Eating disorders risk factors: who is at risk and the signs to know

What eating disorders are

Eating disorders are serious illnesses marked by severe disturbances in a person's eating behaviors. Many people are concerned about their health, weight or appearance from time to time, but some become fixated on weight loss, body weight or shape, and controlling their food intake; these may be signs of an eating disorder (NIMH) (NIMH). Eating disorders are not a choice. They can harm physical and mental health and in some cases can be life-threatening, but with treatment people can recover (NIMH). MedlinePlus adds that they affect the body's ability to get proper nutrition, which can lead to problems such as heart and kidney problems (MedlinePlus).

There is no score or calculator on this page; the factors below are the ones NIMH and MedlinePlus name.

Who is at risk for eating disorders

Eating disorders can affect people of all ages, racial and ethnic backgrounds, body weights and sexes. Even people who appear healthy can have an eating disorder and be extremely ill, and people with eating disorders can be underweight, average weight or overweight (NIMH). Factors NIMH and MedlinePlus name:

• A mix of genetic, biological, behavioral, psychological and social factors. The exact cause is not fully understood; research suggests a combination of these can raise a person's risk (NIMH) (MedlinePlus).
• Sex. Anyone can develop an eating disorder, but they are more common in women (MedlinePlus).
• Age. Eating disorders often appear during the teen years or young adulthood, but they can also develop in childhood or later in life (MedlinePlus).

Common types

• Anorexia nervosa: severely avoiding or restricting food because of a distorted self-image or an intense fear of gaining weight. People may see themselves as overweight even when dangerously underweight (NIMH).
• Binge-eating disorder: regularly losing control of eating and eating unusually large amounts of food (NIMH). MedlinePlus says it is the most common eating disorder in the U.S. (MedlinePlus).
• Bulimia nervosa: regular binge eating followed by unhealthy behaviors to prevent weight gain, such as forced vomiting or using laxatives (NIMH).
• Avoidant restrictive food intake disorder (ARFID): limiting the amount and variety of food because of anxiety or fear of what eating might cause (such as choking or vomiting) or dislike of a food's look or texture (NIMH).

Warning signs

Signs NIMH lists include (NIMH):

• Anorexia nervosa: extremely restricted eating, intense and excessive exercise, extreme thinness, a relentless pursuit of thinness, intense fear of gaining weight, distorted body image, and denial of how serious low body weight is.
• Binge-eating disorder: eating unusually large amounts of food in a short time (for example, within two hours), eating fast, eating when full or not hungry, eating alone or in secret, feeling distressed, ashamed or guilty about eating, and dieting often, possibly without weight loss.
• Bulimia nervosa: the binge-eating signs plus throwing up, taking laxatives, exercising excessively or fasting.
• ARFID: severe restriction of the types or amount of food, lack of appetite or interest in food, dramatic weight loss, stomach problems with no other known cause, and a range of preferred foods that keeps getting smaller.

Anyone with any combination of these symptoms should talk to a health care provider (NIMH).

Health effects and other conditions

Over time, anorexia nervosa can cause thinning of the bones, anemia, muscle wasting, low blood pressure, slowed breathing and pulse, damage to the heart, infertility, brain damage and multiple organ failure. It can be fatal and has an extremely high death rate compared with other mental disorders; suicide is a leading cause of death for people diagnosed with it (NIMH). Binge eating can lead to obesity, type 2 diabetes, heart and blood vessel problems, sleep problems and digestive symptoms (NIMH). Bulimia nervosa can cause a sore throat, swollen salivary glands, worn and decaying teeth, acid reflux, severe dehydration and electrolyte imbalance (NIMH).

People with eating disorders are at risk for other mental illnesses, most often depression, anxiety and substance use disorders, and are at higher risk for suicide (NIMH). See depression risk factors and anxiety risk factors.

Treatment and getting help

Eating disorders can be treated successfully, and early detection and treatment are important for recovery. Treatment plans include individual, group or family psychotherapy, medical care and monitoring, nutritional counseling, and for some eating disorders medication. Some people with a severe eating disorder may need hospital or residential treatment, and family-based treatment can improve outcomes, particularly for adolescents (NIMH).

If you have concerns about your eating behavior or mental health, talk to a primary care provider, who can refer you to a mental health professional such as a psychologist, psychiatrist or clinical social worker (NIMH).

The 988 Lifeline is free and confidential and available 24/7 (988 Lifeline).

Common questions

Can someone at a normal weight have an eating disorder?

Yes. People with eating disorders can be underweight, average weight or overweight, and even people who appear healthy can be extremely ill (NIMH).

At what age do eating disorders start?

They often appear in the teen years or young adulthood, but they can also start in childhood or later in life (MedlinePlus).

Are eating disorders a choice?

No. NIMH says eating disorders are not a choice (NIMH), and MedlinePlus calls them medical conditions, not a lifestyle choice (MedlinePlus).