Thousands of teens and young adults in the United States struggle with eating disorders. There are three types of eating disorders – Anorexia nervosa, Bulimia nervosa, and Binge eating disorder. Eating disorders are serious emotional problems that involve ways of eating, exercising and losing weight that can harm a person’s health. Although it may seem that eating disorders are only about food, weight, and body size, health professionals believe that things are much more complicated than that. People with eating disorders seem to use their eating and exercising activities as an unhealthy way to deal with personal or emotional problems such as stress, depression, or family problems.

Eating disorders are ten times more common in females than in males. Although eating disorders seem to be more common in teens and young adults than in other age groups, a person of any age can develop an eating disorder.

What Causes Eating Disorders?

There is no one cause of anorexia nervosa, bulimia nervosa, or binge eating disorder. Many different things are thought to play a role. Some things that seem to be related to eating disorders are:

  • Exposure to unrealistically thin models and actors on TV, in the movies, and in magazines; having a family history of obesity or eating problems,
  • Having a history of depression;
  • Having family problems
  • Being involved in a sport that requires extreme thinness or a small size, such as ballet or gymnastics; and
  • Having difficulty dealing with unhappy feelings such as sadness, frustration, and anger.This does NOT mean that someone who fits one of these descriptions will develop an eating disorder. It just means that research has shown that some of these descriptions often apply to people who develop eating disorders.

Three Types of Eating Disorders

1. Anorexia Nervosa:

Anorexia nervosa is sometimes called “the self-starving disease.” People with anorexia nervosa lose a lot of weight through dieting and exercising. Without help and support, they may become so thin that their health is in serious danger. They are very scared of being fat, even when they are actually underweight. Although others can see how unusually thin they look, people with anorexia nervosa have a hard time seeing their bodies as they truly appear. Even though they may be quite thin, they see themselves as “too fat” – they have a distorted body image. Because people with anorexia nervosa believe they are fat, people with anorexia nervosa often get upset when others express concern about their weight.

Here are some things you might notice about a person with anorexia nervosa:

  • Eating too little or refusing to eat at all, leading to unhealthy weight loss
  • Strong fear of becoming fat
  • Feeling fat even though thin
  • Unusual ways of eating (eating only one food at a time, refusing to eat in public, eating very slowly, etc.)
  • Exercising too much
  • Depressed, “down” or sad mood
  • Spending less time with family and friends
  • Physical problems such as feeling cold much of the time, constipation, brittle hair and nails, hair loss, low blood pressure, low heart rate, and loss of menstrual periods

2. Bulimia Nervosa:

Bulimia nervosa is an eating disorder that involves binge eating – eating a large amount of food, often in a short time, while feeling out of control of the eating. After bingeing the person suffering from bulimia nervosa will then take action to prevent weight gain. They might do one or more of these behaviors:

  • Purge their system by making themselves throw up, taking laxatives, or diuretics
  • Exercising too much,
  • Going on a strict diet or refuse food (fast)

People with bulimia nervosa are very worried about their weight and body shape. They are usually trying to diet, but they lose control and binge eat, often when they are feeling sad, angry, lonely, or upset in some other way. The cycle of binge eating and purging (or exercising or dieting) leads to mood swings, guilt, shame, and lowered self-esteem. Usually, people with bulimia nervosa are of average weight. They usually feel very ashamed of their behavior and keep it a secret. For these reasons, it is often hard to tell if someone has bulimia nervosa.

Here are some things you might notice about a person with bulimia nervosa:

  • Binge eating (eating a large amount of food, often in a short time, while feeling out of control)
  • Laxative or diuretic use, extreme exercise, or strict dieting after eating
  • Shame or guilt after eating
  • Eating secretly or hiding food
  • Worry about appearance and body size
  • Feeling sad, down, or blue
  • Frequent changes in weight
  • Loss of tooth enamel (from the acid in vomit wearing away the tooth surface)
  • Irregular menstrual periods
  • Puffy-looking cheeks and neck (this is because the glands that make saliva swell up when a person throws up a lot)

3. Binge Eating Disorder:

Binge eating disorder is a lot like bulimia nervosa, except people with binge eating disorder do not purge, exercise too much, or diet after they binge eat. As a result, many people who have binge eating disorder are overweight from the extra calories they take in during eating binges. Like people with other eating disorders, those with binge eating disorder worry a lot about their weight and the way they look, and they often try to lose weight. They often keep their binge eating a secret from others, and feel out of control and ashamed of their eating. The signs and symptoms of binge eating disorder are similar to those of bulimia nervosa, without the symptoms of purging, over-exercising, or extreme dieting.


Eating disorders are usually treated with a combination of psychotherapy (counseling, or “talk therapy”), nutritional counseling, and medical monitoring. Sometimes, medication may be used. If the person with the eating disorder is very ill, he or she may have to stay in the hospital for part of his or her treatment. However, many people get their eating disorder treatment on an outpatient basis. Although individual psychotherapy (just the patient and the counselor) is very common, sometimes family therapy or group therapy is used. When looking for eating disorder treatment, it is usually best to choose professionals (psychologists, psychiatrists, doctors, social workers, nutritionists, etc.) who are specialists in helping people with eating problems.


If you suspect an eating disorder, here are some things you can do:

Take action. Talk with the person about how you feel. Offer to help. Help the person talk with family members and professionals.

If you are still concerned, insist on an evaluation by a doctor or counselor even if he or she says you are overreacting. Promise to “back off” if the doctor or counselor recommends that you should.

Don’t be surprised if the person is angry or resistant. Persons with eating disorders often say they don’t have a problem. Or, they may admit they have a problem but still refuse treatment. Encourage professional help. The sooner treatment begins, the greater the chance for full recovery.

Realize that it may take a long time for the person to get better. Because eating disorders often develop as ways to cope with stress, letting go of an eating disorder can be very frightening. Replacing the eating disorder with healthier coping skills takes time, patience and commitment to change. Often it means reducing the amount of stress in a person’s life. Change does not happen quickly. Recovery may take several months or even several years.

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This information is brought to you by Teenhealth411 Education Staff. It is not intended to substitute for medical care. If you suspect you have a health problem, please contact your doctor or local clinic.