FACT SHEET ON EATING DISORDERS

Types of Eating Disorders:

• Anorexia Nervosa is characterized by an intense fear of gaining weight, self-starvation, loss of menstrual periods, body
dissatisfaction and significant disturbance in perception of shape or size of his or her body, and a body weight that is
15% below normal.
• Bulimia Nervosa is characterized by bingeing (consuming large amounts of food at one sitting while feeling out of
control), purging (getting rid of food by using laxatives, vomiting, obsessive exercise), dissatisfaction with body, and
fear of gaining weight.
• Binge Eating Disorder is characterized by recurrent episodes of binge eating without the purging behavior
of bulimia.
• Eating Disorder Not Otherwise Specified (NOS) includes people who have characteristics of one or more eating
disorder but who do not fit the diagnostic criteria for any one disorder.

Who Suffers from Eating Disorders?

• Approximately 1% of adolescent girls develop anorexia nervosa.
• Approximately 2-3% of young women develop bulimia nervosa.
• Two percent of adults suffer from binge eating disorder.
• Some 90% of those with eating disorders are adolescent and young women.
• Men may constitute as many as 25% of those exhibiting binge eating disorders.
• Bulimia is as high as 15% in college-aged women.
• Although the common perception is that eating disorders are most prevalent among white, upper middle class
young women, recent research indicates that of those who suffer from eating disorders:
• 1 in 5 are poor
• 1 in 4 are non-white
• Teenagers with asthma, attention deficit disorder, diabetes, and other chronic illnesses are reported to experience
eating disorders 2 to 4 times more often

Signs and Symptoms of Eating Disorders

Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder
Intense fear of gaining weight Fear of being fat Eating alone and in secret
Belief that they are fat although they Eats in secret Feelings of guilt, shame
are actually extremely thin Goes to the bathroom immediately and disgust about
Restriction of calories following meals overeating
Avoids social situations where s/he Hoards food Eating large amounts of
may have to eat in front of others Mood swings food when not hungry
Unusual eating habits or rituals Abuse of alcohol or other substances Abuse of alcohol or other
Obsessive or compulsive exercise substances
Over-exercising
Hyperactivity or fatigue Isolation from friends and family
Isolation from friends and family

• Someone with an Eating Disorder NOS may exhibit some combination of the above symptoms.
• All eating disorders may also be characterized by depression.
Physical Effects of Eating Disorders
• Anorexia has the highest rate of death of any psychiatric illness, with 1 in 10 cases leading to death by cardiac arrest,
starvation, other medical complications, or suicide.

Anorexia Nervosa Bulimia Nervosa

Dry skin, sallow complexion Damaged teeth and swollen cheeks
Irregular or ceased menstrual cycle for females Dehydration, weakness, fatigue
Growth of fine hair over body and face Electrolyte imbalance
Purple nail beds and cold extremities Bleeding and infection of the throat
Hair loss Enlargement of lymph or salivary glands
Cardiac problems Digestive and intestinal problems
Dizziness, low blood pressure, fainting Muscle spasms and headaches
Changes in metabolism and energy Irregular menstrual cycle for females
Malfunctioning of pancreas; Damaged kidneys
Osteoporosis

Binge Eating Disorder Eating Disorder NOS

Diseases related to obesity (i.e. diabetes, high blood Any number of the above mentioned effects, depending
pressure, high cholesterol, risk of stroke, sleep apnea) on the behavioral symptoms of the individual

Treatment of Eating Disorders

• Eating disorders are most successfully treated when diagnosed early.
• A complete physical examination is necessary to determine if there is immediate medical danger and to rule out
other illnesses.
• Hospitalization may be required.
• Treatment often involves a combination of interventions including:
Individual, group or family psychotherapy
Cognitive therapy
Behavioral therapy
Nutritional counseling
Antidepressant medication
• Support groups may be helpful for some individuals and are often offered through hospitals as well as by national eating
disorder advocacy organizations. Recovery is a long process and relapse is not uncommon. Support and treatment are
needed to help the individual continue his/her recovery, even if s/he suffers a relapse.

Adolescents and Eating Disorders

• The onset of eating disorders peaks at ages 14 and 18, corresponding to the ages of changes in an adolescent
female’s body and the transition to college/leaving the family home.
• 66% of high school girls and 17% of boys are on diets at any given time.
• 1 in 8 high school girls has used vomiting as a “diet aid.”
• 81% of 10 year olds are afraid of being fat.
• 80% of high school females and 44% of high school males have used exercise to lose weight.
• In a study of high school students’ weight control practices, in the 7 days before the survey 49% of females
and 18% of males had skipped meals to lose weight.
Men and Eating Disorders
• 5-10% of eating disorders occur among males.
• Men more frequently use excessive and obsessive exercise and body-building prior to and during their eating disorder.
• Issues relating to sexuality and gender identity are sometimes associated with male eating disorders and there appears to be
a higher rate of eating disorders among gay males.
• Men may be less likely to seek treatment for an eating disorder because of the social stigma of have a problem that has
generally been perceived as a “woman’s problem.”
• The signs, symptoms and treatment needs of eating disorders in males are similar to those of women.

Athletes and Eating Disorders

• Eating disorders and disordered eating are significant problems for many athletes and a greater risk is associated
with sports in which anaerobic activities predominate over aerobic activities.
• Female athletes are especially at risk in sports which emphasize a thin body or appearance, such as gymnastics,
ballet, figure skating, swimming or distance running.
• Male athletes are especially at risk in body building and wrestling.
• Eating disorders may result in symptoms that interfere with athletic performance and impair athletic capacity.
• Female athletes are particularly at risk for the Female Athlete Triad of amenorrhea (ceased menses), disordered eating, and
osteoporosis (brittle bones).
• A 1996 study of NCAA athletes found that
Binge-eating occurred at least weekly in 13% of male athletes and 10% of female athletes.
25% of male athletes used saunas or steam baths at least weekly to lose weight.
2% of both male and female athletes used steroids to improve performance.
4.4% of female athletes used vomiting to lose weight.
• NCAA studies show that at least 40% of member institutions reported at least one case of anorexia or bulimia
in their athletic programs.

Dieting and Eating Disorders

• 95% of all dieters will regain their lost weight in 1-5 years.
• 20-24% of men and 33-40% of women are actively dieting to lose weight while an additional 28% of men
and women are dieting to maintain weight.
• 91% of women surveyed on a college campus had attempted to control their weight through dieting.
• 59% of individuals entering into treatment for an eating disorder considered a prolonged period of dieting a precipitating
event to the onset of their disorder.
• 35% of normal dieters progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome
eating disorders.
• Americans spend over $40 billion on dieting and diet-related products each year.

Body Image and the Media

• The average American woman is 5’4” tall and weighs 140 pounds. The average American model is 5’11”
and weighs 117 pounds. Most fashion models are thinner than 98% of American women.
• 80% of American women are dissatisfied with their appearance.
• More than 50% of high school girls want smaller hips, thighs, and/or waists.
• Nine-year-old children rate silhouettes of fat figures as having fewer friends, being less liked by their parents,
doing less well in school, being less content with their appearance, and wanting to be thinner.
 REFERENCES
Types of Eating Disorders:
American Psychiatric Association. Diagnostic & Statistical Manual of Mental Disorders Fourth Ed. (DSM-IV). Washington DC, 1994.

Who Suffers from Eating Disorders?

Foreyt JP. Treating the diseases of the 1980’s: Eating Disorders. Contemporary Psychology 1986;31:658-60.
Maine, M. Men with Eating Disorders. National Eating Disorders Screening Program educational newsletter, Wellesley, MA, 1998.
National Institute of Mental Health. Eating Disorders NIH Publication No. 94-3477 Rockville, MD, 1994.
The National Institute of Diabetes and Digestive and Kidney Diseases. Binge Eating Disorders: NIDDK weight-control information
network NIH Publication No. 94-3589 November 1993.
Swedish Medical Center/Seattle. Anorexia: Dying to be thin. Life Skills Education, Northfield, MN, 1996.

Signs and Symptoms of Eating Disorders and Physical Effects of Eating Disorders
American Anorexia Bulimia Association, Inc. Facts on Eating Disorders. New York, NY, 1998.
American Psychiatric Association. Diagnostic & Statistical Manual of Mental Disorders Fourth Ed. (DSM-IV). Washington DC, 1994.
American Psychiatric Association. Let’s Talk Facts About Eating Disorders. Washington, DC, 1996.
Foreyt JP. Treating the diseases of the 1980’s: Eating Disorders. Contemporary Psychology 1986;31:658-60.
National Institute of Mental Health. Eating Disorders NIH Publication No. 94-3477 Rockville, MD, 1994.
Santucci, P. Facts About Eating Disorders. National Eating Disorders Screening Program educational newsletter, Wellesley, MA, 1998.
Swedish Medical Center/Seattle. Anorexia: Dying to be thin. Life Skills Education, Northfield, MN, 1996.
Swedish Medical Center/Seattle. Bulimia: Eating yourself sick. Life Skills Education, Northfield, MN, 1996.

Treatment of Eating Disorders

American Psychiatric Association. Let’s Talk Facts About Eating Disorders. Washington, DC, 1996.
National Institute of Mental Health. Eating Disorders NIH Publication No. 94-3477 Rockville, MD, 1994.
Swedish Medical Center/Seattle. Anorexia: Dying to be thin. Life Skills Education, Northfield, MN, 1996.
Swedish Medical Center/Seattle. Bulimia: Eating yourself sick. Life Skills Education, Northfield, MN, 1996.

Adolescents and Eating Disorders

American Psychiatric Association. Diagnostic & Statistical Manual of Mental Disorders Fourth Ed. (DSM-IV). Washington DC, 1994.
Goodman E. The Pressure to be perfect. Glamour 1996 (Jan):154-181.
Mellin LM, Irwin CE & Scully S: Disordered eating characteristics in girls: A survey of middle class children. Journal of the
American Dietetic Association. 1992; 92:851-53.
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Sardula, et al. Weight Control Practices of U.S. Adolescents and Adults. Annals of Internal Medicine. 1993; 119(7):667-7.
Swedish Medical Center/Seattle. Bulimia: Eating yourself sick. Life Skills Education, Northfield, MN, 1996.

Men and Eating Disorders

Maine M. Men with Eating Disorders. National Eating Disorders Screening Program educational newsletter, Wellesley, MA, 1998.
Weinstein B. Men are upsetting the scales. The Boston Globe: Your Health (A Special Section). October 20, 1996 pgs. 12-17.

Athletes and Eating Disorders

American College of Sports Medicine. Current Comment: Eating Disorders. Indianapolis, IN: Fall 1996.
Powers P, Johnson C: Athletes and Eating Disorders. National Eating Disorders Screening Program narratives. Wellesley, MA, 1998.
Powers PS, Johnson, C: Small Victories: Prevention of eating disorders among athletes. Eating disorders: The Journal of Treatment
and Prevention. 1996;4:364-76.
Dieting and Eating Disorders
Graves L: Why Diets Don’t Work. National Eating Disorders Screening Program narratives. Wellesley, MA 1998.
Johnson & Connors. The Etiology and Treatment of Bulimia Nervosa. Northvale, NJ: Jason Aronson Inc. 1987.
Kurth CL, Krahn DD, Nairn K & Drewnowski A: The severity of dieting and bingeing behaviors in college women: Interview
validation of survey data. Journal of Psychiatric Research. 1995; 29(3):211-25.
National Institute of Health Technology Assessment Conference Panel. Methods for Voluntary Weight Loss and Control.
Annals of Internal Medicine. 1992;116:942-949.
Shisslak CM, Crago M & Estes LS (1995). The spectrum of eating disturbances. International Journal of Eating Disorders.
18(3):209-19.
Smolak L (1996): Next Door Neighbors/Eating Disorders Awareness and Prevention Puppet Guide Book.

Body Image, the Media, and Eating Disorders

Loewy MI: Suggestions for Working with Fat Children in the Schools. Professional School Counseling. 1998; 1(4):18-22.
Smolak L (1996): Next Door Neighbors: Eating Disorders Awareness and Prevention Puppet Guide Book.

Screening for Mental Health

One Washington Street, Suite 304 Wellesley Hills, MA 02481-1706
Douglas G. Jacobs, MD, Executive Director
Phone: 781-239-0071 Fax: 781-431-7447 Internet: www.mentalhealthscreening.org