Eating Disorder Awareness

Eating disorder awareness might seem foreign to some. The topic of eating disorders (EDs) can make quite a few people feel out of their depth or even uncomfortable. In similarities to depression and anxiety, people tend to think eating disorders are made up in one’s mind or don’t actually exist.

It’s often thought that eating disorders have a specific look or that they are only present in females. Those dealing with EDs are often blamed for their disordered state and their well-being isn’t taken seriously. Individuals suffering from EDs are told it’s “not serious” if hospitalization or intense treatment isn’t needed.

I could go on and on about how eating disorders are misunderstood. The list of reasons is endless. That’s exactly why eating disorder awareness is important.

To emphasize this importance, I want to discuss two things: types of eating disorders and statistics.

Types of Eating Disorders

Please note these are generalized descriptions of each type and are not meant to be all-encompassing.

Anorexia Nervosa

  • Characterized by self-induced starvation and excessive weight loss
  • Excessive food restriction and/or exercise
  • Severe fear of weight gain and/or becoming “fat”
  • Disturbed and/or warped perception of body weight or shape
  • The most deadly mental illness due to high suicide rates

Bulimia Nervosa

  • Characterized by regular binge eating behaviors followed by regular purging behavior or other compensatory behaviors
  • Disturbed and/or warped perception of body weight or shape

Binge Eating Disorder (BED)

  • Characterized by regular binge eating without the use of compensatory behaviors such as purging
  • Characterized by eating episodes that are more rapid than normal, eating until uncomfortably full, eating large amounts of food when not hungry, eating alone due to embarrassment

Avoidant/Restrictive Food Intake Disorder (ARFID)

  • Characterized by eating or feeding disturbances such as lack of interest in eating or food, avoiding certain foods based on sensory factors, or concern about unpleasant consequences of eating.
  • Typically not accompanied by warped/disturbed perception of body weight or shape
  • Eating behavior can be described as restrictive, selective, or picky accompanied by failure to meet necessary nutrition and energy needs

Other Specified Feeding or Eating Disorder (OSFED)

  • The majority of individuals who exhibit eating disorder behaviors don’t meet the criteria for any of the above eating disorder diagnoses. These individuals are typically diagnosed with OSFED.
  • Characterized by disordered feeding or eating behaviors that are similar to the disorders listed above but they do not meet the full criteria.
  • Examples of OSFED:
    • Atypical anorexia – where a person exhibits restrictive behaviors but does not have low body weight
    • BED of low frequency/limited duration
    • Bulimia Nervosa off low frequency/limited duration
    • Purging Disorder – recurring purging behavior to influence weight or body shape with the absence of binge eating
    • Night Eating Syndrome – Recurring episodes of night eating after awakening from sleep or excessive food consumption after an evening meal

Unspecified Feeding or Eating Disorder (UFED)

  • Characterized by behaviors that cause clinically significant distress/impairment of functioning, but do not meet the full criteria for an eating disorder diagnosis
  • May be used by clinicians where a clinician chooses not to specify why criteria are not met

Orthorexia Nervosa

  • Characterized by an obsession with eating foods that are considered healthy
  • A condition that includes obsessive behavior when pursuing a healthy diet
  • Not yet recognized as an “official” eating disorder diagnosis
  • You can read more about orthorexia here.

As I stated at the beginning of the section, these definitions are only simple definitions and do not describe the disorders in full and the complications that exist with each. If you feel that you or a loved one may be at risk of an eating disorder, please visit NEDA to seek help.

Eating Disorder Statistics

General Population

  • Worldwide, the number of individuals suffering from an eating disorder has doubled in just 18 years
    • The global rate of eating disorder prevalence doubled from 3.4% of the population to 7.8% between 2000 and 2018.
  • Approximately 30 million Americans will have an eating disorder in their lifetime
  • 4 out of 10 individuals have either personally experienced an eating disorder or know someone who has
  • Eating disorders are among the deadliest mental illnesses, second only to opioid addiction.
  • Anorexia is the most deadly of all mental illnesses with 1 in 5 anorexia deaths being from suicide
  • ~10,200 deaths each year are the direct result of eating disorders, which equates to 1 death every 52 minutes
  • The economic cost of eating disorders is $64.7 billion each year
  • 95% of those who have eating disorders are between the ages of 12 and 25

Females

  • Eating disorders are more than twice as prevalent in females than in males
  • 20 million women will have an eating disorder in their lifetime
  • Women are 1.75-3 times as likely to have anorexia, bulimia, or BED as compared to men
  • Eating disorders are the 3rd most common chronic illness among adolescent females in the US
  • 50% of girls between the ages of 11 and 13 see themselves as overweight
  • 80% of 13-year-olds have attempted to lose weight
  • 50% of teenage females use unhealthy weight control behaviors such as skipping meals, fasting, smoking, vomiting, and taking laxatives
  • Over 60% of women in the military that were surveyed met the criteria for an eating disorder
  • 1 in 200 American women suffers from anorexia

Males

  • 10 million men will have an eating disorder during their lifetime.
  • Males make up 25% of people with anorexia. Males are at an increased risk of dying from anorexia in comparison to females due to a typically late diagnosis.
  • An estimated 10 – 15% of people with anorexia or bulimia are males
  • Men are likely underdiagnosed with eating disorders because clinical assessment tools emphasize a desire to lose weight as opposed to building muscle
  • Disordered eating has increased across all demographics but at an even faster rate for males

Individuals in Larger Bodies

  • Less than 6% of people with eating disorders are medically diagnosed as underweight, which means that 94% of those with eating disorders are medically considered normal weight, overweight, or ob*se.
  • Due to weight stigma in the medical field, people with larger bodies are only half as likely as those at a “normal weight” or “underweight” to be diagnosed with an eating disorder. This is because even though they might meet the eating/feeding criteria, they do not meet the weight criteria. This means they won’t receive a diagnosis and likely won’t receive treatment.

Athletes

  • Athletes are more likely to abuse exercise
  • Athletes are more likely to screen positive for an eating disorder than a nonathlete
  • Athletes are less likely to seek eating disorder treatment due to stigma and expectations to perform
  • For female athletes in aesthetic sports (i.e. gymnastics, figure skating, cheerleading, swimming, dance, etc.), 41.5% reported disordered eating

BIPOC

  • BIPOC are significantly less likely than white people to have been asked by a doctor about eating disorder symptoms
  • BIPOC with eating disorders are half as likely to be diagnosed or to receive treatment
  • Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior
  • Hispanics are significantly more likely to suffer from bulimia nervosa than non-Hispanics
  • Asian American college students reported higher levels of body dissatisfaction and negative attitudes toward obesity than their non-Asian, BIPOC peers

LGBTQ+

  • Gay men are 7x more likely to report binge-eating and 12x more likely to report purging than heterosexual men
  • Gay and bisexual men are significantly more likely to fast, vomit, or take laxatives or diet pills to control their weight and body shape/size
  • 32% of transgender individuals report using their eating disorder to modify their body without hormones
  • Transgender college students report experiencing disordered eating at approximately four times the rate of their cisgender classmates

Individuals with Disabilities

  • 20-30% of adults with eating disorders have autism as well
  • 20% of women with anorexia have high levels of autistic traits
  • ADHD is the most common missed diagnosis when it comes to disordered eating

Quick Summary

As a dietitian, it’s incredibly important for me to spread eating disorder awareness. As the prevalence of eating disorders increases, the signs and the severity deserve to be properly understood.

If you know someone or think you might have an eating disorder, please check out NEDA’s screening tool as well as their helpline.

Thanks for reading!

Rachel Beiler, MHS, RD, LDN