Recognizing Eating Disorders In Adults: What You Need to Know

Eating disorders, including anorexia nervosa and binge eating disorder, can severely affect eating behaviors and cause emotional distress in anyone, regardless of age. However, many adults with eating disorders may go unnoticed or not receive adequate treatment. 

Adults with eating disorders often experience symptoms that affect various aspects of daily life. For example, an adult with bulimia may have difficulty focusing at work, which can affect both their performance and their work relationships. However, support is available, and it’s possible to overcome eating disorders with the right help, including therapy and support groups. 

Are eating disorders more common in children or adults?

Eating disorders affect both children and adults. However, studies show that many eating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating disorder, often start in adolescence. According to one study, around 16% of people show signs of an eating disorder before they turn 14, 48% before 18, and 82% by the age of 25. The median age when these disorders start is around 16 years, with most people starting to have symptoms between ages 15 and 23.

Although many cases of eating disorders start to develop before adulthood, adults aren’t immune to developing an eating disorder later in life. Nearly 29 million Americans will have an eating disorder at some point in their lives, with women being more likely to be diagnosed than men. 

In addition, individuals who undergo treatment for eating disorders may relapse later on. One study examined 16 research papers to understand how often people with anorexia nervosa return to their previous eating behaviors after treatment. It found that 31% of people relapsed, with the highest risk occurring during the first year after treatment and lasting for up to two years. 

Signs and symptoms of eating disorders in adults

Eating disorders in adults can develop in various ways. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides guidelines for healthcare professionals to help identify and diagnose these eating disorders. Common signs include constant worries about food and body shape, restriction of food intake, binge eating episodes, and purging behaviors, among others.

Constant worries about food, weight, and body shape

Adults with eating disorders may obsess over food, weight, and body shape. This obsession can lead to severe anxiety and may interfere with daily life. For example, someone with anorexia nervosa might constantly fear gaining weight, even if they are underweight. Similarly, a person with bulimia nervosa may worry about weight gain after eating.

Severe restriction of food intake

Restricting food intake tends to be a common behavior in eating disorders such as anorexia nervosa and restrictive food intake disorder. People living with these disorders may eat very little, skip meals, or cut out entire food groups. They might go to great lengths to control their eating, such as counting calories carefully or making strict rules about what and when to eat. This can lead to serious weight loss and a lack of nutrients, which can cause various health problems.

Binge eating episodes

Binge eating disorder involves consuming large amounts of food in a short period, often in secret. During these episodes, individuals may experience a loss of control over their eating. They might eat quickly and continue eating even when full. Unlike bulimia nervosa, binge eating disorder doesn’t typically involve purging behaviors, but people with this disorder may still experience challenges with weight and low self-esteem.

Purging behaviors

Purging is a behavior linked to bulimia nervosa and other eating disorders. It often involves actions like self-induced vomiting or use of laxatives to get rid of food from the body. This can lead to serious health problems, including mineral imbalances, digestive problems, and tooth damage. Often, people purge after binge eating to cope with guilt or shame about their food intake.

Excessive exercise

Some adults exercise excessively as a way to control their weight, even when it's harmful to their health. This behavior may be seen in anorexia nervosa and bulimia nervosa. They might spend hours every day exercising, even if they’re tired or injured. 

Avoidance of social situations involving food

Avoiding social events where food is present can be a common sign of eating disorders. Adults might fear judgment or become tempted to eat in a way that goes against their eating disorder rules. They might refuse invitations to parties, family gatherings, or dinners, preferring to eat alone or stick to their restrictive eating patterns.

The effects of eating disorders in adults 

Eating disorders can cause many serious health problems in adults, involving both physical and mental health. Weight loss is common in disorders like anorexia nervosa, while weight gain can happen with binge-eating disorder.

Other effects may include:

• Heart problems: Many people experience changes in their heart rate and blood pressure.
• Mental health challenges: Conditions like depression and anxiety are common and can happen alongside eating disorders.
• Digestive issues: Some individuals may have stomach pain, constipation, or inflammation of the stomach lining.
• Hormone changes: Women might have irregular periods, and men may notice lower testosterone levels.
• Bone health: There is a higher risk of developing weak bones, which may lead to fractures.
• Dental problems: Vomiting, especially in conditions like bulimia, can damage tooth enamel.

These are just some of the possible effects of eating disorders in adults. Complications can vary based on the severity of the eating disorder, the type of eating disorder, and other factors. 

Risk factors for developing an eating disorder as an adult

Various factors may increase the risk of developing an eating disorder in adulthood. Common risk factors may include family history, body image, and stress levels.

Family history of eating disorders

Studies suggest that genetics play a role. If a parent or sibling has an eating disorder, there may be a higher chance another family member might develop one, too. 

History of mental health problems

Mental disorders such as anxiety, depression, or obsessive-compulsive disorder are linked to a higher risk of eating disorders. When an adult has a history of mental disorders, the risk of developing an eating disorder may be higher, but this doesn’t guarantee a person will develop an eating disorder.

Low self-esteem

Low self-esteem can be another factor in developing eating disorders. People with low self-worth might use food and eating habits to gain a sense of control or to cope with their negative perceptions about themselves. This behavior can potentially lead to harmful eating patterns. 

Body image dissatisfaction

Adults who are dissatisfied with their body shape or weight may develop negative eating behaviors to try to change their appearance. Unrealistic standards of beauty from society and the media may contribute to dissatisfaction, making body image problems a common trigger for eating disorders.

High levels of stress

Stress may lead to changes in eating patterns as a way to cope. Whether it's due to work, personal relationships, or other life pressures, stress can greatly affect eating behaviors, increasing the risk of disorders.

No single risk factor is responsible for causing eating disorders. In many cases, a combination of these factors may lead to changes in eating patterns. 

How to manage an eating disorder as an adult

There are different ways to manage an eating disorder as an adult. Treatment often combines therapy, medication, and support groups that focus on different aspects of recovery.

Therapy is often part of the treatment plan for most eating disorders. Enhanced cognitive behavioral therapy (CBT-E) may help change unhealthy eating behaviors and thoughts. Other forms of therapy, like family-based treatment or individual psychotherapy, may also be recommended.

Medications can be an important part of treating some eating disorders, working alongside therapy and positive habits. For example, fluoxetine is often used for people with bulimia nervosa, while lisdexamfetamine may help those with binge-eating disorder by reducing the urge to overeat. 

Self-care strategies may help individuals better manage an eating disorder. For example, mindfulness activities like meditation or yoga may help reduce stress. In addition, journaling may be beneficial as it allows individuals to express their thoughts and emotions, track their eating patterns, and identify triggers.

By focusing on these areas, adults may be able to better manage their eating disorders. In many cases, getting help from professionals such as doctors or counselors can be important to learn the right skills for recovery.

Find support for eating disorders like bulimia or binge eating disorder

You can find support for eating disorders in many ways, whether through professional counseling, support groups, or online resources. These options may help individuals manage their condition and connect with others experiencing similar challenges.

Resources for help with an eating disorder

• National Institute of Mental Health (NIMH): This organization offers information on various eating disorders, their symptoms, and treatment options. It also provides links to other useful resources for seeking treatment.
• Local support groups: Many communities have local support groups that meet regularly. A peer support group allows people to connect with others who are experiencing similar eating disorders. Professional-led groups, guided by therapists, may provide more structure for having discussions and learning healthy eating habits.
• Online forums and communities: Resources like Around The Dinner Table and MumsNet.com may offer forums where individuals can discuss their experiences and support others in a virtual community.

These resources may offer various ways to seek help, making support convenient for everyone in need.

Online therapy for eating disorders

Online therapy may be a helpful way to find support for eating disorders. Online therapy platforms tend to provide flexibility that traditional in-person therapy may lack. 

Individuals may benefit from the convenience of attending sessions from home, which can reduce the stigma and barriers that sometimes accompany seeking help. People with eating disorders can communicate with a therapist via video, audio, or live chat. In addition, ongoing connections with therapists and structured support can help patients stay on track, promoting long-term success.

Is online therapy effective for eating disorders?

Studies have found that online therapy can be highly effective in treating common eating disorders. In one study, 150 participants with bulimia were divided into three groups: two types of online therapy and a traditional 16-week day program. The study’s authors concluded that “all treatments were comparable in effect at follow-up, suggesting that internet treatment is a conceivable alternative to standard treatment.”