Eating disorders and body image

What are eating disorders?

An eating disorder is a mental health condition that disrupts your relationship with food and how you see your body. Eating disorders affect both physical and emotional health, and left untreated they can become serious. Despite common assumptions, they can affect anyone, of any age, gender, or body size.

There are several types. Anorexia nervosa, bulimia nervosa, and binge eating disorder are among the most common, and others include avoidant/restrictive food intake disorder (ARFID). They differ in their patterns, but all involve distress around eating, and it is possible to have more than one. An eating disorder is different from ordinary dieting or picky eating because it is persistent, feels beyond your control, and interferes with your health and daily life.

Eating disorders are common. An estimated 28.8 million people in the U.S. will have one in their lifetime. They most often begin in adolescence, though they can develop at any age.

What are the symptoms of eating disorders?

Symptoms look and feel different for each person and depend on the type. They tend to show up in how someone thinks and behaves around food, as well as in the body. The signs below are common ones to be aware of, in yourself or someone you care about.

Emotional and behavioral signs often center on food, weight, and control.

• A preoccupation with food, weight, or body shape
• Strong guilt, shame, or a sense of being out of control around eating
• Marked changes in eating patterns, such as restricting food or eating large amounts quickly
• Purging behaviors after eating, or withdrawing from meals and social activities

Physical signs are the body's response to the strain of the condition.

• Noticeable or unexplained weight changes
• Fatigue, dizziness, or fainting
• Feeling cold often, or thinning hair
• Digestive problems, a persistent sore throat, or dental issues

You often cannot tell whether someone has an eating disorder by looking at them, since people of any size can be affected. If food or body image is causing distress or getting in the way of daily life, that alone is reason to reach out.

Who is at increased risk for eating disorders?

The exact cause of eating disorders is not known, and research points to a mix of biology, psychology, and environment. Genetics, brain chemistry, cultural pressures, and other mental health conditions all appear to contribute. Knowing the common risk factors can help you make sense of your own experience, even though having them does not mean an eating disorder will develop.

Biological and psychological factors

• A family history of eating disorders or other mental health conditions
• Brain chemistry involving messengers like dopamine and serotonin
• Having anxiety, depression, OCD, or a strong streak of perfectionism

Life and environmental factors

• Trauma, or major life changes like a move, a new school, or a divorce
• Cultural and social pressure around appearance, including social media
• Activities where weight or body size is emphasized, like some sports

Eating disorders most often begin in adolescence. Because the causes are still being studied, these factors describe risk rather than certainty, and developing one is not a matter of vanity or willpower.

How are eating disorders treated?

Eating disorders are treatable, and recovery is possible, though it takes time and usually a care team. Treatment addresses the physical, nutritional, and emotional sides of the condition together, and the right mix depends on the type and severity.

Cognitive behavioral therapy (CBT) is one of the most widely used therapies for eating disorders. It helps you understand and shift the thoughts and behaviors around food and body image that keep the disorder going.

Nutrition counseling with a registered dietitian who specializes in eating disorders can help you rebuild a steadier, less fearful relationship with food and restore your physical health.

Medication such as antidepressants does not treat the eating disorder directly, but it can ease co-occurring anxiety or depression, which often makes recovery easier.

Different levels of care are available, from weekly outpatient sessions to intensive programs or hospital care, depending on how much support your health and safety need.

The right combination is personal, and reaching out early tends to make recovery smoother.

When should you seek help?

It is a good idea to reach out if your relationship with food is causing you distress or getting in the way of everyday life, even if you are not sure it counts as an eating disorder. Signs that call for prompt attention include big changes in eating or weight, frequent dizziness or fainting, chest pain or a racing heart, or a persistent sore throat or reflux.

Eating disorders can affect the heart and other organs, so physical symptoms like fainting or chest pain deserve prompt medical care. Feelings about food or your body can also raise the risk of suicidal thoughts; if you are struggling, call or text 988, the Suicide and Crisis Lifeline. You can also reach the National Alliance for Eating Disorders helpline for free, confidential support. Recovery is possible, and reaching out is the first step. Whenever you feel ready, support will be there for you.