Eating disorders are very serious conditions. They are increasing in numbers all over the world, are associated with several adverse medical and psychological complications, and have the highest mortality rates of any psychiatric disorder.
There are many different types of eating disorders, so let’s distinguish between them in this article.
Common eating disorders
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating Disorder
- Other Specified Feeding or Eating Disorder
Less common eating disorders:
- Rumination Syndrome
- Night Eating Syndrome
- Avoidant/Restrictive Food Intake Disorder
- Orthorexia Nervosa
Let’s dive into the central characteristics that define each of these eating disorders.
Anorexia nervosa is characterized by persistently low body weight, extreme dietary restriction, fear of weight gain, and a strong desire to be thin.
Many people who suffer from anorexia nervosa believe that they are overweight, despite the fact that most are severely underweight. The person usually lacks insight into the seriousness of their restrictive eating behaviors and low body weight.
A portion of people with anorexia nervosa engage in binge eating and various compensatory behaviors, such as driven exercise, self-induced vomiting, and laxative misuse.
Bulimia nervosa is characterized by recurrent binge eating (eating a large amount of food while simultaneously feeling out of control) in combination with inappropriate purging behaviors.
The core psychopathology that drive bulimia nervosa is an overvaluation with weight and shape, which refers to judgements of self-worth that are contingent upon one’s weight and shape. This overvaluation causes people to adopt strict and inflexible diets, which in turn leads to the episodes of binge eating and purging.
Binge Eating Disorder
Binge-eating disorder is characterized by recurrent episodes of binge eating without any inappropriate compensatory behaviors.
The binge eating is usually associated with significant shame, guilt, and regret, and the food consumed during a binge is usually high calorie, processed foods.
Often, the binge eating is caused by negative emotions more so than attempts to diet, and because there are no compensatory behaviors practiced, many people with binge-eating disorder are also overweight or obese.
Other Specified Feeding or Eating Disorder (OSFED)
OSFED are a class of eating disorders do not meet the full criteria for any of the other eating disorders mentioned above, but the pattern of eating causes clinically significant distress.
Some examples of OSFED include:
- Atypical anorexia nervosa: where all criteria for anorexia nervosa are met, but the individual is within or above the normal weight range.
- Binge eating disorder of low frequency and/or limited duration: All of the criteria for binge-eating disorder are met, except at a lower frequency and/or for less than three months.
- Bulimia Nervosa of low frequency and/or limited duration: All of the criteria for bulimia nervosa are met, except that the binge eating and inappropriate compensatory behavior occurs at a lower frequency and/or for less than three months
Pica involves eating items that are not typically thought of as food and that do not contain any nutritional value.
People with pica may choose to eat, for example, hair, paint, or dirt.
It is important to note that the ingestion of the substance is not part of a culturally supported or socially normative practice (e.g., certain culture groups promote eating clay as part of a medicinal practice). Also, the eating of these substances must be developmentally inappropriate. For example, pica would not occur in children aged 2 or below who put small objects in their mouth to explore their senses.
Rumination syndrome is characterized by effortless regurgitation of most foods following consumption, due to the involuntary contraction of the muscles around the abdomen.
The regurgitation is not the usual self-induced vomiting we see in bulimia nervosa; rather, it is effortless and there is no retching, nausea, heartburn, odor, or abdominal pain associated, and it is not practiced for weight loss purposes.
Night Eating Syndrome
In night eating syndrome, people feel the need to compulsively eat at night. Most of the calories consumed occur during the night and people find themselves eating after awakening from sleep, or by excessive food consumption after the evening meal.
The behavior is not better explained by environmental influences or social norms, or by the presence of another mental health problem, like binge-eating disorder. People who exhibit night eating syndrome experience clinically significant distress and impairment.
Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID is a feeding and eating disorder that is characterized by a persistent failure to meet appropriate nutritional and/or energy needs.
This can therefore lead to significant and rapid weight loss; nutritional deficiency; dependence on oral nutritional supplements; and significant interference with psychological, social, and emotional functioning.
Note that ARFID is not associated with body image concerns nor is it a result of a lack of available food.
Orthorexia Nervosa is not an official eating disorder, but it is getting a lot of attention. It is characterized by an obsession or unhealthy fixation with eating healthy foods.
Other common characteristics of orthorexia Nervosa include; a strong desire to consume a personally defined healthy diet; elimination of foods and food groups believed to be impure; obsessive preoccupation with the quality of food eaten; excessive amount of time spent reading about or preparing specific foods based on their perceived quality; and intolerance of others’ food beliefs.