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Understanding Eating Disorders: Types, Symptoms, Risk Factors, and Treatment

July 4, 2024

Manhattan woman sitting in a bathroom staring at a scale.

Gaining insight into the various types, symptoms and risk factors of eating disorders enables us to extend empathy and aid to those affected, challenging stigmas and misunderstandings. This knowledge empowers individuals to seek help, emphasizing the significance of a healthy connection with food and body image. Awareness of available treatments allows for informed choices in seeking appropriate care that is tailored to individual needs. This understanding not only aids in prevention by promoting healthy habits and early intervention but also supports community education to reduce the prevalence of eating disorders.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), six recognized eating disorders exist: anorexia nervosa, bulimia nervosa, binge-eating disorder, pica, rumination disorder and avoidant/restrictive food intake disorder.

Anorexia Nervosa 

Anorexia emerges when one constantly restricts their food intake to keep a trim body weight as a result of a deep fear of weight gain or feeling overweight. This can lead to a distorted self-perception and an inability to recognize the severity of their low body weight.


Individuals with anorexia commonly grapple with obsessive-compulsive tendencies, anxiety and perfectionism. They often have a clear preference for control and tend to display rigid, inflexible thinking. These traits manifest notably in their eating behaviors. For instance, they might adhere strictly to designated meal times or employ specific utensils or carefully examine nutrition labels and precisely measure their food portions. Additionally, they may excessively focus on their weight, grapple with feelings of isolation, depression, insecurity and perfectionism, while engaging in intense exercise routines or fixating on calorie intake. Individuals facing eating disorders often restrict their intake to such an extent that they experience various physical complications including stomach issues, electrolyte imbalances, hair loss, brittle bones, dizziness, dry skin or fainting. 

Risk Factors

Anorexia is often a result of genetic factors, life experiences like childhood trauma and societal beauty standards, although these alone are not solely responsible. Social comparisons, particularly prevalent in college settings, can contribute to the groundwork for the development of this disorder. Individuals with anorexia typically struggle with obsessive-compulsive traits, anxiety and perfectionism, displaying a pronounced need for control and adamant thinking patterns.


Treating anorexia usually involves a mix of therapies like cognitive behavioral therapy (CBT), nutritional guidance and sometimes medication to address associated conditions like depression or anxiety. The primary focus of treatment is on restoring a healthy weight and reshaping negative perceptions about body image and food. While recovery requires persistent effort, pushing forward consistently can empower individuals to craft a joyful, satisfying life.

Bulimia Nervosa

Bulimia arises when someone repeatedly indulges in binge eating episodes and subsequently takes actions to avoid weight gain. These actions may involve vomiting, using and abusing laxatives or diuretics, starvation or excessive exercising. Binge eating revolves around a lost sense of control while ingesting an unusually large quantity of food within a specific time frame.


Symptoms commonly linked with bulimia nervosa encompass an obsession with body shape and weight, a persistent fear of weight gain, recurring episodes of consuming an unusually large amount of food within a single episode, feeling a loss of control, engaging in actions like vomiting or excessive exercise to avoid gaining weight after a binge and practicing calorie restriction.

Feet standing on a scale. Finding freedom from an eating disorder is possible. Learn about all the types of EDs.

Risk Factors

Bulimia frequently emerges during adolescence, with risk factors encompassing a history of childhood physical or sexual abuse, exposure to stressful events, childhood obesity, early onset of puberty and mental health challenges like low self-esteem, anxiety and depression. Additionally, there’s a biological component contributing to the development of bulimia. In their late teens, women have a higher chance of getting bulimia compared to men. If someone in their immediate family had obesity or an eating disorder, there’s a greater chance they might also develop bulimia.


Treatment for bulimia often involves therapies like CBT or dialectical behavior therapy (DBT), alongside nutritional guidance and, in some cases, medication (like antidepressants). These help to handle and control binge-purge cycles and modify unhealthy eating patterns and address underlying emotional issues. 

Binge-eating disorder 

Binge-eating disorder is characterized by an individual who repeatedly indulges in binge eating, consuming an excessive amount of food within a short time frame and feeling a lack of control during these episodes. Binges might involve rapid eating, eating beyond the point of discomfort, eating despite not feeling hungry, opting to eat alone due to embarrassment and experiencing feelings of guilt or shame afterward.


Symptoms of binge-eating disorder may include eating until discomfort rather than satisfaction, consuming food too quickly to register the amount or its impact, turning to food to cope with emotional stress and experiencing obsessive thoughts about food and specific cravings. They may also hide food in various locations, avoid eating socially and engage in frequent dieting. 

Risk Factors

Manhattan woman staring at her food, trying to decide if she should eat it or not.

Several risk factors linked to binge eating comprise psychological elements like depression, anxiety, low self-esteem or dissatisfaction with one’s body, along with engaging in dieting and restrictive eating practices. Past traumatic experiences, such abuse or neglect, can also contribute to this disorder, along with personality traits like perfectionism and impulsivity.


Treatment primarily revolves around therapies like CBT or interpersonal Therapy (IPT) aimed at altering eating behaviors and addressing emotional triggers linked to binge eating. The overarching goal is to establish healthier coping mechanisms, regulate eating patterns and cultivate a balanced relationship with food, ultimately reducing the frequency and intensity of binge episodes.


Pica is a disorder characterized by persistent cravings and consumption of nonfood substances over a period of at least one month. These items can vary widely but are not considered food; they may include dirt, clay, chalk, soap, paper, hair, cloth, wool, pebbles and laundry starch, among others.


Many of the symptoms of pica include consuming nonfood items, persistent cravings for nonedible substances, ingesting nonedible substances despite known risks and attempting to hide or conceal this consumption behavior. Individuals may also encounter health complications such as gastrointestinal problems, nutritional deficiencies, toxicity, infections or blockages.

Risk Factors

Pica can be influenced by various risk factors including nutritional deficiencies, along with developmental factors (notably between ages two and three). Mental health conditions like intellectual disabilities, autism spectrum disorder or obsessive-compulsive disorder (OCD) can contribute as well. Stress, trauma and hormonal changes during pregnancy, leading to nutritional deficiencies, can also be influential factors.


Treatment methods for pica vary based on severity and causation. They might include therapy, addressing nutritional deficiencies and behavioral interventions focused on preventing the consumption of nonfood items while managing underlying causes.

Rumination disorder

Rumination disorder is a less common and not extensively understood eating disorder marked by the regurgitation of food. This regurgitated food is then either rechewed, reswallowed or expelled. Unlike vomiting, this regurgitation doesn’t evoke feelings of nausea, gagging or an aversion to food. Instead, it’s a reflexive or habitual behavior that normally occurs within 30 minutes of eating.


While the symptoms of rumination disorder may vary, they commonly include repeated regurgitation of food, rechewing and reswallowing, physical sensations of food returning to the mouth without the usual discomfort or distress associated with vomiting and weight loss or nutritional deficiencies. 

Risk Factors

Rumination disorder can manifest across various developmental stages. It may occur in infants, particularly among those with delays in development or intellectual disabilities. However, it can also appear in adolescents and adults. Psychological elements, such as stressful life events or anxiety, may contribute to the onset or worsening of rumination disorder. Additionally, individuals with preexisting gastrointestinal issues or disorders might be more susceptible to developing rumination behaviors. Certain environmental stressors or conditions could heighten the risk of this disorder, particularly if they evoke feelings of anxiety or discomfort during or after meals. 

Person's hands wrapped up with a tape measure, over a plate and utensils. Find out more about eating disorders with this blog.


Treatment typically involves behavioral therapy, retraining swallowing patterns and dealing with any underlying emotional issues. The goal of the treatment is to disrupt the habitual regurgitation and rechewing of food, replacing it with healthier coping mechanisms and addressing emotional triggers to prevent the recurrence of this behavior.

Avoidant/Restrictive Food Intake Disorder

Avoidant/restrictive food intake disorder (ARFID) stands as an eating disorder distinguished by restricted or selective eating habits, resulting in insufficient nutritional intake or marked impairment in both physical and psychosocial functioning. Unlike other eating disorders, ARFID doesn’t revolve around concerns about body image or weight; instead, it primarily involves the avoidance of particular foods or limitations in food intake due to sensory sensitivities, fear of adverse outcomes or a general lack of interest in eating.


Symptoms of ARFID include restricted food intake involving avoiding or limiting certain foods due to sensory characteristics like texture, taste or smell. It can also stem from fears of adverse consequences such as choking or vomiting, or simply a lack of interest in eating certain foods. Nutritional deficiencies are also visible through inadequate intake of nutrients, which can result in weight loss, failure to gain weight (particularly in children) or deficiencies in essential nutrients. Feelings of anxiety or distress linked to eating can result in behaviors that involve avoiding meals altogether or being extremely selective about the individual’s food consumption. Physical symptoms may include gastrointestinal problems, feelings of lethargy, fatigue or other manifestations related to insufficient nutrient intake.

Risk Factors

Risk factors associated with ARFID include those with heightened sensory sensitivities, experiencing aversion to certain textures or tastes, difficulties transitioning to solid foods and selective eating habits. Additionally, individuals dealing with anxiety, experiences with trauma or other mental health conditions might develop ARFID as a coping mechanism. ARFID is more prevalent among individuals on the autism spectrum due to sensory sensitivities and rigid eating patterns associated with this condition. Chronic illnesses, gastrointestinal issues or other medical conditions impacting eating or digestion may also contribute to the development of ARFID.


Treatment generally includes nutritional counseling, gradual exposure to feared foods, and, in some cases, therapy to address underlying causes while expanding the range of accepted foods. The primary goal of ARFID treatment is to enhance the individual’s nutritional intake and improve their relationship with a wider variety of foods, ensuring they receive adequate nourishment for optimal health and well-being.


At Manhattan Wellness, we understand that your relationship with food can be complicated. With all the messages and images we are bombarded with on social media, it can be difficult to navigate a positive relationship with food.  That’s why our female therapists want to support you in tackling your eating disorder with compassion and care. Let us help you create an empowering narrative that will benefit all aspects of your life. If you are interested in beginning counseling for women:

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Our therapists understand that life in New York City is not always easy, and that other issues can come up along the way. To better support you, we offer a variety of services to cater to your individual needs. The therapy services we offer are Therapy for Self Esteem, Anxiety Treatment, and therapy for dating and relationship issues. As well as therapy for college students, support for maternal mental health, body image therapy, and so much more. Are you feel like you’re not living the life you want and need to make changes? Let’s talk about it.

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