Eating Disorders Therapy: Symptoms, Research, And Treatments

Medically reviewed by April Justice, LICSW
Updated November 4, 2024by BetterHelp Editorial Team

The American Psychiatric Association (APA) estimates that up to 5% of the population experiences eating disorders, with many developing these conditions in adolescence and young adulthood. However, the National Eating Disorders Association states that eating disorders can affect people of all ages, genders, sexual orientations, and backgrounds.

With the significant prevalence of eating disorders, it can be important to recognize the symptoms and learn about available treatments, whether for you or a loved one. However, to determine whether eating disorders therapy or another form of treatment is right for you, it may be helpful to start by learning more about what eating disorders are. 

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Are you experiencing an eating disorder?

What are eating disorders? 

According to the American Psychiatric Association, eating disorders are serious behavioral conditions that can be characterized by disturbances in a person’s eating behaviors. These disorders can also affect how a person thinks about eating and the emotions they associate with food. Research shows that one person dies every 52 minutes in the United States as the result of an eating disorder. Statistics like this underscore the severity of these disorders and the importance of understanding their eating disorder symptoms. 

Symptoms of eating disorders

While the symptoms of eating disorders can vary, they can include food restriction, avoidance of specific foods, preoccupation with food or the act of eating, intense focus on body weight or shape, and feelings of anxiety about the consequences of eating certain foods. However, the precise symptoms a person has typically depend on what type of disorder they are experiencing. 

What are the different types of eating disorders?

There are various types of eating disorders that a person may experience, each with its own set of symptoms. To begin, we’ll look at some eating disorders that may not be as well known as others but that can still have a significant impact on a person’s health: avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder. 

Avoidant restrictive food intake disorder (ARFID)

ARFID can be characterized by a severe dislike of specific foods or food groups. This can cause a person to be seen as “picky” or generally having a low appetite, as they may only be willing to eat a small number of foods. These individuals may have preferences due to sensory aspects of the foods, including smell, color, and texture. Individuals experiencing ARFID could also worry about these foods harming them in some way, such as through choking, food poisoning, and allergic reactions. 

Pica

Individuals with pica may consume things that are not typically considered foods or that have no nutritional value. These items may vary and can include:

  • Rocks
  • Hair
  • Soap
  • Paper
  • Paint chips
  • Cloth

Pica may be more common during specific parts of a person’s life, including during childhood. This disorder can be dangerous, as the items a person eats could result in poisoning or intestinal distress. 

Rumination disorder

Those with rumination disorder typically regurgitate and re-chew food several times before swallowing or spitting it out. For rumination disorder to be diagnosed, this behavior typically needs to occur repeatedly for a period of at least one month and cannot be attributed to a medical condition. 

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Are there other types of eating disorders?

In addition to avoidant restrictive food intake disorder (ARFID), pica, and rumination disorder, there are several other eating disorders a person can experience. These eating disorders (which can potentially be more common) include binge eating disorder, bulimia nervosa, and anorexia nervosa. These disorders can each present with their own unique set of symptoms that may impact how a person thinks about and interacts with food. 

What are the symptoms of binge eating disorder?

Binge eating disorder (BED) can cause a person to consume significant quantities of food in a short amount of time, which can be referred to as a binge episode. During these episodes, those with BED may feel as though they lose control and cannot stop themselves from eating, even if they want to. Other symptoms can include:

  • Using food as a way to cope with difficult emotions
  • Eating until one feels significant discomfort
  • Eating even when one isn’t hungry
  • Hiding the act of eating or how much one is eating
  • Becoming preoccupied with food or the act of eating
  • Feeling guilt or shame surrounding eating

Is binge eating always a symptom of binge eating disorder?

While binge eating can indicate that someone is experiencing binge eating disorder, this may not always be the case. It is possible for a person to occasionally binge-eat without developing BED. In order to be diagnosed with BED, binge-eating typically needs to occur at least one day a week for three months on average. 

What are the symptoms of bulimia nervosa?

Like those with binge-eating disorder, individuals with bulimia nervosa can experience binge-eating episodes where they feel an uncontrollable compulsion to consume large quantities of food. However, one primary difference between these disorders is that individuals with bulimia nervosa typically purge after binging. These purges can involve a variety of behaviors, such as forced vomiting, use of laxatives or diuretics, excessive fasting, and excessive exercise. Other symptoms of bulimia nervosa can include:

  • Irregular periods
  • Feelings of anxiety or depression
  • Fatigue
  • Preoccupation with appearance
  • Low self-esteem
  • Fear of gaining weight

What are the symptoms of anorexia nervosa?

Anorexia nervosa can be characterized by an obsession with food, eating, and body weight. Individuals with anorexia nervosa can also experience challenges with self-image, sometimes believing that they are overweight even if they are at a “healthy weight” or underweight as determined by a medical professional. 

The specific symptoms of this condition can vary depending on which subtype a person is experiencing: binge-purge anorexia nervosa or restrictive anorexia nervosa. Individuals with restrictive anorexia nervosa may consume very little calories or exercise excessively to burn calories, while those with binge-purge anorexia nervosa can experience periods of binge-eating and purging. 

Other symptoms of anorexia nervosa may include:

  • Dizziness
  • Fainting
  • Brittle nails and hair
  • Acid reflux and heartburn
  • Muscle weakness
  • Constipation

Can an eating disorder impact a person’s mental health? 

Eating disorders can have a significant negative impact on a person’s mental health. Research shows that those with an eating disorder may be at a higher risk of developing a comorbid psychiatric disorder. In a 2023 study, researchers found that more than 70% of individuals with an eating disorder experienced a comorbid mental illness, either before or during the acute stages of their disorder (or in the long-term course.) These comorbidities include substance use disorder (>10%), mood disorders (>40%), anxiety disorders (>50%), and personality disorders (>53%). 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Treating eating disorders may involve addressing these mental health conditions. However, to treat eating disorders and comorbid conditions, it is typically essential to talk to a mental health or medical professional. These individuals can provide a diagnosis and help determine what treatments could be the most effective. 

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Are you experiencing an eating disorder?

What mental health therapies can help those with an eating disorder? 

One of the primary therapies that may help those experiencing an eating disorder is a form of talk therapy known as enhanced cognitive behavioral therapy (CBT-E). This type of therapy can follow four distinct stages:

  • Stage One: With the help of a CBT-E provider, individuals can understand the source of their struggles with eating and find ways to modify their eating patterns. This stage can also involve addressing concerns that individuals have with their appearance or weight. 
  • Stage Two: The second stage of CBT-E can be brief, as progress from stage one is assessed and the structure of the primary stage of treatment (stage three) is determined. 
  • Stage Three: During stage three, individuals may attend weekly sessions that can focus on the processes that could be contributing to eating-related challenges. This can involve addressing the concerns that a person shared in stage one, such as worries about body shape and food consumption. Stage three can also allow a person to work through the emotions they feel before, during, or after meal times and the effects that restrictive dieting can have on an individual. 
  • Stage Four: The final stage of CBT-E can involve preparing for any setbacks a person may experience in the future and maintaining the changes they’ve made. 

Other types of therapy may also be beneficial for those living with eating disorders, such as acceptance and commitment therapy and family-focused therapy. However, while these therapeutic approaches can be beneficial, in-person forms of therapy may not be available to everyone. Some individuals may live in an area without a sufficient number of mental health professionals, which can increase the challenge of finding a therapist. Others might prefer to talk with a mental health professional through different communication formats, such as texting, phone calls, or video chats. In these situations, it may be beneficial to explore online therapy. 

Research shows that online therapy can be as effective as therapy delivered in person. In a 2023 study, researchers analyzed data from multiple trials to determine whether in-person and telehealth therapy differed in efficacy. They found no significant differences between these approaches on a variety of outcomes, such as function, overall improvement, working alliance, client satisfaction, and symptom severity after treatment. 

Takeaway

Eating disorders can impact a person's thoughts and behaviors associated with food and the act of eating. These disorders can include binge-eating disorder, bulimia nervosa, and anorexia nervosa, ARFID, pica, and rumination disorder. In order to treat these and other disorders, it may be beneficial to speak with a therapist. Therapy for eating disorders can vary but may include enhanced cognitive behavioral therapy (CBT-E), which may help individuals understand and address the patterns that impact their disorder. 

If you’re experiencing symptoms of an eating disorder, know that you don’t have to face it alone. With BetterHelp, you can be matched with a therapist who has experience treating eating disorders, usually within 48 hours. Take the first step toward connecting with a therapist and reach out to BetterHelp today.

Healing from eating disorders is possible
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