Eating Disorders

The term eating disorder refers to a group of conditions where an eating behavior threatens a person’s health. Eating disorders can affect a person’s physical, mental, emotional and social well-being.

Eating disorders are serious mental health problems. People with eating disorders can have lifelong health problems. The effects can be deadly. It is vital to seek treatment for eating disorders.

Often people think of eating disorders as a lifestyle choice, but they’re not. An eating disorder is a mental health illness that can be treated.

Types of Eating Disorders

Anorexia Nervosa

The person is not able to keep their weight at or above the normal range for their age and height. This is due to restricted food intake. People with anorexia nervosa may also binge and purge.

Avoidant Restrictive Food Intake Disorder (ARFID)

The person places extreme limits on what types and amounts of food they eat. But they don’t have the body image concerns seen in people with anorexia. For some, this is due to longstanding selective or picky eating. For others, it is due to a fear of some physical problem (like fear of choking or belly pain). ARFID can lead to malnutrition. This will limit a child’s ability to grow and develop how they should.

Binge Eating Disorder

The person eats much more food in a short period of time than most people would eat. This happens again and again. They feel like they lack control when this happens. Someone with binge eating disorder may eat even when he or she is not hungry.

Bulimia Nervosa

The person has cycles of overeating followed by doing things to prevent weight gain. The person with bulimia nervosa may vomit, use laxatives or diuretics, or over exercise.

Eating Disorders Not Otherwise Specified (EDNOS)

This term is used for people who:

  • Have disordered eating behaviors
  • Are unhappy with their body weight or shape
  • May have harmful weight-control behaviors that do not meet the full criteria for anorexia or bulimia

This is also called other specified feeding or eating disorder (OSFED).

Female Athlete Triad (Relative Energy Deficiency in Sport)

This can occur when an athlete is in negative energy balance. Weight loss is not always seen. Body changes that are not healthy (such as menstrual cycles stopping) occur. This is due to the athlete not eating enough to support the body’s needs.

Orthorexia

The person is obsessed with proper or healthy eating. But they are not concerned about weight or body shape. Orthorexia is not yet a formal diagnosis. This type of rigid eating can be a symptom of some other mental health condition (such as obsessive-compulsive disorder).

How Common Are Eating Disorders?

Estimates show that about 20 million women and 10 million men in the United States will suffer from an eating disorder at some point in their lives.

Eating disorders affect both males and females. They can develop in people of all ages, races, ethnic backgrounds, body shapes, weights, sexual orientation and income levels

Signs and Symptoms

The signs and symptoms of eating disorders vary. Below are signs that may point to an eating disorder or other serious condition. Your child may not have all of these symptoms. Your child may also have others that are not listed here. 

Call your child’s primary care doctor if you notice any of these: 

Physical

  • Sudden or major weight loss
  • For females, lighter menstrual cycle (periods) than normal or missed periods
  • Not able to stay at the advised weight
  • Feeling dizzy or passing out
  • Purple hands and feet
  • Hair loss
  • Not able to handle cold temperatures 

Behavioral / Emotional

  • Changes in thoughts or behaviors about weight, shape, and looks
  • Being obsessed with food, nutrition or exercise
  • Lasting negative comments about weight or body
  • Checking the mirror often for flaws they think they have
  • Having a poor self-image or self-esteem that is tied to their looks
  • Mood swings, irritability, depression
  • Withdraw from social activities
  • Self-imposed food restriction (restricting both the type of foods eaten and how much food is eaten)
  • Binging behaviors: you may notice large amounts of food missing in short timeframes
  • Purging behaviors (such as going to the bathroom right after eating)
  • Hoarding and hiding food
  • Trying not to eat in front of others
  • Strange eating or food habits (like chewing food more than normal or not letting foods touch)
  • Cutting out whole food groups (like fats or carbs)
  • Eating the same foods over and over 

Other more severe symptoms may develop over time (like organ failure and brain damage). This is why it’s crucial to seek care as soon as signs of an eating disorder are noted.

Causes

Studies continue to be done on a wide range of topics linked to eating disorders. Research is showing that they are caused by a mix of factors that include genetic, biological, behavioral, psychological, social and environmental elements.

Risk Factors

Eating disorder risk factors vary. But there are some broad things that are similar that point to an increased chance that a person will develop an eating disorder. 

Some of the risk factors include: 

  • Having a first-degree family member with a diagnosed eating disorder
  • A history of dieting
  • Childhood focus on being thin
  • Doing sports or other activities in which being thin is stressed

Diagnosis

Eating disorders are diagnosed based on your child’s eating habits and symptoms. The doctor will do a physical exam to check your child’s overall health. The doctor will rule out other causes of the symptoms. 

Because eating disorders are a form of mental illness, your child will also need a psychological evaluation with an expert in mental health. 

Other tests, such as lab tests and questionnaires, may be ordered as well. 

At Cincinnati Children’s, your child may see any or all of our treatment team members, such as:

  • Medical doctors who are experts in the care of teens
  • Mental health experts such as:
    • Child psychiatrists
    • Child psychologists
    • Mental health therapists
  • Registered dietitians who are experts in nutrition

Treatment

There is treatment for eating disorders. Most often the sooner the treatment starts, the better the outcome.

The treatment model with the most success is called family-based treatment (FBT). This is also known as the Maudsley approach.

Because eating disorders involve physical, emotional and social elements, treatment focuses on all of these. Your child will receive the medical care they need as well as nutritional counseling. Psychotherapy (or talk therapy) is often a part of treatment. This may include any sessions that are one-on-one, group and family-based. Medicines are sometimes part of treatment as well.

It can take a long time for a person to recover, and they can relapse. But people are able to fully recover.

Last Updated 10/2018

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The Eating Disorders Program at Cincinnati Children's treats patients who have significantly unhealthy eating behaviors.