Table of Contents

What Are Eating Disorders?

Eating disorders are serious mental health conditions that involve severe and often persistent disturbances in eating behaviors, along with distressing thoughts and emotions about food, weight, or body shape. These patterns can take many forms (such as restricting food, binge eating, or compensatory behaviors like purging) and can interfere with daily functioning and overall wellbeing.

Because eating disorders can impact physical health (affecting areas like nutrition, heart health, digestion, and bone health) professional support is important. Eating disorders can affect people of any age, gender, or background. However, with the appropriate care, many individuals work toward recovery.

Types of Eating Disorders

Anorexia Nervosa

Anorexia nervosa, often referred to simply as “anorexia”, is a disorder which involves severely limiting how much one eats because of an irrational fear of gaining weight. It is the least common eating disorder but is usually what comes to mind when people think about an eating disorder. The image evoked is typically that of an emaciated, young, white female of middle to upper socioeconomic status, but the reality is that eating disorders can affect anyone—all age groups, genders, racial identities, etc.

Eating disorders can affect individuals of all body sizes, and anorexia is no exception—it may occur in people with smaller or larger bodies. The primary behavior associated with anorexia is restrictive eating. In recent years, the prevalence of anorexia among males has been increasing, particularly among those who identify as LGBTQ. Eating disorders are most common in Westernized cultures, where the idealization of thinness is widespread.

All eating disorders carry significant medical risks, but anorexia has the highest mortality rate of any mental illness, surpassed only by opioid overdose deaths.

Although disordered eating behaviors are the most visible symptoms, eating disorders are fundamentally psychiatric illnesses rooted in a combination of biological, psychological, and social factors. Effective treatment must address these behaviors—starting with nutritional rehabilitation as the most urgent intervention—but also consider the underlying issues that contribute to the development and persistence of the disorder.

Bulimia Nervosa

Bulimia nervosa, commonly referred to as bulimia, is a serious eating disorder characterized by a cycle of binge eating followed by compensatory behaviors to prevent weight gain, such as vomiting, excessive exercise, fasting, or misuse of laxatives or diuretics. People suffering with bulimia often have an unrealistic body image. They may be obsessed with their weight, are intensely self-critical, and often judge themselves harshly for what they perceive to be serious flaws. Because bulimia is related to self-image and is not just about food, it can be challenging to overcome, but treatment can often help people feel better about themselves, adopt healthier eating patterns, and even reverse serious health complications.

Key Features:

  • Binge Eating: Consuming an unusually large amount of food in a short time with a feeling of loss of control.
  • Compensatory Behaviors: Engaging in behaviors to “undo” the binge, such as self-induced vomiting (purging) or over-exercising.
  • Body Image Disturbance: Self-esteem is overly influenced by body shape and weight.
  • Frequency: These behaviors typically occur at least once a week for three months or more.

Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a mental health condition where a person can’t stop thinking about one or more perceived flaws in their appearance. They often believe that an inconspicuous or even non-existent physical attribute is a serious defect, and that they must do whatever they can to correct it. People who have BDD cannot control these thoughts, which can cause consistent emotional distress to the point of interfering with their daily lives.

We do not know the exact cause of BDD, but it usually starts in the teenage years when physical appearances become more of a concern. Body dysmorphic disorder can affect all genders and is more prevalent than most people realize. The disorder currently affects about 2% of the population and frequently co-occurs with other mental health challenges such as obsessive compulsive disorder (OCD), disordered eating, depression, and anxiety.

Binge Eating Disorder

A binge eating disorder is a serious condition in which someone frequently consumes excessive amounts of food (called bingeing) and feels unable to stop eating once they have started. People with binge eating disorders often endorse feeling ‘out of control’ during these moments.

The food choices during a binge episode can often be less nutrient dense, and ones that have historically been forbidden for that person to eat. These eating patterns provide short-term relief from painful emotions but, eventually, the emotions return with more intensity, and binge eating patterns continue.

This disorder is a serious but treatable condition. Episodes of binge eating can significantly and negatively impact your health and well-being, making it especially important to identify the signs and symptoms of binge eating, and to get the help you need to get better.

Signs and Symptoms of Eating Disorders

Anorexia Nervosa

Without treatment, anorexia takes a toll on both mental and physical health; that’s why it’s important to know the signs, and to monitor anyone who is showing those signs.

Mental health symptoms tend to revolve around a person’s distorted body image and a fear of gaining weight. This causes the person to engage in unhealthy behaviors around food, such as severely restricting what and how much they eat. These rigid and obsessive behaviors lead to physical signs of anorexia such as excessive weight loss and thinness.

Psychological and Emotional Symptoms of Anorexia:

  • Obsessions about food
  • Strong fear of gaining weight
  • Negative body image/dysphoria or distortion
  • Social isolation/withdrawal
  • Irritability
  • Flat affect
  • Numb mood
  • Low self-esteem

Behavioral Symptoms of Anorexia:

  • Dieting or fasting in extreme ways
  • Eating only a few specific foods, typically those lower in calories or perceived as “healthy”
  • Refusing to eat or making excuses to avoid eating
  • Ordering or preparing food, but not eating it
  • Leaving during or right after eating to go to the restroom
  • Lying about how much they ate
  • Chewing and then spitting out the food
  • Excessive and/or compulsive exercising
  • Vomiting and/or abusing laxatives in efforts to avoid weight gain
  • Wearing baggy clothing to hide low weight (if the individual can recognize their thinness)

Physical Symptoms of Anorexia:

  • Weight changes
  • Dizziness, feeling faint
  • Low blood pressure
  • Fatigue
  • Feeling cold
  • Dehydration
  • Irregular heart rate
  • Yellowish or dry skin
  • Thinning or brittle hair

Bulimia Nervosa

Bulimia signs and symptoms may be behavioral, physical, or emotional and psychological:

Behavioral Signs:

  • Frequent episodes of binge eating (eating large amounts of food in a short time)
  • Purging behaviors (self-induced vomiting, or misuse of laxatives, diuretics, or enemas)
  • Excessive exercise or fasting after eating
  • Secrecy around eating or disappearing after meals (often to vomit)
  • Ritualistic eating habits (e.g., cutting food into tiny pieces, eating in private)
  • Frequently looking in the mirror for perceived flaws
  • Preoccupation with weight, food, and dieting

Physical Signs:

  • Fluctuating weight (can be normal, underweight, or overweight)
  • Swollen cheeks or jaw area (from salivary gland enlargement)
  • Sore throat or chronic sore throat
  • Dental erosion or cavities (due to stomach acid from vomiting)
  • Calluses or scars on knuckles (from inducing vomiting, known as Russell’s sign)
  • Acid reflux or gastrointestinal problems
  • Dehydration
  • Electrolyte imbalances (can lead to irregular heartbeat or even heart failure)
  • Fatigue or dizziness

Emotional and Psychological Signs:

  • Low self-esteem and distorted body image
  • Mood swings, irritability, or depression
  • Feelings of guilt or shame after eating
  • Anxiety, especially around meal times or weight gain
  • Loss of control during binge episodes

Binge Eating Disorder

People who binge eat often do so in secrecy, hiding their activities because they feel shame or guilt about what they are doing. If you suspect that you or a loved one has fallen into this maladaptive pattern of eating, you should look for some of these signs and symptoms:

  • Eating large amounts of food quickly.
  • Eating alone or eating in secret.
  • Hoarding or hiding food without reason.
  • Feelings of guilt or shame around eating.
  • Dieting continually with no significant change in weight.
  • Dramatic fluctuations in weight gain or loss.
  • Expressing feelings of perfectionism.
  • Expressing feelings of low self-esteem.

Body Dysmorphic Disorder

Signs and symptoms of body dysmorphic disorder include:

  • Being extremely preoccupied with one or more perceived flaws in your appearance that are not observable by others
  • A strong belief that you have a defect in your appearance that makes you ugly
  • Engaging in behaviors aimed at fixing or hiding the perceived flaw
  • Constantly comparing your appearance with others
  • Constantly checking yourself in a mirror or avoiding mirrors
  • The preoccupation with perceived flaws causes significant distress or challenges in social, occupational, or other areas of functioning

Eating Disorder Evaluation & Testing

An Eating Disorder Testing and Evaluation involves a comprehensive assessment of the individual’s physical and mental health. This helps in understanding the underlying factors contributing to the eating disorder, such as genetic predispositions, psychological triggers, social influences, or co-occurring mental health conditions. A thorough evaluation allows healthcare professionals to address these factors holistically and develop an effective treatment approach.

These professionals will conduct patient mental health assessments, medical examinations, and laboratory tests of blood samples. Checking for additional health problems is crucial, as disordered eating can have many harmful side effects.

Evaluations can also be valuable in a preventive context. They provide an opportunity to educate individuals, families, and communities about the signs, risks, and consequences of eating disorders. By raising awareness and promoting early intervention, evaluations contribute to the prevention of eating disorders and the promotion of positive body image and healthy relationships with food.

Clinical Guidelines for a Diagnosis of Eating Disorders

Clinical guidelines for the diagnosis of Eating Disorders provide a standardized framework for healthcare professionals to assess and diagnose these conditions.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for eating disorders outlines central elements of eating disorders. It provides specific diagnostic criteria for Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and other specified feeding and eating disorders. These criteria include behavioral, psychological, and physical indicators that must be met for a formal diagnosis. While the specifics vary based on each eating disorder, some common components are:

  • Disordered eating involving binging and purging or intake restriction
  • Obsessive concern with weight
  • Being underweight

Standardized Screening for Eating Disorders

Eating Disorder Diagnostic Scale (EDDS) is a self-report questionnaire that screens for various eating disorder symptoms, including restrictive eating, binge eating, and compensatory behaviors. It also assesses body dissatisfaction and other associated psychological factors.

Diagnostic Exams and Tests for Anorexia Nervosa

During a diagnosis of anorexia nervosa, doctors usually conduct a range of tests to rule out any other reason for the weight loss.

An anorexia diagnosis test will include:

  • Physical examination. Weight, height, BMI, blood pressure, heart rate, and temperature will be recorded.
  • Laboratory tests. By examining a blood sample electrolytes and protein levels will be checked, and the functioning of organs (liver and kidneys) will be assessed.
  • Psychological evaluation. A psychiatrist or mental health professional will inquire about thoughts, feelings, and eating habits. Sometimes, a self-assessment questionnaire is completed to check for any overlapping mental health conditions.

Find one of our mental health care clinics near you to schedule a testing and evaluation for anorexia nervosa.

Diagnostic Exams and Tests for Bulimia Nervosa

The process of diagnosing bulimia nervosa includes many diagnostic examinations and tests:

  • Physical examination. Weight, height, BMI, blood pressure, heart rate, and temperature will be recorded. Individuals with bulimia nervosa are usually normal weight to slightly overweight.
  • Laboratory tests. By examining a blood sample electrolytes and protein levels will be checked, and the functioning of organs (liver and kidneys) will be assessed.
  • Psychological evaluation. A psychiatrist will evaluate to determine attitudes toward eating. The SCOFF questionnaire is helpful to identify patients that meet the diagnostic criteria for anorexia or bulimia nervosa.

Diagnostic Exams and Tests for ARFID

A person with ARFID doesn’t restrict their food intake because of physical appearance concerns, but due to sensory sensitivities or fears surrounding food.

ARFID tests and diagnostic exams include:

  • Physical examination. Weight, height, BMI, blood pressure, heart rate, and temperature will be recorded, to identify any additional health concerns.
  • Laboratory tests. By examining a blood sample electrolytes and protein levels will be checked, and the functioning of organs (liver and kidneys) will be assessed.

Eating Disorder Evaluation & Testing FAQ

Can a registered dietitian or nutritionist provide an eating disorder evaluation?
Yes, dieticians and nutritionists are qualified to assess disordered eating by conducting a thorough assessment based on lab results, personal history, relationship with food, BMI, % body weight, and exercise patterns.

Is there an eating disorder quiz I can take?
Yes, if you think you might have an eating disorder, taking a quick online quiz can point you in the right direction. Mental Health America offers a free and confidential eating disorder quiz to take online. Taking an eating disorder test doesn’t replace an official eating disorder diagnosis, but it can help people identify when they need professional help. In some cases, people don’t realize that the way they eat is disordered, and an online quiz can provide some clarity.

Are eating disorder assessments covered by insurance?
While eating disorder assessments are usually covered by insurance, follow-up treatment can be costly. Typically, individuals will need a team of providers for eating disorder treatment, and the severity of the condition may require inpatient or outpatient care. Some insurance providers only support outpatient care when substance abuse is considered the primary issue.

Do I need to go to an eating disorder clinic to get tested and assessed?
Eating disorder clinics provide specialized care and treatment for many disorders, but visiting one is not essential for everyone. You can get tested by a therapist, psychiatrist, or a doctor. Mental health care clinics like LifeStance can provide a multidisciplinary team expertise to properly evaluate someone for an eating disorder.

Can I self-diagnose an eating disorder?
No, as eating disorders are incredibly serious and require professional help, self-diagnosis is not recommended. If you suspect that you may have an eating disorder, book an appointment with your primary healthcare provider or a mental health care provider specializing in eating disorders to seek advice for the next steps to take.

How do you make someone realize they have an eating disorder?
If you think someone you know may be suffering from an eating disorder, it is important to let them know you are there to support them. It can be incredibly difficult to address but encouraging them to seek professional help while expressing your care is a good place to start. Anosognosia (feelings of denial) is a common symptom of an eating disorder, and telling someone else who is close to them may be the right step in this situation.

LifeStance Health specializes in Eating Disorder Treatment with multiple locations in 33 states. Services vary by location.

Find a location near you:

Treatments for Eating Disorders

Mental health treatments for disordered eating and eating disorders focus on helping individuals build a healthier relationship with food, their body, and their emotions.

Treatment options may include:

  • Comprehensive evaluation by a licensed mental health professional to create a personalized treatment plan.
  • Cognitive-behavioral therapy (CBT) to work on identifying and changing unhelpful thoughts and behaviors around food and body image.
  • Dialectical behavior therapy (DBT) to build skills for managing emotions and reducing harmful behaviors.
  • Family-based therapy (FBT), particularly for adolescents, to support recovery with family involvement.
  • Interpersonal therapy (IPT) to address social and relationship factors that may contribute to disordered eating.
  • Nutritional counseling with a registered dietitian to restore balanced eating patterns and address food fears or misconceptions.

In more severe cases or when health is at risk, higher levels of care may be needed, such as:

  • Intensive outpatient programs (IOP) or partial hospitalization programs (PHP) that provide structured support while living at home.
  • Inpatient or residential treatment for individuals needing 24-hour medical and emotional support.
  • Support groups and peer support to provide connection, encouragement, and shared understanding during recovery.

With compassionate, evidence-based care, recovery is possible — and help is available at any stage of the journey.

Seeking Help
If you or someone you care about struggles with disordered eating or symptoms of an eating disorder, it’s crucial to seek help. Early intervention tends to improve recovery outcomes. Contact a licensed mental health professional specializing in eating disorders.

If you are experiencing an emergency, call 911 or the Suicide & Crisis Lifeline at 988.

Traditional Therapy Options
Discussing bulimia and related issues with a mental health professional during psychotherapy (also known as talk therapy or psychological counseling) can help improve symptoms of bulimia. A few kinds of therapy that may be effective include:

Cognitive Behavioral Therapy (CBT):

  • Cognitive Behavioral Therapy can help individuals with bulimia recognize the patterns between their thoughts, emotions, and eating behaviors. It focuses on identifying and challenging distorted beliefs about food, body image, and self-worth, and replacing them with more balanced, realistic thinking. CBT also teaches practical coping strategies to reduce binge-purge cycles and develop healthier eating habits.

Family-Based Treatment (FBT):

  • Family-Based Treatment is especially suitable for adolescents with bulimia. This approach empowers parents (of adolescents with bulimia) to take an active role in interrupting disordered eating behaviors, re-establishing regular meals, and supporting their child’s nutritional recovery. It also helps families build healthier communication patterns and restore the teen’s autonomy around food in a developmentally appropriate way.

Eating Disorder Treatment FAQ

Which eating disorder is the hardest to treat?
All eating disorders can be difficult to treat, and severity is assessed on a case-by-case basis. Anorexia nervosa is typically the most difficult to treat, as many people with anorexia nervosa struggle to accept they have an eating disorder. This means they often fail to access the help they need before their condition is life-threatening.

What is the recovery rate for eating disorders?
Statistics show that 60% of those who receive professional eating disorder therapy recover completely. Although anorexia nervosa is the most common cause of death, eating disorders overall have the highest mortality rate of any mental condition.

Can someone be hospitalized to treat an eating disorder?
Yes, in some cases eating disorders become so severe that in-patient care is required for recovery. In-patient hospitalization is the most severe form of care, which provides patients with additional support, structure, medical care, and monitoring.

What’s the difference between an eating disorder clinic and an eating disorder center?
Both eating disorder clinics and eating disorder treatment centers can help you recover from an eating disorder. While specialized treatment centers tend to be private, with in-patient care offered, and are more expensive, eating disorder clinics will provide you with diagnosis and outpatient care. An eating disorder clinic can be a part of a mental health care clinic like LifeStance Health. Clinics offer outpatient services and provide a range of treatment options, such as individual therapy, group therapy, nutrition counseling, and psychiatric consultations.

Is there an eating disorder hotline I can call?
Yes, the National Eating Disorders Association has a hotline you can call for over-the-phone support. The NEDA Helpline is available at 1-800-931-2237, by text at 1-800-931-2237, or through the online chat services if you can’t access a phone.

Who is qualified to provide eating disorder counseling?
Qualified professionals who can provide eating disorder counseling typically have specialized training and experience in the field of eating disorders. Psychologists, Licensed Professional Counselors and Licensed Clinical Social Workers (LCSW) with expertise in eating disorders can provide individual therapy, group therapy, and various evidence-based therapeutic approaches tailored to the specific needs of individuals with eating disorders. They can help individuals address underlying psychological factors, distorted thoughts and beliefs, body image concerns, and emotional regulation.

Psychiatrists can provide psychiatric evaluations, medication management, and collaborate with other treatment providers to address co-occurring mental health conditions such as depression, anxiety, or obsessive-compulsive disorder that may be present alongside the eating disorder.

How do I find an eating disorder therapist near me?
LifeStance provides a detailed online directory of therapists, helping you access the help you need. Select the state you live in and browse what each therapist has to offer to choose the right eating disorder therapist for you.

What are the risks of untreated eating disorders?
If left untreated, eating disorders can have dire health consequences for the individual. The specific risks vary between different eating disorders, but common risks include:

  • Fatigue
  • Heart failure
  • Muscle loss and weakness
  • Dehydration

Does insurance cover eating disorder treatment near me?
Most insurance plans include some coverage for treating eating disorders, but the amount that is covered depends on your insurance plan, the state, and the severity of your disease.

Medication Treatment Options for Eating Disorders

While there is no medicine for eating disorders in general, some individuals with eating disorders experience depression. The most commonly prescribed medications for depression include:

  • Selective Serotonin Reuptake Inhibitors (SSRIs) such as Fluoxetine, Citalopram, Sertraline, Paroxetine, and Escitalopram
  • Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) such as Venlafaxine and Duloxetine
  • Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs) such as Bupropion

Online Eating Disorder Counseling

While onsite appointments are sometimes necessary (e.g. if height and/or weight tracking need to be done in-person), eating disorders can also be treated online through online therapy and psychiatry sessions, providing accessible support from the comfort of home. Lifestance Mental Health offers therapy and psychiatry appointments online, which helps reduce the need to travel to in-person sessions and offer options for individuals to receive professional care.

Group Therapy for Eating Disorders

Group therapy can be a supportive tool for treating eating disorders, helping individuals connect in shared experiences and create a sense of community. Lifestance provides group therapy in select states, both in person and online, allowing individuals to relate with others facing similar challenges while receiving professional guidance in a supportive environment.

photo of LifeStance provider Matt Solit

Clinically Reviewed By:

Matt Solit, MSW, LMSW
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Matthew received his B.A. in Anthropology from the University of Arizona and his master’s in social work from the Catholic University of America in his hometown of Washington, D.C. He has engaged in numerous speaking events on topics from clinical diagnostic skills-building to clinical best-practices and risk management.