Treatments For Eating Disorders
Starting treatment as early as possible is important because there can be long-term health consequences for people with chronic eating disorders.
There is no ‘one size fits all’ approach to treating eating disorders since everyone is different. Often a team of health professionals is involved in an individual’s treatment, including a , and .
Some of the treatment options include:
Mental Health Treatment Locator
For more information, resources, and research on mental illnesses, visit the NIMH website at . The National Library of Medicines MedlinePlus website also has information on a wide variety of mental disorders.
For general information on mental health and to locate treatment services, call the Substance Abuse and Mental Health Services Administration Treatment Referral Helpline at 1800662HELP . SAMHSA also has a Behavioral Health Treatment Locator on its website that can be searched by location.
General Eating Disorder Statistics
- Eating disorders affect at least 9% of the population worldwide.1
- 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime.2
- Less than 6% of people with eating disorders are medically diagnosed as underweight.1
- 28-74% of risk for eating disorders is through genetic heritability.1
- Eating disorders are among the deadliest mental illnesses, second only to opioid overdose.1
- 10,200 deaths each year are the direct result of an eating disorderthats one death every 52 minutes.2
- About 26% of people with eating disorders attempt suicide.1
- The economic cost of eating disorders is $64.7 billion every year.2
What Are The Risks Associated With Disordered Eating And Dieting
The risks associated with disordered eating are severe. People with disordered eating may experience: A clinical eating disorder such as anorexia nervosa, bulimia nervosa, binge eating disorder or other specified feeding and eating disorders Osteoporosis or osteopenia: a reduction in bone density caused by a specific nutritional deficiency Fatigue and poor sleep quality Gastrointestinal problems such as constipation and/or diarrhoea Headaches Feelings of shame, guilt, and low self-esteem Depressive or anxious symptoms and behaviours Nutritional and metabolic problems
What Are The Common Causes Of An Eating Disorder
Eating disorders are often blamed on the pressure to be thin. Pressure can stem from friends, family, the workplace, and often the media.
However, it is also possible that the cause is much more complex than this.
Some experts believe that if you have a family history of eating disorders, depression, or substance misuse then you could be more likely to suffer from an eating disorder.
Certain characteristics, such as an obsessive personality, can also make someone more likely to develop an eating disorder.
People In Larger Bodies Eating Disorder Statistics
- Less than 6% of people with eating disorders are medically diagnosed as underweight.1
- Larger body size is both a risk factor for developing an eating disorder and a common outcome for people who struggle with bulimia and binge eating disorder.12
- People in larger bodies are half as likely as those at a normal weight or underweight to be diagnosed with an eating disorder.13
Abnormal Brain And Hormone Function
In people without eating disorders, semi-starvation triggers anxiety, depression, neuroticism, and obsessive behavioural patterns around food. These mental conditions support a continuous cycle of starvation. Brain imaging studies suggest that people suffering from eating disorders have alterations in their brain circuitry that contribute to these diseases. Also, abnormalities in activities or structure of the hypothalamus and problems with serotonin pathways promote the development of eating disorders. These abnormalities may explain why people with anorexia can inhibit their appetite and why people with binge eating disorder or bulimia are susceptible to overeating.
Family And Friends Of Someone With An Eating Disorder
Parents, siblings, partners, friends, extended family, work colleagues and others often experience many different feelings as they learn to cope with the effects of an eating disorder on the person, and on their own lives. The strain of living with an eating disorder can create tensions and divisions within a family. There may be feelings of confusion, grief, anger, guilt and fear. Family and friends can remind their loved one that the effort associated with recovery will be worthwhile for everyone. The most important thing is to show love, care and faith in the person, and seek advice at the earliest possible time.Some suggestions for family and friends include:
The Link Between Depression And Eating Disorders
may lead to eating disorders, but thereâs also evidence that eating disorders can result in depression. âBeing severely underweight and malnourished, which is common in anorexia, can cause physiological changes that are known to negatively affect mood states,â says Lisa Lilenfeld, PhD, an associate professor of clinical at Argosy University in Arlington, Va., who specializes in eating disorders.
Depression in people with eating disorders typically has its own unique features, according to Ira M. Sacker, MD, an eating disorders specialist at Langone Medical Center at New York University and author of Regaining Your Self: Understanding and Conquering the Eating Disorder Identity.
âPeople who develop eating disorders feel as people that theyâre not good enough,â Sacker says. âThey become obsessed with perfectionism. That perfectionism begins to focus on what they eat. But underlying it is depression and anxiety. Often, these patients have suffered a lot of emotional trauma.â
People with binge eating disorder are frequently or , for instance. This can lead them to feel chronically depressed about the way they look. After succumbing to an episode of binge eating, they may feel disgusted with themselves, worsening their depression.
To determine if depression is part of an eating disorder, doctors use a well-tested battery of questions that tease out the most common symptoms of depression. These include:
Association Is Not Cause
There is no single cause for any eating disorder. This may shock some people who look for causes in childhood experiences or traumas. What we do know is that there are several known risk factors which make it more likely that a person will develop an eating disorder. And there are known risk factors for specific types of eating disorder. Someone with any kind of eating disorder is more likely to be sensitive, prone to anxiety, has high standards yet poor self-confidence. The reasons why these factors have come together in any one individual will be personal. Sometimes it is just an accident of birth and sometimes it is a build up of experiences.
Below are some of the known risk factors for eating disorders:
Eating disorders most commonly start off with dieting behaviour. You can read more about the effects and the psychology of dieting on our information page. Even though most eating disorders begin with a diet, not all dieters will get an eating disorder.
Unloading The Gun And Getting Help
Like all patients with mental illnesses, those with eating disorders cant simply snap out of it; it takes help.
If you or someone you know is struggling with an eating disorder, call the NEDA Helpline Monday-Friday 9 a.m. to 5 p.m. EST at 1-800-931-2237 or visit for more information.
Tonight, the Empire State Building will be illuminated with blue and green lights, the colors of the National Eating Disorders Association. Grefe sees this as a major milestone and further confirmation by the public that eating disorders as serious conditions that warrant attention and research funding.
When Should I Call The Doctor
You should call your healthcare provider if you have an eating disorder and you:
- Find that your relationship to food is causing you distress.
- Find that your relationship to food is getting in the way of your everyday activities.
- Have a severe sore throat or acid reflux.
- Have slurred speech or blurred vision.
People With Disabilities Eating Disorder Statistics
- Women with physical disabilities are more likely to develop eating disorders.9
- 20-30% of adults with eating disorders also have autism.10
- 3-10% of children and young people with eating disorders also have autism.10
- 20% of women with anorexia have high levels of autistic traits. There is some evidence that these women benefit the least from current eating disorder treatment models.10
- ADHD is the most commonly missed diagnosis in relation to disordered eating.11
What Forms Of Treatment Are Effective For Anorexia Nervosa
Treatment of anorexia nervosa involves nutritional rehabilitation to normalize weight and eating behavior. Psychotherapy is aimed at correcting irrational preoccupations with weight and shape, managing challenging emotions and anxieties and preventing relapse. Interventions include monitoring weight gain, prescribing an adequate diet, and admitting patients who fail to gain weight to a specialty inpatient or partial hospitalization program. Specialty programs combining close behavioral monitoring and meal support with psychological therapies are generally very effective in achieving weight gain in patients unable to gain weight in outpatient settings. The fear of fatness and body dissatisfaction characteristic of the disorder tend to extinguish gradually over several months once target weight and normal eating patterns are maintained, and 50-75% of patients eventually recover. No medications have been shown to significantly facilitate weight gain in patients with this disorder. In the case of patients under 18 years of age, family therapy aimed at helping parents support normal eating in their child has been found to be more effective than individual therapy alone.
How To Treat Eating Disorders
Due to the insidious ways in which eating disorders pervade all aspects of ones body, mind, and life, receiving the appropriate treatment is important. There are various levels of care designed to treat specific stages of eating disorder severitythese range from inpatient at a medical facility down to outpatient. Any eating disorder treatment center can assess a struggling individual to determine the appropriate level of care.
Outside of receiving treatment in general, it is also important to ensure the facility uses evidence-based practices, as these can lead to better long-term outcomes.
There are many evidence-based treatments that can support eating disorder recovery; the most well-known and most commonly used is Cognitive Behavioral Therapy , Dialectical Behavior Therapy , and Family-Based Treatment .
Do not be afraid to ask any questions that arise if you or a loved one are searching for the treatment that will best support recovery.
What If I Have An Eating Disorder
If you think you may have an eating disorder:
Tell someone. Tell a parent, teacher, counselor, or an adult you trust. Let them know what you’re going through. Ask them to help.
Get help early. When an eating disorder is caught early, a person has a better chance of recovery. Make an appointment with your doctor or an eating disorders specialist.
Go to all appointments. Treatment takes time and effort. Work hard to learn about yourself and your . Ask questions any time you have them.
Be patient with yourself. There’s so much to learn, and change happens a little at a time. Take care of yourself and be with people who support you.
How Are Eating Disorders Treated
It is important to seek treatment early for eating disorders. People with eating disorders are at higher risk for suicide and medical complications. Some people with eating disorders may also have other mental disorders or problems with substance use.
Treatment plans for eating disorders include psychotherapy, medical care and monitoring, nutritional counseling, medications, or a combination of these approaches. Typical treatment goals include restoring adequate nutrition, bringing weight to a healthy level, reducing excessive exercise, and stopping binge-purge and binge-eating behaviors. Complete recovery is possible.
Specific forms of psychotherapy and cognitive behavioral approaches can be effective for treating specific eating disorders. For more about psychotherapies, visit .
Research also suggests that medications may help treat some eating disorders and co-occurring anxiety or depression related to eating disorders. Information about medications changes frequently, so talk to your health care professional and check the U.S. Food and Drug Administration website for the latest warnings, patient medication guides, or newly approved medications.
How Do I Find Treatment?
The NIMH is a federal research agency and cannot provide medical advice or practitioner referrals. However, there are tools and resources available at that may help you find a provider or treatment.
Children & Young Adults Eating Disorder Statistics
- 42% of 1st-3rd grade girls want to be thinner.16
- 81% of 10 year old children are afraid of being fat.17
- 46% of 9-11 year-olds are sometimes or very often on diets.18
- 35-57% of adolescent girls engage in crash dieting, fasting, self-induced vomiting, diet pills, or laxatives.19
- In a college campus survey, 91% of the women admitted to controlling their weight through dieting.20
Finding Help For Eating Disorders And Depression
There is no magic bullet for treating eating disorders coupled with depression. Even intensive research treatment programs have a high drop rate. Patients who do well for a period of time often relapse.
âStill, thereâs a lot that we can do to treat underlying depression and change the way people think about themselves and their relationship to food,â Sacker says. The first step is finding a psychiatrist or psychologist with extensive experience in treating eating disorders, experts agree. After that, success depends on a patientâs willingness to change.
Wildes, J. Psychiatry Research, Oct. 30, 2008; vol 161: pp 51-58.
Chavez, M. American Psychology, April 2007; vol 62: pp 159-166.
Kaye, W. Biological Psychiatry, April 2001; vol 49: pp 644-652.
Stice, E. Journal of Consulting and Clinical Psychology, February 2007; vol 75: pp 20-32.
Pike, K. American Journal of Psychiatry, November 2003; vol 160: pp 2046-2049.
Walsh, B. American Journal of Psychiatry, March 2004; vol 161: pp 556-561.
Appolinario, J. Current Drug Targets, April 2004; vol 5: pp 301-307.
Brambilla, F. International Clinical Psychopharmacology, November 2009; vol 24: pp 312-317.
Reas, D. Obesity, September 2008, vol 16: pp 2024-2038.
Lisa Lilenfeld, PhD, associate professor of clinical psychology, Argosy University, Arlington, Va.
Ira M. Sacker, MD, Langone Medical Center, New York University.
If You Think You Have An Eating Disorder
Many people have problems with their eating. If you do have an eating disorder, it is important to seek help. Remember that with support from health professionals, eating disorders can be recovered from. Getting professional help and support from others is important. Recovery may be slow as you learn to approach food in a more positive way and understand the reasons for your behaviour, but the effort will be worthwhile.
Who Is At Risk For Eating Disorders
Eating disorders can affect people of all ages, racial/ethnic backgrounds, body weights, and genders. Although eating disorders often appear during the teen years or young adulthood, they may also develop during childhood or later in life .
Remember: People with eating disorders may appear healthy, yet be extremely ill.
The exact cause of eating disorders is not fully understood, but research suggests a combination of genetic, biological, behavioral, psychological, and social factors can raise a persons risk.
Common Types Of Eating Disorders
Although the term eating is in the name, eating disorders are about more than food. Theyre complex mental health conditions that often require the intervention of medical and psychological experts to alter their course.
These disorders are described in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, fifth edition .
In the United States alone, an estimated 20 million women and 10 million men have or have had an eating disorder at some point in their life .
This article describes 6 of the most common types of eating disorders and their symptoms.
Eating disorders are a range of psychological conditions that cause unhealthy eating habits to develop. They might start with an obsession with food, body weight, or body shape.
In severe cases, eating disorders can cause serious health consequences and may even result in death if left untreated.
Those with eating disorders can have a variety of symptoms. However, most include the severe restriction of food, food binges, or purging behaviors like vomiting or over-exercising.
Although eating disorders can affect people of any gender at any life stage, theyre most often reported in adolescents and young women. In fact, up to 13% of youth may experience at least one eating disorder by the age of 20 .
Summary Eating disorders are mental health conditions marked by an obsession with food or body shape. They can affect anyone but are most prevalent among young women.
Symptoms Of Eating Disorders
There are some warning signs that are common to people with eating disorders. These may include:
- weight loss, weight gain or weight fluctuation usually due to dieting, but sometimes from an illness or stressful situation
- preoccupation with body appearance or weight
- sensitivity to cold
The main types of eating disorder include:
- anorexia nervosa characterised by restricted eating, weight loss, and fear of gaining weight
- bulimia nervosa periods of binge eating , followed by attempts to compensate with excessive exercise, vomiting, or periods of strict dieting. Binge eating is often accompanied by feelings of shame and being ‘out of control’
- binge eating disorder characterised by recurrent periods of binge eating. Binge eating can include:
- eating much more than usual
- eating until uncomfortably full
- eating large amounts when not feeling hungry.
Feelings of guilt, disgust and depression can follow binge eating episodes. Binge eating does not involve compensatory behaviours, such as for bulimia nervosa
- other specified feeding or eating disorder feeding or eating behaviours that cause the individual distress and impairment, but do not meet the criteria for the first three eating disorders.
What Forms Of Treatment Are Effective For Bulimia Nervosa
Most uncomplicated cases of bulimia nervosa can be treated on an outpatient basis although inpatient treatment is occasionally indicated. The best psychological treatment is cognitive-behavioral therapy, which involves self-monitoring of thoughts, feelings, and behaviors related to the eating disorder. Therapy is focused on normalizing eating behavior and identifying environmental triggers and irrational thoughts or feeling states that precipitate bingeing or purging. Patients are taught to challenge irrational beliefs about weight and self-esteem. Several medications have also been shown to be effective in decreasing bingeing and purging behaviors in bulimia.
Why Do Young Adults Develop Eating Disorders
Eating disorders, including anorexia and bulimia, are complicated, serious and potentially devastating. Theyre caused by a complex combination of factors, including genetic, biochemical, psychological, cultural and environmental. While researchers havent been able to pinpoint the specifics behind these causes, they can identify various factors that make individuals susceptible to eating disorders.
There are many misconceptions in our society about what causes eating disorders. Eating disorders are rarely about food or wanting to be thin. Instead, sufferers use food and unhealthy behaviors like dieting, starving, bingeing and purging to cope with unpleasant and overwhelming emotions and stressful situations. At least in the short term, these behaviors relieve anxiety and stress. Long term, however, they actually increase anxiety and stress and create other serious complications.
Eating disorders are illnesses, not character flaws or choices. Individuals dont choose to have an eating disorder. You also cant tell whether a person has an eating disorder just by looking at their appearance. People with eating disorders can be underweight, normal weight or overweight. Its impossible to diagnose anyone just by looking at them.
While no one thing causes eating disorders, here are some of the factors that may contribute to the problem:
My Battle With Anorexia
I began by not eating properly and became obsessed with counting calories, weighing myself, and controlling the food that I was putting into my body.
I remember looking at food and saying I cant have this, I cant have that due to the number of calories that it contained.
To this day I am not really sure what triggered my anorexia. But I now realize that there were a couple of difficult things that were going on in my life that could be contributing factors.
I was in a relationship with someone I really liked and it suddenly ended right before this harsh period. This was something that I found difficult to come to terms with.
I was also living back with my parents having lived on my own before. Living back with them was another bit of control I seemed to lose and I wasnt enjoying my job, working for an insurance company.
There is one particular moment that I remember and it will probably always stick in my head.
I went to work and told the training manager that I was planning on losing 10lbs so that I could get down to 150lbs. I remember him looking at me and saying, So youre going to settle for being semi-chunky then?
It was that phrase that planted the seed that, even if I did lose a couple of pounds, in my head, I would still feel overweight.
Dieting And The Diet Cycle
Dieting is one of the strongest predictors for the development of an eating disorder. Weight loss and fad diets do not take people’s individual requirements into consideration and can result in a person feeling hungry, experiencing low moods, lacking in energy levels and developing poor mental and physical health.
The diet cycle explains how many eating disorders can develop and are maintained.
The dieter limits the amount of food or type of food eaten.
When food intake is restricted, the body responds both physically and mentally. The metabolism slows down to conserve energy, appetite increases and the craving for the restricted foods increases. At this stage, people may feel deprived, irritable and fatigued.
Break diet rule:
The diet rules are almost inevitably broken, with the body wanting and needing the food that has been restricted. Overeating can often follow as dieters think, Ive broken my diet, so I may as well have the lot.
When breaking the diet rule, people are often left with feelings such as guilt, low self-esteem and negative body image. People may feel that they have failed and that they lack willpower.
Unhappy with weight or shape:
With these feelings comes a resolve to do better. People are often led back to the diet or restriction, and the diet cycle begins again.
How Is Eating Disorders Diagnosed
Because eating disorders can be so serious, it is important to seek help if you or a loved one thinks that you might have a problem. Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms. It is important to be honest about your eating and exercise behaviors so your provider can help you.
- A physical exam
- Blood or urine tests to rule out other possible causes of your symptoms
- Other tests to see whether you have any other health problems caused by the eating disorder. These can include kidney function tests and an .
How Can I Participate In Research
Clinical research is medical research that involves people like you. People volunteer to participate in carefully conducted investigations that ultimately uncover better ways to treat, prevent, diagnose, and understand human disease. Clinical research includes clinical research trials that test new treatments and therapies as well as long-term natural history studies, which provide valuable information about how disease and health progress.
What Treatment Is Available
There are several different types of treatment available for those who are suffering from an eating disorder.
Treatment generally involves monitoring a persons physical health while helping them deal with the psychological causes.
Some people may be advised to go through a course of cognitive behavioral therapy , which focuses on changing how they think about certain situations.
Alternatively, interpersonal psychotherapy treatment is available, which involves talking about relationship-based issues.
There is also dietary counseling to help people maintain a healthy diet.
Now that we know what an eating disorder is, how it appears, and what are some available treatments, lets hear Ryans real battle with an eating disorder.
Does Our Program Have Published Treatment Outcomes
You can read about patient satisfaction with our treatment program for anorexia nervosa. Reference: Guarda AS, Cooper M, Pletch A, Laddaran L, Redgrave GW, Schreyer CC. Acceptability and tolerability of a meal-based, rapid refeeding, behavioral weight restoration protocol for anorexia nervosa.
You can read about our treatment outcomes for anorexia nervosa in Hopkins BrainWise: A Weighty Approach to Anorexia Nervosa.Reference: Redgrave GW, Coughlin JW, Schreyer CC, Martin LM, Leonpacher AK, Seide M, Verdi AM, Pletch A, Guarda AS. Refeeding and weight restoration outcomes in anorexia nervosa: Challenging current guidelines. Int J Eat Disord. 2015;48:866-73. Pubmed link:
Learn more about .
Treatment Approaches To Depression And Eating Disorders
Two very different approaches have been shown to help some patients. One approach is the use of or mood stabilizers. In a 2001 study of 35 patients with anorexia who had managed to eat enough to achieve a healthy weight, for instance, the antidepressant was shown to reduce the risk of relapse.
For binge eating disorder, two different kinds of medications are sometimes prescribed by doctors — and an anticonvulsant drug called Topamax . These drugs have been shown to reduce bingeing, either alone or in combination. Unfortunately, over time, many patients relapse.
Another approach is cognitive behavioral therapy, or CBT. The goal is to change the way people think about food and eating and encourage healthier eating behaviors. One CBT method is called dissonance therapy. People with eating disorders who have become obsessed with the idea that they must be extremely thin to be attractive are encouraged to reject this unattainable image in favor of a more realistic ideal. Studies show that this approach can significantly reduce symptoms of bulimia, especially bingeing and in some patients.
Researchers have also had success encouraging some patients to adopt healthier eating habits. This approach uses a combination of education about healthy food choices and techniques for monitoring change, such as keeping food diaries. When appropriate, patients are also encouraged to become more physically active.