Types of Eating Disorders

There are various types of eating disorders, and each of them has a specific diagnostic criterion that differentiates it from other similar illnesses. Recognition of these distinct differences can significantly improve the treatment plan and recovery outcomes. (source: NIMH, n.d.)

Mentioned below is an eating disorders list that includes both common and rare eating disorders along with their symptoms.

1.  Anorexia Nervosa

Anorexia Nervosa is defined as behaviors of self-starvation leading to low weight for age and height. Of all psychiatric illnesses, it has the highest mortality rate and, therefore, can be extremely dangerous and potentially dangerous. The body mass index (BMI), i.e., a measure of weight according to height, is below 18.5 in a person with anorexia. (source: MedlinePlus, n.d.)

Following are the two types of anorexia nervosa, including:

• Purging type is characterized by intermittent binge eating followed by purging behavior
• Restricting type is characterized by weight loss due to excessive exercise, fasting, or dieting.

The dieting behavior in anorexia is due to an intense fear of becoming fat. As a consequence of the purging behaviors or prolonged starvation, the following symptoms may appear:

• Menstrual irregularities
• Cold intolerance
• Muscle wasting
• Heartburn
• Stress fractures
• Depression, poor concentration, and irritable mood

2.  Bulimia Nervosa

There are three essential features commonly found in patients with bulimia nervosa: repetitive episodes of binge eating, self-evaluation with undue influence by the body weight and shape, and inappropriate behaviors to prevent weight gain. Someone engaging in these behaviors at least once a week can be labeled as a case of bulimia nervosa. (source: NEDA, n.d.)

Individuals suffering from bulimia nervosa can either be underweight, overweight, normal weight, or even obese. This high variation in body appearance, together with hidden behaviors related to food, may mask their underlying eating disorder. Considered one of the worst eating disorders, bulimia is characterized by the following symptoms:

• Chronic sore throat
• Frequent bathroom breaks after meals
• Disappearance of large amounts of food or unexplained empty food containers or wrappers
• Swollen salivary glands in cheeks
• Heartburn
• Misuse of laxatives, diuretics, or diet pills
• Recurrent diarrhea with no explanation
• Fainting or dizziness due to dehydration
• Dental decay

3.  Binge Eating Disorder

Commonly referred to as BED, binge eating disorder is the most common and the worst type of eating disorder, among others. Individuals with this issue indulge in episodes of eating large quantities of food in a short period, followed by experiencing a sense of loss of control over their eating habits, leading to distress. However, what differentiates it from bulimia nervosa is a lack of behaviors to get rid of food, such as fasting, exercise, vomiting, or misuse of laxatives.

The binge eating behaviors seen in BED are chronic and may lead to serious health complications, such as hypertension, diabetes, obesity, and cardiovascular events. To diagnose binge eating disorder, frequent binges of at least once every week for three consecutive months with a lack of sense of control on food consumption is required. Additionally, the following features may be observed:  (source: WHO, 2022)

• Eating until uncomfortably full
• Eating at a higher speed than usual
• Consuming large amounts of food even if not hungry
• Feeling depressed, guilty, or disgusted with oneself after an episode of binge eating
• Eating in solitary to avoid embarrassment due to overeating

4.  Avoidant Restrictive Food Intake Disorder

Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by picky eating leading to a disturbance in eating. It often results in failure to meet the nutritional requirements of the body. The avoidance or limitation of food intake in this disorder is due to one or more of the following:

• Low appetite
• Loss of interest in food or eating
• Feeling anxious about the consequences of eating, such as the fear of vomiting, nausea, constipation, choking, or an allergic reaction. ARFID may develop due to an adverse event of food poisoning or choking followed by an urge to avoid food altogether.
• Avoidance of food based on its sensory characteristics, such as appearance, smell, color, or texture

Individuals with ARFID exhibiting difficulties with normal eating may exhibit one or more of the following symptoms: (source: NICE, 2017)

• Nutritional deficiency
• Significant weight loss or failure to gain weight in growing children
• Declined social functioning due to an inability to eat in the company of others
• The need to use nutritional supplements or feeding tubes to meet daily dietary intake

The impact of ARFID on psychological and physical health is comparable to that in people with anorexia nervosa. However, in contrast, these people do not exhibit any concerns about their body shape or weight. It is common to misdiagnose it in people with autism spectrum disorders who show sensory sensitivities and rigid eating behaviors that do not necessarily lead to the impairment required for diagnosing ARFID. It is important to remember that ARFID does not include food restriction due to dieting, religious fasting, cultural practices, lack of food, or developmentally normal behaviors such as picky eating in children.

Food restriction or avoidance generally develops in infancy or early childhood and may continue as a person enters adulthood. Regardless of the age of commencement, ARFID can severely impact families, leading to high-stress levels during mealtimes and social eating events.

5.  Pica

Pica refers to an eating disorder characterized by consistently eating things with no nutritional value. These behaviors tend to persist for at least one month and have severity levels high enough to require clinical attention. (source: SAMHSA, n.d.)

Labeled as one of the rare eating disorders, pica includes ingestion of the following substances depending on age: pebbles, chalk, hair, cloth, soap, paint chops, paper, charcoal, clay, string, and clay. Such individuals do not usually have an aversion to food. The behavior exhibited by individuals with pica is inappropriate to their developmental level and is not included in their culturally supported practice. The eating disorder can occur in childhood, adolescence, and adulthood; however, childhood-onset is more common. Bear in mind that pica cannot be diagnosed in children under the age of 2 years as they put small objects in their mouths as a part of normal development. 

Pica is commonly seen in people with intellectual disability and autism spectrum disorder but can also occur in normally-developing children. Individuals diagnosed with pica are at risk of ingesting toxic substances (such as lead in paint chips) or developing intestinal blockages (due to ingestion of pebbles). (source: FindTreatment.gov, n.d.)

6.  Rumination Disorder

Rumination disorder includes repeated episodes of regurgitation and re-chewing of food after eating it. In simpler words, individuals with this eating issue bring back the swallowed food in their mouth on purpose, rechew it, and re-swallow it or spit it out. It can commonly occur in people of all age groups, including infancy, childhood, and adulthood.

Diagnosing rumination disorder requires the fulfillment of the behavioral criteria described below:

• It must occur consistently for at least one month
• It must not be secondary to a medical problem or gastrointestinal issue
• It must not occur as a part of another behavioral eating disorder
• It must be severe enough to require clinical attention