Eating Disorders

Anorexia Nervosa  |  Bulimia Nervosa  |  Binge Eating Disorder

sitting-womanThe term “eating disorder” (ED) encompasses a wide range of unhealthy behaviors that center on an individual’s relationship to food, exercise, and his or her body.  The official diagnostic classification system (DSM-5) lists six distinct diagnoses.

Of the six diagnoses, the majority of patients we see at EDINM suffer with Anorexia Nervosa, Bulimia Nervosa, and/or Binge Eating Disorder, all of which are discussed in detail on this website.  The remaining disorders are described briefly at the bottom of this page.

At the heart of almost every case of Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder is a common core disturbance — the over-emphasis placed on the importance of shape, weight, and their control.  In pursuit of that control, this cognitive disturbance drives the individual to engage in energy intake and expenditure behaviors that ultimately interfere with both physical and mental health.

Anorexia Nervosa

What are the symptoms of Anorexia Nervosa?

  • —Food restriction leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
  • —Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
  • —Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

Some people with Anorexia Nervosa keep their weight low by consistently eating very little, others also severely restrict their food intake but punctuate the restriction with bouts of binge eating and purging. The longer a person has Anorexia Nervosa, the more likely it is that a binge-purge pattern will develop.

Who develops Anorexia Nervosa? Anorexia Nervosa affects approximately .5% to 1% of late adolescent and adult females. It is more common among females than males.

What are the risks associated with Anorexia Nervosa? The effects of Anorexia Nervosa on its victims can roughly be divided into three broad categories — physical, psychological, and social. Physically, Anorexia Nervosa affects almost every body system.

Anorexia Diagram

Drawing reproduced with permission of

Psychologically, the person with Anorexia Nervosa is generally focused on weight and food to the exclusion of most other things. She or he  is obsessed by the fear of gaining weight, is frequently irritable and depressed, and eventually develops difficulty thinking clearly and remembering things.

Socially, Anorexia Nervosa interferes with the individual’s ability to maintain satisfying relationships. Obsession with weight and food takes away the ability to focus on friends and family and the affected individual often finds him- or herself quite isolated.

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Bulimia Nervosa

What are the symptoms of Bulimia Nervosa?

  • Recurrent episodes of binge eating.  Binge eating is defined as eating in a discrete period of time an amount of food that is definitely larger than most people would eat in similar circumstances, and having no feeling of control over what or how much is eaten
  • Recurrent inappropriate compensatory behaviors after the binge episodes (i.e., efforts to negate the food intake)
  • Self-esteem is exceedingly influenced by body shape and weight

Who develops Bulimia Nervosa? Approximately 1% to 4% of women in industrialized countries develop Bulimia Nervosa.  Its onset is typically during adolescence or young adulthood, but it can have its initial occurrence earlier or later in life as well.  Females outnumber males with this disorder.

What are the risks associated with Bulimia Nervosa?

Physically as is the case for Anorexia Nervosa, Bulimia Nervosa affects multiple body systems:

  • Metabolism — weakness, irritability, dehydration, electrolyte imbalance
  • Gastrointestinal — abdominal pain, automatic vomiting, obstipation (severe constipation due to intestinal obstruction), constipation, irregular bowels, bloating
  • Reproductive — spotty/scanty menstrual periods, infertility
  • Face/neck — swollen cheeks and neck, dental decay, throat pain
  • Cardiomuscular — weakness, heart palpitations

Psychologically, the person with Bulimia Nervosa tends to be pre-occupied with thoughts about food and weight to a degree that may interfere with performance in work or school settings.  It is not uncommon for the individual with Bulimia Nervosa to also experience depression and anxiety as well as struggle with impulse control problems (e.g., substance abuse).

Socially, the person with Bulimia Nervosa may find it difficult to participate in shared activities with others for fear of overeating or being prevented from purging after eating.  Due to the secretive nature of binge/purge behavior, the individual may find him- or herself lying to friends and family about his or her whereabouts or behavior. Back to top

Binge Eating Disorder

What are the symptoms of Binge Eating Disorder?

  • Recurrent episodes of binge eating characterized by eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat, and feeling a sense of lack of control over the episode
  • The binge eating episodes are associated with at least three of the following:
    • Eating more rapidly than usual
    • Eating until uncomfortably full
    • Eating large amounts of food when not physically hungry
    • Eating alone because of embarrassment about the amount eaten
    • Self-disgust, depression, or feeling very guilty afterward

Who develops Binge Eating Disorder? It is estimated that approximately 20% to 30% of the obese population seeking weight management help meets criteria for Binge Eating Disorder. Among the general population, estimates of its prevalence range from .7% to 4%.  No particular gender differences have been observed.  Most people with Binge Eating Disorder are either overweight or obese.

What are the risks associated with Binge Eating Disorder? In addition to overweight and obesity, which carry their own associated medical risks, Binge Eating Disorder is often accompanied by depression and poor self-esteem. Back to top

The three eating disorders that do not share the core cognitive disturbance of Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder are:

Pica — Persistent eating of non-nutritive, non-food substances.

Avoidant/Restrictive Food Intake Disorder — Lack of interest in eating, or avoidance based on the sensory qualities of food or concerns about aversive consequences of eating leading to a persistent failure to meet appropriate nutritional and/or energy needs.

Rumination Disorder — Repeated regurgitation of food that is either re-swallowed or spit out.

griffin-adminEating Disorders