Eating disorder symptoms, types and causes

Food is an important part of our lives. But managing our relationship with food isn’t always easy.

Life experiences, mental health and other medical conditions can further complicate a person’s relationship with food, which may change eating habits and behaviors, and possibly lead to eating disorders.

Eating disorders are serious conditions that can lead to long-term physical health effects – but recovery is possible with eating disorder treatment. In this post, we explain some of the signs and symptoms of eating disorders, possible causes and how to get help for yourself or a loved one.

What is an eating disorder?

An eating disorder is a serious mental health disorder that can cause significant medical complications – it is not a choice. Individuals with eating disorders engage in eating behaviors such as restriction, binge eating and purging that significantly impact their functioning.

Some people may use eating disorder behaviors as a way to change or control their body weight or shape. At other times, an eating disorder may be a person’s way of coping with upsetting life experiences such as a stressful job, a trying relationship or an untreated mental health condition like anxiety or depression.

You can have an eating disorder if you’re underweight, overweight or a completely average weight. And you can develop an eating disorder regardless of your gender, age, race, ethnicity, sexual orientation or socioeconomic status.

Common eating disorder symptoms to look for

Chances are you know someone with an eating disorder. It’s estimated that about 9% of the U.S. population will have an eating disorder at some point in their lives. But you can’t always tell if someone has an eating disorder based on their symptoms or appearance.

Disordered eating patterns can differ from person to person. And people with eating disorders often go to great lengths to keep others from finding out about their habits and behaviors. Still, there are some common eating disorder symptoms to watch for.

Changes to eating habits

It’s not always easy to identify when someone’s eating habits are a sign of an eating disorder since eating disorders don’t affect everyone in the same way. However, possible behaviors may include:

Bingeing, or eating a lot of food in a short amount of time
Skipping meals
Eating a very small amount of food
Eating too fast
Removing entire food groups from their diet
Avoiding foods because of the texture, color or smell
Only eating low-carb, low-fat or diet foods
Chewing gum or drinking lots of water instead of eating
Emotional eating

Rigid attitudes about food

While a person may not come out and say that they have an eating disorder, their attitudes toward food can be a strong clue.

They’ll likely have very rigid ideas about what foods are okay to eat. They may label specific foods (or groups of foods) as good or bad. For example, they may consider all carbohydrates or fats bad and unhealthy.

Distorted body image

Some people with eating disorders have trouble seeing their body the way it really is. They may see a very large body in the mirror when they are very thin. Their struggle with body image or an overfocus on their weight or body shape often impacts how they function each day.

Changes to behaviors

People with eating disorders are often very good at hiding eating disorder behaviors. But there may be signs of eating disorders in what a person does and how they interact with others, including:

Making excuses so they don’t have to eat around others
Eating in secret
Weighing themselves frequently
Spending a lot of time looking in the mirror
Going to the bathroom during or after meals
Excessively exercising to make up for eating
Withdrawing from friends and family
Changes in mood – they may seem more irritable, depressed or anxious

Physical changes

A person’s general appearance isn’t always a good indicator of an eating disorder because there aren’t always noticeable changes in appearance –especially in the beginning stages of an eating disorder. But the following are physical changes to watch for:

Big changes in weight, such as significant weight loss, weight gain or weight that frequently goes up and down
Dry or brittle skin, nails or hair
Fine hair growth on body and face
Hair loss
Burst blood vessels in eyes
Swollen glands along the jaw and cheeks, puffiness around the face
Tooth decay and gum disease
Headaches and fatigue
Abdominal pain and constipation
Dizziness or lightheadedness
Irregular or absent periods
Constantly feeling cold

What causes eating disorders? Several factors can play a role

It’s hard to provide a simple answer about what causes eating disorders because there are so many possible factors, and they can vary from person to person. Still, if someone has developed an eating disorder, it’s likely that it’s been influenced by one or more of the following factors:

Mental health disorders

Eating disorders are more common in people with other mental health conditions. Research shows that up to 97% of people with eating disorders have one or more mental health condition such as depression, anxiety, bipolar disease, post-traumatic stress disorder (PSTD), phobias or substance abuse.

Genetics

New research shows our genes can make us 40-60% more vulnerable to eating disorders. If someone in your immediate family has an eating disorder, you’re more likely to develop one.

Brain chemistry

People with eating disorders can have imbalances in the brain chemicals that control hunger, appetite and digestion. But scientists are still trying to figure out what causes these imbalances and how (or if) they contribute to eating disorders.

Perfectionism

People with perfectionistic personality traits may have unrealistically high expectations about their looks and accomplishments – and their self-worth is often based on meeting these high standards. A person who is a perfectionist may continue to work toward these ideals, even if there are negative outcomes.

Physical and emotional trauma

Experiencing trauma can make it more likely for a person to develop an eating disorder. A person’s trauma may stem from a single event, such as an accident or the death of a loved one. People may also experience ongoing trauma caused by physical, sexual or emotional abuse.

Being teased or bullied about weight or body

People who’ve been teased or bullied based on their size or weight are more likely to develop eating disorders. It’s important to remember that bullying behaviors aren’t always obvious. Seemingly innocent comments made by teachers, doctors, coaches and family members can be harmful if they make someone feel ashamed about their body, weight or size.

Stressful situations

Stress eating is a real thing. Times of stress, even good stress, can cause increases or decreases in appetite. When stress is ongoing, it can contribute to mental health concerns and eating disorders. For example, people of color and people who identify as LGBTQ+ experience minority stress and ongoing discrimination that can make eating disorders more likely.

Family attitudes and behaviors

Parents and other family members can unintentionally contribute to disordered eating by what they say and do. Comments about body shape or size can make a lasting impression, whether it’s talking about dieting, using “fat” in a negative way or worrying about their child’s weight gain.

A child’s attitudes about food can become distorted if they grow up hearing that certain foods are good or bad, or if their parents are overly restrictive about when, what and how much they can eat.

Peer pressure

Research shows that eating disorder behaviors may be learned from friends – usually someone at school who has an eating disorder. For example, a child may change their eating habits because that’s what their friends are doing. Some kids will be able to stop disordered eating behaviors as they grow older. But for some, these childhood behaviors turn into a lifelong struggle with an eating disorder.

Culture

The diet culture in the U.S. makes it difficult to have healthy attitudes about food and body size. We’re told that we have complete control over how our body looks and how much we weigh. But the truth is, for most people, diet and exercise play a much smaller role in body shape and size than uncontrollable factors like genetics and social influences.

Yet, we grow up learning that being thin is good and healthy, and that having a bigger body is bad and unhealthy. These widespread attitudes greatly contribute to unhealthy eating behaviors and eating disorders.

Social media

Some research shows that the more time a child spends looking at photos and videos on social media, the more likely they are to have an eating disorder.

Looking at media of others (especially videos and photos that have been altered using filters) can make people feel unhappy about their appearance. Plus, many social media platforms include information that promotes eating disorders.

Dieting

Individuals of all ages who engage in restrictive dieting put themselves at risk for developing an eating disorder. The National Eating Disorders Association (NEDA) states that those who diet moderately are five times more likely to develop an eating disorder. For individuals who have a family history of eating disorders, the chances increase even more.

Dieting can lead to increased obsessions with food and weight. It intensifies feelings of guilt and shame associated with food, and can cause unhealthy eating behaviors that can turn into an eating disorder.

Types of eating disorders

There are different types of eating disorders. Eating disorders are usually tied to negative emotions such as anxiety, self-esteem and appearance. The following are descriptions of some of the most common types of eating disorders. But it’s important to remember that behaviors and symptoms can differ from person to person.

Anorexia nervosa

Anorexia is an eating disorder where a person significantly restricts their food intake. People with anorexia may not have an accurate view of their body and are often underweight.

People with anorexia take extreme measures to lose weight or prevent weight gain. In addition to restricting how much they eat, they may also limit the types of food they eat, overexercise, vomit after eating or misuse laxatives.

Physical symptoms of anorexia are related to starvation and include dizziness, significant weight loss, hair loss and fine hair growth on the body and face. Anorexia can lead to malnutrition, depression, anxiety, isolation from family and friends, and severe health complications.

Bulimia nervosa

Bulimia is characterized by periods of bingeing, followed by compensatory behaviors to “get rid” of the food eaten during a binge. Types of compensatory behaviors include self-induced vomiting, misusing laxatives and overexercising.

Signs of bulimia include anxiety about appearance, eating large amounts of food at a time, hoarding food and eating in secret. Untreated bulimia can lead to tooth decay, gum disease and problems with the heart, kidney and esophagus. This eating disorder is especially dangerous when purging is frequent or ongoing.

Binge eating disorder

Binge eating disorder (sometimes called BED) is where a person frequently eats an excessive amount of food and feels unable to stop even when they’re full. Dieting can lead to binge eating as restricting calories during the day can lead to bingeing at night.

Binge eating disorder is different from bulimia because people who have binge eating disorders don’t purge after bingeing to “make up” for the extra calories. People with binge eating disorder may struggle with their weight or live in larger bodies. But people can have a binge eating disorder even if they’re of average weight. Dangers of an untreated binge eating disorder include social isolation, worsening mental health and weight-related medical conditions such as heart disease and type 2 diabetes.

Diabulimia

An eating disorder may cause a person with diabetes to mismanage their condition by skipping meals, eating too much, restricting the amount of insulin they take or stopping their insulin altogether. When someone has an eating disorder and type 1 diabetes, it’s sometimes referred to as diabulimia.

A body needs insulin to turn the sugars in food into energy. If a body doesn’t have enough insulin, it cannot break down all the sugars in food – instead, the body breaks down the body’s own fat and muscle, which results in weight loss. But this weight loss is not healthy. Over time, high blood sugar levels can seriously damage a person’s nerves, blood vessels, tissues and organs. People with diabulimia are at increased risk for heart attack, stroke, vision problems, kidney damage and nonhealing wounds.

Avoidant/restrictive food intake disorder

People with avoidant/restrictive food intake disorder (ARFID) have an intense struggle with food and eating, which results in weight loss or failure to grow. Unlike other eating disorders, ARFID is not related to body image. Instead, it’s caused by lack of interest in eating, sensory issues, or fears of choking or vomiting. ARFID often starts in childhood, but it can also be a problem for adults.

People with ARFID may avoid foods based on texture, color, flavor or smell. They may also have no interest in eating or think that eating will cause them to vomit or choke.

Concerning symptoms of ARFID include weight loss, inability to meet growth milestones, malnutrition and problems at school, work or home that are related to food or social interaction.

Other specified feeding or eating disorders

Other specified feeding or eating disorders (OSFED) is used to describe eating disorders that don’t meet the criteria of a specific condition such as anorexia, bulimia or binge eating – but still significantly affect a person’s physical or mental health.

For example, a person might be diagnosed with an OSFED if they have the eating habits and behaviors of someone who has anorexia but don’t have a low body weight. Another example of an OSFED is purging behavior without bingeing.

Symptoms of OSFED tend to be similar to those experienced with other eating disorders and include very disturbed eating habits, significant changes in body weight, low self-esteem, depression and anxiety.

What to do if you think someone has an eating disorder

Eating disorders are serious mental illnesses and can even be life threatening. Recovering from an eating disorder takes time and a lot of physical and emotional support from family, friends and doctors.

Here’s the thing: Even if you’re ready to help, there’s a chance that the person with the eating disorder may not be ready or willing to take it – at least not yet. But don’t give up. Your love and support can mean all the difference as someone with an eating disorder journeys toward wellness. Here are things you can do if you think someone might have an eating disorder:

Let them know you’ll support them, no matter what

It can be tricky to know what to say. Here are some ideas to get you started:

I'm very concerned.
Things have changed. You don't seem like yourself.
We miss eating meals with you.
You're so busy exercising, you don't seem to have time for friends anymore.
I love you, no matter what.
I think it would be good to talk to a professional about these changes.
I'll be with you. I'll always be there for you.

Avoid talking about weight

Don’t mention their weight or their appearance – even compliments like, “you look really healthy” can be triggering, causing them to obsess about their weight. Also, skip talking about your own weight. When it comes down to it, there’s no reason to comment about the size or shape of any body – even your own.

Be careful when talking about food and eating

While it’s natural that you want to find a common ground, avoid talk that normalizes unhealthy eating behaviors. Yes, everyone skips meals occasionally, but calling it out can make it seem like eating disorders aren’t a serious condition that require medical care.

Instead, keep the focus on them and how their eating habits are affecting their physical and mental health. Say things like, "I'm concerned you're not eating enough and that your body and mind aren’t getting enough fuel for all your activity.”

Listen without judgement

If someone opens up to you about an eating disorder, it’s important to provide focused attention and listen without judgement. So, put away your phone and give them your complete attention, preferably in a quiet space.

As they talk about their situation, don’t interrupt or try to fix the issue. Just let them know you’re listening by nodding your head. Once they’re done talking, ask what you can do.

Encourage them to talk to their doctor

Many people with eating disorders don’t think they need treatment. But it’s still important to encourage them to talk to their doctor. Your concern may be the thing that makes them realize that they need help.

If you think your child has an eating disorder, make an appointment with their doctor to talk about your concerns and the changes you’re seeing. Ask if evaluation and treatment at an eating disorder center like Melrose Center may make sense for them.

Learn more about eating disorders

It’s also important to learn more about eating disorders and the resources that are available. Some good options include:

Get help for eating disorders

Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations and socioeconomic statuses.

If you think a loved one has an eating disorder or if you’re struggling, Melrose Center can help. Our expert care teams include doctors, therapists and dietitians ready to support your recovery in mind and body.