Eating Disorders

bulimia nervosa

Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors to prevent weight gain. Binge eating involves consuming an unusually large amount of food in a short period while feeling a lack of control. Common compensatory behaviors include purging through self-induced vomiting or laxative use, though some individuals engage in excessive exercise or fasting instead.

binge eating disorder

Binge eating disorder (BED) is characterized by recurrent episodes of eating unusually large amounts of food in a short period while experiencing a sense of loss of control. Unlike bulimia, eating binges are not followed by compensatory behaviors such as purging, but they are followed by significant distress, including feelings of guilt and embarrassment. The resulting psychological distress distinguishes binge eating disorder from overeating. BED was first recognized as a distinct diagnosis by the American Psychiatric Association in the 2013 release of the Diagnostic and Statistical Manual, Fifth Edition (DSM-5).

BED is the most common eating disorder. The lifetime prevalence in the United States is approximately 2.6%, with international surveys averaging around 1.9% (Udo & Grilo, 2018; StatPearls, 2024). Unlike other eating disorders, BED affects men at rates closer to women—approximately 3.5% of women and 2% of men in the U.S. will experience BED in their lifetime (Eating Recovery Center, 2024).^[2]

anorexia nervosa

Anorexia nervosa is an eating disorder characterized by the maintenance of a bodyweight well below average through starvation and/or excessive exercise. Individuals suffering from anorexia nervosa often have a distorted body image, referenced in the literature as a type of body dysmorphia, meaning that they view themselves as overweight even though they are not.

Like bulimia nervosa, anorexia nervosa is associated with a number of significant negative health outcomes: bone loss, heart failure, kidney failure, amenorrhea (cessation of the menstrual period), reduced function of the gonads, and in extreme cases, death. Approximately 25% of deaths among individuals with anorexia nervosa are from suicide, highlighting the serious psychological burden of this condition (Arcelus et al., 2011). Furthermore, there is an increased risk for a number of psychological problems, which include anxiety disorders, mood disorders, and substance abuse (Mayo Clinic, 2012a).

Lifetime prevalence rates for anorexia nervosa range up to 4% in women and approximately 0.3% in men (van Hoeken & Hoek, 2020). Notably, rates of anorexia among younger adolescents (under age 15) have increased in recent years.

Not all eating disorders are driven by body image. Avoidant/Restrictive Food Intake Disorder (ARFID) involves restriction or avoidance of food due to sensory sensitivity, low interest in eating, or fear of negative consequences (like choking), resulting in nutritional and/or psychosocial impairment.

Who is most at risk?

Eating disorders affect people of all genders, races, ages, and body types. While eating disorders were once stereotyped as primarily affecting young, white, affluent women, research increasingly challenges this narrow view. Studies show that eating disorders occur at similar rates across racial and ethnic groups, though people of color are significantly less likely to be diagnosed or asked about disordered eating by healthcare providers (Marques et al., 2011). This disparity in diagnosis and treatment—not actual prevalence—likely accounts for earlier findings that emphasized white populations.

Adolescents and young adults remain the highest-risk age group, with females between the ages of 15 and 19 showing the highest rates. Global data shows that eating disorder prevalence has increased over the past three decades. Between 1990 and 2021, the global prevalence rate increased by approximately 18% among adolescents and young adults, with rates continuing to rise (Li et al., 2025).

Both biological and social factors contribute to eating disorder risk. There is evidence that genetic factors may predispose people to these disorders (Collier & Treasure, 2004). Sociocultural factors also play an important role, including exposure to messaging about body ideals. While earlier research focused on thin ideals portrayed in traditional media such as television and fashion magazines, social media has emerged as a significant factor. Research shows a meaningful correlation between social media use—particularly exposure to appearance-focused content—and body dissatisfaction and disordered eating behaviors. Importantly, the type of content consumed appears to matter more than the amount of time spent online (Sanzari et al., 2023).

Eating Disorders in Men

Men are often underrepresented in eating disorder research and clinical settings. Historically, eating disorders in men have been underdiagnosed and underreported, in part due to stigma and the misconception that eating disorders only affect women (Halbeisen et al., 2024).^[3] Current estimates suggest men account for approximately 25% of eating disorder cases. Male presentations may differ somewhat—men are more likely to use excessive exercise as a compensatory behavior and may focus on muscularity rather than thinness. LGBTQ+ individuals show elevated rates of eating disorders compared to heterosexual peers (Feldman & Meyer, 2007).

Treatment of Eating Disorders

Treatment for eating disorders often involves a multidisciplinary approach that combines medical, psychological, and nutritional therapies. Common treatment components include:

• Psychotherapy: Cognitive-behavioral therapy (CBT) is commonly used to address the distorted beliefs and behaviors related to eating, body shape, and weight.
• Medication: Antidepressants may be prescribed to treat underlying mental health conditions like depression or anxiety, which are often comorbid with eating disorders.
• Hospitalization: In more severe cases, inpatient treatment may be required to manage life-threatening health complications.
• Nutritional support: Nutritional counseling and monitored meal plans help restore healthy eating patterns and nutritional status.
• Family-based treatment: This approach is particularly effective for adolescents, involving the family in the patient’s recovery and showing remission rates of approximately 49% compared to 34% with individual treatment alone (Lock et al., 2010).
• Ongoing support: Support groups and aftercare provide additional layers of support throughout recovery.

Early intervention significantly improves the chances of recovery (National Institute of Mental Health, 2021).

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