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Eating Disorders Awareness: What You Should Know

Eating disorders are serious mental and physical illnesses that can affect people of all genders, races, ages, sexual orientations, body shapes, and weights. At least 9%, or 28.8 million, Americans will suffer from an eating disorder in their lifetime. Eating disorders are the second most fatal mental illness, with 10,200 deaths each year are the direct result of an eating disorder– that's one death every 52 minutes!

Having an eating disorder does not look the same for every person. Less than 6% of people with eating disorders are medically diagnosed as “ underweight.” National Eating Disorder Awareness Week (NEDAwareness Week) is an annual campaign to educate people about the realities of eating disorders and to provide hope, support, and visibility to those suffering from an eating disorder and their families.

Did You Know…

  • In a large study of 14– and 15-year-olds, dieting was the most important predictor of a developing eating disorder. Those who dieted moderately were 5x more likely to develop an eating disorder, and those who practiced extreme restriction were 18x more likely to develop an eating disorder than those who did not diet.

  • By age 6, girls especially start to express concerns about their own weight or shape. 40-60% of elementary school girls (ages 6-12) are concerned about their weight or about becoming too fat. This concern endures through life.

  • Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.

  • One study found that 35% of female and 10% of male college athletes were at risk for anorexia nervosa and 58% of female and 38% of male college athletes were at risk for bulimia nervosa.

  • Despite similar rates of eating disorders among non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, people of color are significantly less likely to receive help for their eating issues.

  • Transgender individuals experience eating disorders at rates significantly higher than cisgender individuals.

  • According to the National Center on Addiction and Substance Abuse, up to 50% of individuals with eating disorders abused alcohol or illicit drugs, a rate five times higher than the general population.

  • When researchers followed a group of 496 adolescent girls for 8 years, until they were 20, they found:

    • 5.2% of the girls met the criteria for DSM5 anorexia, bulimia, or binge eating disorder.

    • When the researchers included nonspecific eating disorder symptoms, a total of 13.2% of the girls had suffered from a DSM-5 eating disorder by age 20.

Statistics from the National Eating Disorders Association

Anorexia nervosa is an eating disorder that is characterized by weight loss; difficulty maintaining an appropriate body weight in proportion to height, age, and stature; and commonly distorted body image. People with anorexia might restrict the number of calories or types of food they eat, compulsively exercise, purge via vomiting and/or laxatives, and/or binge eat. This disorder typically develops during adolescence, however more and more children and adults are being diagnosed with anorexia. While we may think of a person struggling with anorexia as someone who looks severely underweight, this is not always the case. Studies have found that larger-bodied individuals can also have anorexia, but are less likely to be diagnosed because of cultural prejudice against fat and obesity.

Bulimia Nervosa is characterized by a cycle of binging and compensatory behaviors like self-induced vomiting to compensate for the effects of binge eating. This constant binge-and-purge cycle affects the entire digestive system and can lead to electrolyte and chemical imbalances that affect the heart and other major organ functions.

Binge Eating is the most common eating disorder in the United States. It is characterized by recurrent episodes of eating large quantities of food, loss of control during the binge, and shame, distress, and/or guilt after binge eating. Binge eating can lead to clinical obesity, weight stigma, and weight cycling. People who struggle with Binge Eating Disorder are usually around a normal to higher-than-average weight, although the disorder can be diagnosed at any weight.

The earlier an eating disorder is detected, the higher the chances for recovery. It is important to know the warning signs of an eating disorder and catch it as soon as possible. Common symptoms of an eating disorder according to NEDA are:

  • Emotional and Behavioral

    • In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns

    • Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting

    • Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

    • Appears uncomfortable eating around others

    • Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)

    • Skipping meals or taking small portions of food at regular meals

    • Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)

    • Withdrawal from usual friends and activities

    • Frequent dieting

    • Extreme concern with body size and shape

    • Frequent checking in the mirror for perceived flaws in appearance

    • Extreme mood swings

  • Physical

    • Noticeable fluctuations in weight, both up and down

    • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

    • Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)

    • Difficulties concentrating

    • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)

    • Dizziness, especially upon standing

    • Fainting/syncope

    • Feeling cold all the time

    • Sleep problems

    • Cuts and calluses across the top of finger joints (a result of inducing vomiting)

    • Dental problems, such as enamel erosion, cavities, and tooth sensitivity

    • Dry skin and hair, and brittle nails

    • Swelling around area of salivary glands

    • Fine hair on body (lanugo)

    • Cavities, or discoloration of teeth, from vomiting

    • Muscle weakness

    • Yellow skin (in context of eating large amounts of carrots)

    • Cold, mottled hands and feet or swelling of feet

    • Poor wound healing

    • Impaired immune functioning

Men and Eating Disorders

Many people assume that men do not suffer from eating disorders, but this is not true. Eating disorder behaviors including, binge eating, purging, laxative abuse, and fasting for weight loss are almost as common in men as they are in females. Men represent 25% of individuals with anorexia and bulimia and 36% of individuals with binge eating disorder. From 1999 to 2009 there was a 53% increase in the number of men hospitalized for an eating-disorder-related reason.

The stigma against male mental health issues means that many men are not diagnosed with eating disorders until they have already progressed and some men may never seek help. This can result in a higher risk of eating-disorder-related death. Men with eating disorders often suffer from other mental illnesses like depression, excessive exercise, substance disorders, and anxiety. Men in treatment for an eating disorder can feel out of place when they are surrounded by mostly females. A gender-sensitive approach that recognizes the different needs and dynamics for men with eating disorders is critical for effective treatment and an all-male treatment environment is recommended when possible.

Diagnosis is the first and only step towards recovery from an eating disorder. Treatment usually involves both psychological and nutritional counseling as well as medical and psychiatric monitoring. A treatment team commonly includes physicians, psychotherapists, dietitian, psychiatrist, additional therapists, and a case manager. Treatment generally includes correcting life-threatening medical and psychiatric symptoms, interrupting eating disorder behaviors, establishing normalized eating and nutritional rehabilitation, challenging unhelpful and unhealthy eating disorder and eating disorder related thoughts and behaviors, addressing ongoing medical and mental health issues, and establishing a plan to prevent relapse. If you or someone you know may be suffering from an eating disorder, get help right away.

  • NEDA’s confidential eating disorder helpline 800-931-2237 is available to call Monday-Thursday from 11AM-9PM and Friday from 11AM-5PM.

  • The NEDA Helpline chat is available Monday-Thursday from 9AM-9PM and Friday from 9AM-5PM.

  • If you are in a crisis and need help immediately text NEDA to 741741. This crisis tet line provides free 24/7 support.

  • Find treatment providers near you here

  • Eating Disorders Screening Tool

  • Resource guides by area from The Hub

  • List of free peer support groups from The Hub

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