How Common Are Eating Disorders? Learn The Prevalence Of Common Disorders

There are many types of eating disorders. Most eating disorders involve a disruption in healthy eating behavior, along with an excessive focus on or worry about body weight. Having an eating disorder frequently interferes with a person's physical, mental, and social functioning. When they are severe, eating disorders can be life-threatening, so identifying and treating them can be vital.

In this article, we explore what are called "feeding and eating disorders," as listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We describe what each eating disorder entails and discuss research about its prevalence. Finally, we delve into treatment options for eating disorders, including therapy.

How common are eating disorders?

The prevalence of eating disorders appears to have increased throughout the COVID-19 pandemic. A study published in 2022 reported a higher worldwide prevalence of eating disorders compared to previous research. According to this study, up to 17.9% of women and 2.4% of men have had an eating disorder by the time they become young adults.

Anorexia nervosa

In general, when a person has anorexia nervosa, they persistently pursue thinness by restricting their food intake. They often have an extreme fear of gaining weight, as well as a distorted body image that can leave them believing they are overweight when they are not. 

In some cases, a person with anorexia nervosa may binge on food and then purge, or intentionally vomit it up. Often, people with anorexia deny that they are thin, despite significant weight loss. They may also engage in excessive exercise, think about food often, and hide or lie about how little they eat.

It can be important to note that not all individuals with anorexia nervosa are underweight. Anorexia can arise in people of all body sizes. Those with anorexia who are not underweight may be given the diagnosis of “atypical anorexia nervosa.”

How common is anorexia nervosa?

Over the course of a lifetime, up to 6.3% of women and 0.3% of men develop anorexia nervosa. Anorexia nervosa commonly occurs in adolescent girls. While some people may have anorexia nervosa for many years, it's usually uncommon for someone in middle age or older to develop the disorder for the first time. 

Bulimia nervosa

Bulimia nervosa typically involves eating large amounts of food, often rapidly, then engaging in attempts to prevent weight gain and compensate for the food that was eaten. These attempts may involve vomiting (purging), taking laxatives, exercising excessively, dieting, or fasting. 

As with anorexia nervosa, people with bulimia nervosa commonly have a deep fear of weight gain, even if they have what is considered a normal or healthy weight. People with bulimia nervosa often sense they are out of control during the binging phase of their eating patterns and then feel ashamed afterward.

Although anorexia nervosa and bulimia nervosa can both involve binge eating and purging, the two disorders differ. People with anorexia tend to be underweight (although this is not always the case), and those with an average or higher weight are normally considered to have atypical anorexia nervosa. 

People with bulimia nervosa tend to have a weight that fluctuates around what are viewed as normal levels. At times, they may be underweight, but they may also often be a normal weight or overweight. It tends to be rare for a person with anorexia nervosa to be overweight. People with bulimia nervosa may be more likely than those with anorexia nervosa to feel bad about their eating disorder and talk to others about it.

How common is bulimia nervosa?

Research suggests that up to 2.6% of women and 0.2% of men have bulimia nervosa at some point in their lives. Anorexia nervosa and bulimia nervosa appear to be the most common eating disorders among adolescent girls and young women. As with anorexia nervosa, it's uncommon for bulimia nervosa to develop for the first time in middle age or beyond.

Binge eating disorder

As with bulimia nervosa, binge eating disorder usually involves periods of binge eating large quantities of food. A person often senses they are out of control during a binge and may continue eating even when they become uncomfortably full. Binge eating disorder normally differs from bulimia nervosa in that the disorder only involves binge eating and doesn't involve compensatory behavior, like purging or taking laxatives, in an attempt to "cancel out" the binge.

Sometimes, people with binge eating disorder eat very quickly. They may also eat alone out of embarrassment about the way they eat or how much they eat. People with this disorder often eat even when they are not hungry and then feel guilty, disgusted, or depressed afterward. Unlike people with anorexia nervosa and bulimia nervosa, those with binge eating disorder tend to be more likely to be obese. However, they may still be preoccupied with their body shape or weight.

How common is binge eating disorder?

Around 3.5% of women and 2% of men may be diagnosed with binge eating disorder. The demographics of people with binge eating disorder don't necessarily follow the same patterns as those seen in anorexia nervosa and bulimia nervosa. This disorder appears to be more evenly spread across genders. 

In addition, middle-aged and older adults tend to be more likely to have binge eating disorder than anorexia nervosa or bulimia nervosa. In some weight-loss programs, around one-third of people with obesity have binge eating disorder. 

Avoidant/restrictive food intake disorder (ARFID)

Children with avoidant/restrictive food intake disorder (ARFID) usually eat very little, which can lead to weight loss and delayed growth. ARFID may lead to nutrient deficiencies and can even become life-threatening. The undereating seen in ARFID typically differs from that in anorexia nervosa because a child with ARFID normally isn't excessively concerned with their weight or body image.

Experts aren't yet entirely sure why children with ARFID restrict their food intake. Often, to others, people with ARFID appear to be "picky eaters," and others may think they don't eat adequately because they don't like their food options. People with ARFID can be distinguished from "picky eaters" when they lose weight or experience slowed growth or nutritional deficiencies. ARFID may be more common among children, as well as individuals with autism, developmental disorders, anxiety, or a history of trauma. 

How common is avoidant/restrictive food intake disorder?

Research shows that up to 3.2% of children and 3.1% of adults have ARFID worldwide. The disorder usually first appears in childhood, often before age seven. In some people, ARFID continues into adulthood. Unlike anorexia nervosa and bulimia nervosa, ARFID is thought to occur evenly across gender, or it may be more common in boys.

Other eating disorders

In addition to these eating disorders, there are others that are less common and less studied. These generally fall under the label of Other Specified Feeding and Eating Disorder (OSFED) in the DSM-5. As with anorexia nervosa, bulimia nervosa, and binge eating disorder, these eating disorders often involve a preoccupation with body weight, body shape, and weight loss.

Night eating syndrome

In night eating syndrome, a person typically binge eats during the night. They often eat after waking up from sleep but may also do a lot of their eating in the evening or at night before bed. Around 1.5% of people in the U.S. are thought to have night eating syndrome, and the disorder is often associated with obesity, depression, and sleep disturbances.

Purging disorder

People who have purging disorder may engage in vomiting, laxative use, excessive exercise, or other methods in an attempt to control their weight. Unlike people with anorexia nervosa and bulimia nervosa, those with purging disorder normally do not binge eat prior to purging. Up to 4.8% of adolescent girls have purging disorder.

Orthorexia

In orthorexia, sometimes called orthorexia nervosa, a person generally develops an unhealthy obsession with healthy eating. This obsession may lead to a fear or avoidance of entire categories of food, like wheat, carbohydrates, fat, or "junk food." People with orthorexia may also become preoccupied with the purity of their food and become distressed if its content or type of preparation differs from what they prefer. 

Research has returned conflicting results regarding how many people have orthorexia, with prevalence ranging from 6.9% to 75.2%, depending on the study. With a lack of diagnostic criteria, different researchers may define orthorexia differently, which can explain the range of results. If orthorexia receives its own list of diagnostic criteria in the future, prevalence statistics should become more accurate.

Eating disorders and mental health

Eating disorders are considered mental health disorders. They often overlap with other mental illnesses. Research has found that the following psychiatric disorders tend to be more common among people with eating disorders:

• Generalized anxiety disorder (GAD)
• Social anxiety disorder
• Obsessive-compulsive disorder (OCD)
• Major depressive disorder (MDD)
• Bipolar disorder (BD)
• Personality disorders
• Substance use disorders (SUDs)
• Psychosis and schizophrenia
• Body dysmorphic disorder (BDD)
• Attention-deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorder (ASD)
• Post-traumatic stress disorder (PTSD)
• Suicidality
• Non-suicidal self-injury (NSSI)

Therapy for eating disorders

Eating disorder treatment can involve a variety of professionals, including primary care doctors, registered dietitians, psychiatrists, and therapists. If you're seeking a therapist with whom to discuss your eating habits, you might prefer remote therapy. Remote therapy generally allows you to attend sessions from the comfort of your preferred location instead of having to travel to an office. BetterHelp can connect you with the remote therapist best qualified for your unique situation.

Research on therapy for eating disorders and mental health

A research study published in 2021 compared a group of 49 adults who had received in-person therapy treatment for eating disorders with 76 who received remote therapy treatment. The study found that people who received remote therapy for eating disorders "showed similar improvements on eating symptoms" as well as "satisfaction with services" compared to those who received their treatment in person. The study authors concluded that remote and in-person treatments for eating disorders "are comparable,” and remote therapy may be a good option for people who face barriers to seeing a therapist in person.