- Eating disorders affect approximately 28.8 million Americans during their lifetime
- The three most common types are anorexia nervosa, bulimia nervosa, and binge eating disorder
- Eating disorders have the highest mortality rate of any psychiatric disorder
- Approximately 50% of individuals with eating disorders also misuse substances
- Warning signs include dramatic weight changes, food rituals, excessive exercise, and withdrawal
- Early intervention significantly improves prognosis and reduces medical complications
- Treatment includes nutritional rehabilitation, psychotherapy, and medical monitoring
- Recovery is possible at any stage, though earlier treatment yields better outcomes
Published: February 2026 | Last Updated: February 2026 | Reading Time: 6 min
What Are Eating Disorders?
Eating disorders are serious mental health conditions characterized by persistent disturbances in eating behavior and the distressing thoughts and emotions associated with food, body weight, and body shape. They are not lifestyle choices, phases, or vanity — they are complex psychiatric illnesses with biological, psychological, and social underpinnings that can have life-threatening medical consequences.
Types of Eating Disorders
Anorexia Nervosa is characterized by restriction of energy intake leading to significantly low body weight, intense fear of gaining weight, and disturbance in the way one's body weight or shape is experienced. It has two subtypes: restricting type and binge-eating/purging type. Anorexia has the highest mortality rate of any mental illness.
Bulimia Nervosa involves recurrent episodes of binge eating followed by compensatory behaviors to prevent weight gain — self-induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise. Unlike anorexia, individuals with bulimia are typically at normal weight or slightly above.
Binge Eating Disorder (BED) is characterized by recurrent binge episodes without regular compensatory behaviors. It is the most common eating disorder in the United States.
Other Specified Feeding or Eating Disorders (OSFED) includes atypical anorexia (significant weight loss but not underweight), subthreshold bulimia or BED, purging disorder, and night eating syndrome.
Eating Disorders and Substance Use
The Connection
The co-occurrence of eating disorders and substance use disorders is alarmingly high. Approximately 50% of individuals with eating disorders misuse alcohol or drugs, compared to 9% of the general population. Both conditions share common risk factors including impulsivity, difficulty regulating emotions, perfectionism, childhood trauma, and family history.
Specific substance-eating disorder patterns include alcohol use with bulimia (disinhibition facilitates binge eating), stimulant use for appetite suppression (in anorexia), laxative and diet pill abuse, and insulin restriction in individuals with diabetes ("diabulimia").
Warning Signs
Physical signs include dramatic weight loss or fluctuation, dizziness and fainting, dry skin and brittle nails, dental erosion (from purging), calluses on knuckles (Russell's sign from purging), and always feeling cold.
Behavioral signs include food rituals (cutting food into tiny pieces, rearranging food), frequent bathroom visits after meals, excessive exercise despite injury or illness, wearing loose clothing to hide body changes, social withdrawal, and collecting or hoarding food.
Treatment
Medical Stabilization
For individuals with severe eating disorders, medical stabilization is the first priority. This may include hospitalization for critically low weight, electrolyte imbalances, or cardiac complications, nutritional rehabilitation with careful refeeding protocols, and monitoring for refeeding syndrome (a potentially fatal complication of nutritional restoration after prolonged starvation).
Psychotherapy
Evidence-based therapies include CBT-E (enhanced cognitive-behavioral therapy) for all eating disorders, family-based treatment (FBT/Maudsley Method) for adolescents with anorexia, dialectical behavior therapy (DBT) for eating disorders with emotional dysregulation, and interpersonal therapy (IPT) for bulimia and BED.
Nutritional Counseling
Registered dietitians specializing in eating disorders provide meal planning, nutritional education, and support for normalizing eating patterns without triggering disordered behaviors.
Frequently Asked Questions
Are eating disorders only about food?
No. Eating disorders are complex mental health conditions in which food, weight, and body image become channels for expressing and managing deeper emotional distress. Effective treatment addresses the underlying psychological issues, not just the eating behavior.
Can men have eating disorders?
Yes. While eating disorders are more commonly diagnosed in women, approximately 10 million American men experience an eating disorder during their lifetime. Men are underdiagnosed due to stigma and the misconception that eating disorders are exclusively female conditions.
How long does eating disorder recovery take?
Recovery timelines vary significantly by individual and disorder severity. Many people show meaningful improvement within 6-12 months of treatment, but full recovery may take several years. Early intervention significantly shortens the recovery timeline and reduces medical complications.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
- Deloitte Access Economics. (2020). The Social and Economic Cost of Eating Disorders in the United States.
- National Eating Disorders Association. (2024). Statistics and Research on Eating Disorders.
- Harrop, E.N. & Marlatt, G.A. (2010). The comorbidity of substance use disorders and eating disorders in women. Addictive Behaviors.
- Treasure, J., et al. (2020). Eating disorders. The Lancet.
This article was reviewed by the Valley Spring Recovery Center Editorial Team. For co-occurring disorder treatment, call (201) 781-8812 or visit our admissions page.
Valley Spring Recovery Center — Evidence-based addiction treatment in Norwood, New Jersey.