More Than Food: Signs and Symptoms of Eating Disorders

Eating disorders are among the most complex and potentially life-threatening mental health challenges. They are often hidden, and yet they affect millions of people worldwide. Current estimates suggest that more than 55 million individuals live with eating disorders. Globally, these conditions account for the loss of more than 3 million lives every year. Behind these numbers are people, families, and communities who are searching for understanding and healing.

Eating disorders typically emerge from a complex blend of biological factors, psychological vulnerabilities, and social pressures, often reflecting a deep struggle with emotions and identity. In today’s culture, where body image pressures are magnified by social media and body positive movement is slowing down (or as some say, is over), more and more people, especially teens and young adults, are finding themselves struggling.

Here are the main symptoms of these serious illnesses that can cause medical complications and, in some cases, can be fatal.

Signs and Symptoms of Anorexia Nervosa

Marked by an intense drive to keep body weight extremely low, anorexia often involves restrictive eating, excessive exercise, or purging behaviors. Over time, this cycle of self-starvation can cause dangerous, and potentially lethal, health issues, ranging from heart failure to osteoporosis, and carries one of the highest risks of premature death among mental health conditions.

People with this condition are at risk of serious health complications from starvation, and suicide is also a major cause of death. Anorexia nervosa has the highest mortality rate of any psychiatric disorder, with estimates of up to 10%.

Common signs and symptoms of anorexia nervosa include:

Extremely restricted eating: Involves cutting out large portions of food, skipping meals, or eliminating entire food groups in an effort to lose weight through caloric restriction. Over time, this restriction can cause serious nutritional deficiencies and harm overall health.
Intense and excessive exercise: Characterized by rigid, compulsive exercise routines that feel impossible to skip, even when injured or exhausted. Exercise becomes less about enjoyment or fitness and more about burning calories or controlling weight.
Extreme thinness (emaciation): Noticeable weight loss that results in frailty and a body size well below what is medically healthy. This level of thinness can cause the body to shut down vital functions to conserve energy.
Relentless pursuit of thinness: A constant drive to lose weight, often accompanied by obsessive dieting and strict rules around food. This pursuit can dominate thoughts and daily life, leaving little space for other interests or relationships.
Intense fear of gaining weight: Even a small change in body weight can trigger overwhelming anxiety, guilt, or panic. This fear often overrides hunger cues and physical needs, reinforcing restrictive or compensatory behaviors.
Distorted body image: Individuals may perceive themselves as overweight even when underweight or medically malnourished. This distorted self-view can fuel ongoing restriction and prevent recognition of the problem.
Denial of low body weight seriousness: Many people minimize or dismiss the dangers of their condition, insisting their health is fine. This denial can delay treatment and increase the risk of severe medical complications.

Anorexia nervosa can be life-threatening, particularly if the disorder is prolonged. Persistent fatigue, dizziness, and heart irregularities may indicate a stage of the illness that requires urgent medical attention. Severe complications include bone thinning, anemia, muscle weakness, slowed heart rate, brain damage, infertility, and, in extreme cases, multi-organ failure. Medically treating self-starvation is complex as refeeding syndrome can occur.

Signs and Symptoms of Bulimia Nervosa

Bulimia nervosa is often secretive and these behaviors can become a compulsive pattern that affects both physical and emotional health.

Bulimia involves cycles of binge eating followed by compensatory purging in attempts to avoid weight gain. Many people with bulimia nervosa are young and of normal weight, or even overweight, making detection and diagnosis difficult. Purging can take many forms, including vomiting, laxative misuse, fasting, or extreme exercise. People with type 1 diabetes may also misuse insulin. The toll on the body is significant, with risks to the heart, kidneys, digestive system, teeth, and bones.

Common signs and symptoms include:

Binge eating: Episodes of eating unusually large amounts of food in a short period, often much more than most people would eat under similar circumstances. These binges are usually accompanied by a distressing sense of being out of control.
Self-induced vomiting: Purposely bringing up food after eating as a way to prevent weight gain. This behavior can cause serious damage to the throat, teeth, and digestive system over time.
Excessive use of laxatives or diuretics: Taking medications to force the body to eliminate food or fluids, in hopes of reducing calories or weight. This can be extremely dangerous, leading to dehydration, electrolyte imbalances, organ stress, and long-term health complications.
Intense or excessive exercise: Engaging in exercise not for enjoyment or health, but as a compulsive way to compensate for eating. Workouts may become rigid, exhausting, and even harmful if continued despite pain or injury.
Fasting or skipping meals: Going long periods without food to avoid calorie intake or “make up” for eating episodes. This restrictive pattern often fuels the cycle of bingeing and purging, making recovery more difficult.

Over time, bulimia nervosa can cause serious health complications, including chronic sore throat, swollen salivary glands, tooth enamel erosion, acid reflux, gastrointestinal problems, dehydration, and dangerous electrolyte imbalances. Severe cases can lead to life-threatening medical emergencies.

Signs and Symptoms of Binge-Eating Disorder

Binge-eating disorder is a serious eating condition with recurrent episodes of consuming large amounts of food quickly and often secretly, accompanied by feelings of loss of control.

Episodes may be followed by guilt, shame, or emotional distress. BED is the most common eating disorder in the United States, affecting people across gender and age, though it often begins in adulthood.

Common signs and symptoms include:

Eating large amounts of food in a short time: Consuming unusually large quantities of food, often within a two-hour window. These episodes go far beyond what most people would eat in a similar situation.
Eating rapidly during binge episodes: Food is often consumed very quickly, sometimes without fully tasting or enjoying it. This rapid pace can heighten the sense of losing control.
Eating when not hungry or until uncomfortably full: Episodes may begin without physical hunger and often continue past the point of physical discomfort. Natural hunger and fullness cues are overridden by emotional or compulsive urges.
Eating alone or in secret: Many people hide their eating episodes due to embarrassment, shame, or fear of judgment. Secrecy can reinforce feelings of isolation and distress.
Feeling distressed, guilty, or ashamed after eating: Binge episodes are frequently followed by painful emotions such as guilt, regret, or self-criticism. These feelings can fuel the cycle of binge eating and make seeking help harder.
Frequent dieting without weight loss: Repeated attempts to restrict food intake or follow diets often fail to produce lasting results. This can create a frustrating cycle of restriction, bingeing, and renewed attempts at control.

Over time, binge-eating disorder can lead to serious health consequences such as obesity, type 2 diabetes, cardiovascular problems, sleep disturbances, and gastrointestinal issues like acid reflux, bloating, and diarrhea. Severe cases may significantly impact physical health and emotional well-being.

Other eating disorders

Although awareness of eating disorders has grown, many people still picture them in narrow term, most often imagining someone who eats very little, is severely underweight, or engages in purging. In reality, these symptoms reflect only a small part of the spectrum: eating disorders can occur at any body size, and serious health consequences are possible even without noticeable weight loss.

Beyond anorexia, bulimia, and binge eating disorder, there are several lesser-known eating disorders that challenge common assumptions about how these conditions “should” look.

Avoidant/Restrictive Food Intake Disorder (ARFID): ARFID involves limiting food intake due to sensory sensitivities (such as texture, smell, or taste) or fears of choking, vomiting, or other adverse effects. Unlike anorexia or bulimia, it is not driven by body image concerns. This condition can lead to significant nutritional deficiencies, weight loss, or social difficulties around eating.
Pica: Pica is characterized by eating substances that are not considered food, such as dirt, paper, chalk, or hair. These behaviors often occur for at least one month and can lead to dangerous health complications, including poisoning, infections, or intestinal blockages. While more common in children, pica can occur at any age and is often linked to nutritional deficiencies or developmental conditions.
Pica, and non-food cravings, is surprisingly common during pregnancy. In one study of pregnant women, nearly half experienced pica, particularly during the first trimester.
Rumination disorder: Rumination disorder involves repeatedly regurgitating food, which may be rechewed, reswallowed, or spit out. This behavior is not due to a medical condition and often happens effortlessly, sometimes soon after eating. Over time, it can cause weight loss, malnutrition, and social withdrawal due to embarrassment.
Other Specified Feeding or Eating Disorder (OSFED): OSFED is a diagnosis for individuals whose symptoms do not fully align with anorexia, bulimia, or binge eating disorder, but who still experience significant distress and impairment. For example, someone may show most—but not all—features of anorexia or binge eating disorder. Despite being less widely recognized, OSFED is common and can be just as serious as other eating disorders.

Moving Toward Healing

Every eating disorder is unique in its expression, but they all disrupt both body and mind. Because symptoms often overlap, accurate diagnosis is essential. While the journey can feel overwhelming, recovery is possible with a combination of medical care, psychotherapy, nutritional guidance, and strong social support.

Most importantly, if you or someone you care about is struggling, remember: eating disorders are not a reflection of weakness. They are treatable conditions, and healing begins with compassion, awareness, and reaching out for help.