms include:
- Extremely restricted eating
- Intense and excessive exercise
- Extreme thinness (emaciation)
- A relentless pursuit of thinness and unwillingness to maintain a healthy weight
- Intense fear of gaining weight
- Distorted body image or self-image
- Denial of the seriousness of low body
Over time, anorexia nervosa can lead to numerous serious health consequences, including:
- Thinning of the bones (osteopenia or osteoporosis)
- Mild anemia
- Muscle wasting and weakness
- Delayed puberty
- Severe constipation
- Low blood pressure
- Slowed breathing and pulse
- Damage to the structure and function of the heart
- Feeling tired all the time
- Infertility
- Brain damage
- Multiple organ failure
Anorexia nervosa can be fatal. It has an extremely high death rate compared with other mental disorders. People with anorexia nervosa are at risk of dying from medical complications associated with starvation. Suicide is a leading cause of death for people diagnosed with anorexia nervosa.
Bulimia nervosa
Bulimia nervosa is a condition where people have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or over overweight.
Symptoms include:
- Chronically inflamed and sore throat
- Swollen salivary glands in the neck and jaw area
- Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
- Acid reflux disorder and other gastrointestinal problems
- Intestinal distress and irritation from laxative abuse
- Severe dehydration from purging of fluids
- Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack
Over time, bulimia nervosa can lead to serious health consequences, including:
- Chronically inflamed and sore throat
- Swollen salivary glands in the neck and jaw area
- Worn tooth enamel and increasingly sensitive and decaying teeth
- Acid reflux disorder and other gastrointestinal problems
- Intestinal distress and irritation
- Severe dehydration
- Electrolyte imbalance
Binge-eating disorder
Binge-eating disorder is a condition where people lose control over their eating and have reoccurring episodes of eating unusually large amounts of food. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S.
Symptoms include:
- Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
- Eating even when you’re full or not hungry
- Eating fast during binge episodes
- Eating until you’re uncomfortably full
- Eating alone or in secret to avoid embarrassment
- Feeling distressed, ashamed, or guilty about your eating
- Frequently dieting, possibly without weight loss
Over time, binge eating can lead to serious health consequences, including:
- Obesity
- Type 2 diabetes
- Cardiovascular problems
- Sleep problems
- Gastrointestinal symptoms (such as acid reflux, bloating, and diarrhea)
Avoidant restrictive food intake disorder
Avoidant restrictive food intake disorder (ARFID), previously known as selective eating disorder, is a condition where people limit the amount or type of food eaten. Unlike anorexia nervosa, people with ARFID do not have a distorted body image or extreme fear of gaining weight. ARFID is most common in middle childhood and usually has an earlier onset than other eating disorders. Many children go through phases of picky eating, but a child with ARFID does not eat enough calories to grow and develop properly, and an adult with ARFID does not eat enough calories to maintain basic body function.
Symptoms include:
- Severe restriction of types or amount of food eaten
- Lack of appetite or interest in food
- Dramatic weight loss
- Upset stomach, abdominal pain, or other gastrointestinal issues with no other known cause
- Limited range of preferred foods that becomes even more limited (“picky eating” that gets progressively worse)
Over time, ARFID can lead to serious health consequences, including:
- Unhealthy weight loss
- Malnutrition
- Changes to physical growth
- Functional impairments associated with academic performance, work, and relationships
What mental illnesses can co-occur with eating disorders?
People with eating disorders are at risk for co-occurring mental illnesses, which most often include depression, anxiety, and substance use disorders. People with eating disorders are also at a higher risk for suicide. It’s critical to treat any co-occurring conditions as part of the treatment plan.
How are eating disorders treated?
Eating disorders can be treated successfully. Early detection and treatment are important for recovery. Treatment plans for eating disorders include:
- Individual, group, or family psychotherapy to identify and change troubling emotions, thoughts, and behaviors about food. Learn more about psychotherapy.
- Medical care and monitoring to treat the health consequences of an eating disorder and monitor overall well-being.
- Nutritional counseling to help people eat well and reach and maintain a healthy weight.
- Medication to treat the symptoms of some eating disorders, including bulimia nervosa and binge-eating disorder, and to reduce symptoms of co-occurring anxiety or depression. There are currently no medications approved by the U.S. Food and Drug Administration (FDA) to treat the symptoms of anorexia nervosa or ARFID.
How can I find help?
If you have concerns about your eating behavior or mental health, talk to a primary care provider. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out the next steps. Find tips for talking with a health care provider about your mental health.
You can learn more about getting help on the NIMH website. You can also learn about finding support and locating mental health services in your area on the Substance Abuse and Mental Health Services Administration (SAMHSA) website.
What are clinical trials and why are they important?
Clinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.
NIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about participating in clinical trials.
This information may be downloaded as a PDF from the National Institute of Mental Health website.
If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org . In life-threatening situations, call 911.
Source: National Institute of Mental Health | Eating Disorders: What You Need to Know, http://www.nimh.nih.gov/health/publications/eating-disorders | public domain. Last revised February 2025
