Eating Disorders

You are here

What are Eating Disorders?

Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. The four most common eating disorders are Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Feeding or Eating Disorders Not Elsewhere Classified. Eating disorders currently affect approximately 25 million Americans, in which approximately 25% are male. Anorexia has the highest mortality rate among all psychological disorders.

Eating disorders do not discriminate between gender, class, race or age. They can and do happen to anyone. Contrary to popular belief, an eating disorder is not based on food. There are several contributing factors that may lead to the emergence of an eating disorder although no defined cause has been established. Contributing factors include: Biological factors (Eating disorders often run in families. The risk of developing an eating disorder is 50-80% determined by genetics), Social factors (unrealistic pressures to obtain the "perfect" body; the constant influx of images of perfection; and narrow definitions of beauty), Psychological factors (substantial co-morbidity with other mental health disorders - ie. depression, anxiety, Obsessive-Compulsive Disorder, low self-esteem; and feelings of lack of control), and Interpersonal factors (history of abuse; being teased for size or weight; traumatic life event(s); and difficulty expressing feelings and emotions).

An eating disorder can go unnoticed for a significant amount of time, and often, if it is recognized, denial usually follows, leaving the disorder still untreated.

1. Anorexia Nervosa

2. Bulimia Nervosa

3. Binge Eating Disorder (BED)

4. Feeding or Eating Disorders not elsewhere Classified

5. Orthorexia

6. Bigorexia

7. Body Dysmorphic Disorder

8. Night Eating Disorder

9. Pica

10. Males and Eating Disorders

Getting Help


Anorexia Nervosa

Anorexia Nervosa is an eating disorder characterized by self-induced starvation and excessive weight loss. According to Dr. Thomas Insel, Director of National Institute of Mental Health, "Research tells us that Anorexia is a brain disease with severe metabolic effects on the entire body." While Anorexia is the 3rd most common chronic illness among adolescents, eating disorders do not discriminate between age, gender, race or class — no one is immune.

Warning Signs
Significant weight loss
Distorted body image
Intense fear/anxiety about gaining weight
Preoccupation with weight, calories, food, etc.
Feelings of guilt after eating
Denial of low weight
High levels of anxiety and/or depression
Low self-esteem
Withdrawal from friends and activities
Excuses for not eating/denial of hunger
Food rituals Intense, dramatic mood swings
Pale appearance/yellowish skin-tone
Thin, dull, and dry hair, skin, and nails
Cold intolerance/hypothermia
Abuse of laxatives, diet pills, or diuretics
Excessive and compulsive exercise

Health Complications
Amenorrhea (cessation of menstrual cycle)
Abnormally slow and/or irregular heartbeat Low blood pressure
Poor circulation in hands and feet
Muscle loss and weakness (including the heart)
Dehydration/kidney failure
Memory loss/disorientation
Chronic constipation
Growth of lanugo hair
Bone density loss/Osteoporosis

Bulimia Nervosa

Bulimia Nervosa is an eating disorder characterized as bingeing (excessive or compulsive consumption of food) and purging (getting rid of food). Symptoms may include repeated episodes of bingeing and purging, eating beyond the point of fullness, feeling out of control during a binge, inappropriate compensatory behaviors following a binge, frequent dieting, and extreme concern with body weight and shape.

Warning Signs
Bingeing and purging
Secretive eating and/or missing food
Visits to the bathroom after meals
Preoccupation with food
Weight fluctuations
Excessive and compulsive exercise regimes — despite fatigue, illness, or injury
Abuse of laxatives, diet pills, and/or diuretics
Swollen parotid glands in cheeks and neck
Discoloration and/or staining of the teeth
Broken blood vessels in eyes and/or face
Calluses on the back of the hands/knuckles from self-induced vomiting
Sore throat
Feelings of shame and guilt
Self-criticism and low self-esteem
High levels of anxiety and/or depression

Health Complications
Electrolyte imbalances that can lead to irregular heartbeat and seizures
Vitamin and mineral deficiencies
Gastrointestinal problems
Chronic irregular bowel movements and constipation
Inflammation and possible rupture of the esophagus
Tears in the lining of the stomach
Chronic kidney problems/failure
Tooth decay

Binge Eating Disorder (BED)

Binge Eating Disorder is characterized as recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control. This disorder is associated with marked distress and occurs, on average, at least once a week over three months (American Psychiatric Association). BED is the most common eating disorder in the United States. An estimated 3.5% of women, 2% of men, and 30% to 40% of those seeking weight loss treatments can be clinically diagnosed with BED.

Warning Signs
Eating large quantities of food, without purging behaviors, when not hungry
Sense of lack of control over eating
Eating until uncomfortably/painfully full
Weight gain/fluctuations
Feelings of shame and guilt
Self-medicating with food
Eating alone/secretive eating
Hiding food
High levels of anxiety and/or depression
Low self-esteem

Health Complications
Overweight or obese
Type II Diabetes
Lipid abnormalities (Including increased cholesterol)
Increased blood pressure
Chronic kidney problems
Gastrointestinal problems
Heart disease
Gallbladder disease
Joint and muscle pain
Sleep apnea

Feeding or Eating Disorders not elsewhere Classified

Feeding or Eating Disorders Not Elsewhere Classified (FED-NEC) is characterized as disturbances in eating behavior that do not necessarily fall into the specific category of anorexia, bulimia, or binge eating disorder. It is the most common eating disorder diagnosis. Warning signs and related medical/psychological conditions of FED-NEC are similar to, and just as severe as, those for the other eating disorders.

Warning Signs 
Atypical anorexia nervosa: All of the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual's weight is within or above the normal range.
Bulimia nervosa (of low frequency and/or limited duration): All of the criteria for bulimia nervosa are met, except that the binge eating and inappropriate compensatory behaviors occur, on average, less than once a week and/or for less than 3 months.
Binge-eating disorder (of low frequency and/or limited duration): All of the criteria for binge-eating disorder are met, except the binge eating occurs, on average, less than once a week and/or for less than 3 months.
Purging Disorder: Recurrent purging behavior to influence weight or shape (e.g., self-induced vomiting, misuse of laxatives, diuretics, or other medications) in the absence of binge eating.
Night eating syndrome: Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. There is awareness and recall of the eating. The night eating is not better explained by external influences such as changes in the individual's sleep-wake cycle or by local social norms. The night eating causes significant distress and/or impairment in functioning. The disordered pattern of eating is not better explained by binge-eating disorder or another mental disorder, including substance use, and is not attributable to another medical disorder or to an effect of medication.


Orthorexia is an eating disorder, coined in 1997 by Steven Bratman, MD, that is defined as an obsession with "healthy or righteous eating." It often begins with someone's simple and genuine desire to live a healthy lifestyle.

An individual dealing with Orthorexia fixates on defining the "right" foods, foods that can be safely eaten. They will spend just as much time and energy thinking about food as someone with Bulimia or Anorexia. They may not think about calories, but they think about the overall "health benefits" and how the food was processed, prepared, etc. Individuals with Orthorexia tend not to eat out as much because they do not trust the preparation of foods other than what they have prepared.

The obsession for healthy foods could come from a number of sources such as family habits, society trends, economic problems, recent illness, or even just hearing something negative about a food type or group, which then leads them to ultimately eliminate the food or foods from their diet.

Something to keep in mind: The severe restrictive nature of Orthorexia has the potential to morph into Anorexia.


Muscle Dysmorphia (or more informally Bigorexia) is a disorder that causes a person to constantly obsess and/or worry about being too small, underdeveloped, and/or underweight. Typically those who have Muscle Dysmorphia are not frail or underdeveloped at all, and actually have large muscle mass. They obsess about having the perfect physique and believe their muscles are inadequate.

This disorder is a form of Body Dysmorphic Disorder and is related to Obsessive Compulsive Disorder. Those with Muscle Dysmorphia constantly obsess over their imperfections, further distorting their self perception. This can significantly impair the person's mood, often causing depression or other emotional distress. Feelings of inadequacy may affect many areas of their life.

Who Develops this?

Both men and women can be affected by this disorder, although men are most susceptible. It is estimated that approximately 10% of the men who are obsessive gym-goers have this disorder. Many of these people may compete in body building competitions and are addicted to lifting weights. One reason Muscle Dysmorphia may be a common disorder is due to the common stereotype that men are supposed to be big and strong.

Warning Signs

Distorted self-image

Missing social events, skipping work, and cancelling plans in order to work out

Never being satisfied with one's muscle mass

Working out despite an injury

Maintaining extreme workout methods

Maintaining a strict, high-protein and low-fat diet

Using excessive amounts of food supplements

Steroid abuse, unnecessary plastic surgery, and even suicide attempts


Body Dysmorphic Disorder

BDD or Body Dysmorphic Disorder is a preoccupation or obsession with a defect in visual appearance, whether that be an actual slight imperfection or an imagined one. BDD goes beyond normal concern with one's appearance and may significantly impair normal, everyday functioning, as well as interpersonal relationships.

Common Symptoms

Low self-esteem

Unreasonable fears of rejection from others due to perceived ugliness

Some realization that one's perception of his/her "defect" is distorted, but an uncontrollable impulse to think about it


Night Eating Disorder

Night eating syndrome, or NES, is an eating disorder diagnosis that primarily characterizes an ongoing, persistent pattern of late-night binge eating. The individual may not be aware at the time of what they are doing when they are eating.

NES was originally described by Dr Albert Stunkard in 1955. NES affects between 1 and 2% of the population. 6% of people seeking treatment for obesity have NES and 28% of those seeking gastric bypass surgery suffer from NES.

Although it can affect all ages and both sexes, it is more common in young women. Unlike binge eating, which is done in relatively short episodes, NES involves continual eating throughout the evening.

Symptoms and Behaviors (May Include)

Skips breakfast and delays first meal for several hours after awakening

The individual will eat more than half of daily food intake during and after dinner.

Late-night binges almost always consist of consuming sugary foods and carbohydrates

Suffer from stress, depression or anxiety, often in connection with their eating habits

These night eating episodes typically bring guilt rather than hedonistic enjoyment

Trouble falling asleep or staying asleep

Are more likely than the general public to sleepwalk

Tense, anxious, upset or guilty while eating



Pica is a disorder where an individual has a strong, persistent desire to eat, lick, or chew nonnutritive substances for a period of at least 1 month. The name Pica comes from the Latin word for "magpie," which is a bird that's known for eating anything and everything.

Although the cravings associated with Pica may be related to vitamin or mineral deficiencies, ingesting non-foods can cause serious medical complications such as intestinal obstruction, intestinal perforation, infections, or lead poisoning.


Males and Eating Disorders

Can males have eating disorders? Absolutely! Misconceptions about eating disorders being a "female" disease (or a "gay" disease when seen in males) often perpetuate strong feelings of shame in males about having an eating disorder. This shame may result in denial of the eating disorder and/or reluctance to seek treatment. Eating disorders are clinically similar in both genders, but differ in terms of gender-specific aspects. In comparison to females, males tend to be more concerned with body size, specifically with building muscle, than with weight loss.

Male eating disorders are on the rise, and the numbers are increasing quite rapidly. A 2007 study by Harvard Medical School found that 25% (not the traditionally stated 10-15%) of study participants with anorexia and bulimia were male. An estimated 40% of those with binge eating disorder are male.

Men need to know that it is okay to seek professional help for their problems. There is hope, help is available, and recovery is possible. Males with eating disorders need to be their own best advocate for seeking treatment. Remember, many doctors are under the mistaken assumption that males are not affected by eating disorders. Therefore, doctors may not diagnose or may misdiagnose an eating disorder in a male.


Getting Help

If you suspect that you or someone you know has developed an eating disorder, please do not deny that a problem exists and try to get specialized, professional help as soon as possible. Learn about eating disorders and do not be afraid to talk to someone about your situation. Major health hazards may occur if an eating disorder goes undetected and/or untreated. Please know that help is available and recovery is definitely possible.


Did you know?

If you need to need to speak with someone privately and confidentially, please contact the Lehigh Counseling and Psychological Services to make an appointment. This office provides individual counseling, group therapy, faculty/staff and/or parent consultation upon request.

Online Eating Disorder Screening:

This tool provides people with the option to take a free, anonymous self-assessment to gauge their risk of an eating disorder. The anonymous online screening takes only a few minutes and consists of a series of questions, developed by treatment professionals in the eating disorders field, which are designed to indicate whether clinical help is needed.

Information Courtesy of: