It can be hard to write about eating disorders without also doing a bit of mythbusting. There are just so many misconceptions about what eating disorders are, and who gets them. For most of us, the words ‘eating disorder’ conjure up an image of a young, thin, frail, White female.  But eating disorders affect people of all ages, body types and ethnicities.  

First, the basics. Here are a few brief descriptions of the most common ED diagnoses:

ARFID

ARFID, or Avoidant Restrictive Food Intake Disorder, is most common in youth, but like all eating disorders, can start or persist in adulthood as well.  Persons with ARFID are unable to meet their nutritional requirements due to limiting the volume and/or variety of foods they eat. They may suffer from a number of nutrient deficiencies, or may require supplements (like Ensure or Boost) to meet their needs.

ARFID symptoms can impact weight and development differently, and while some individuals lose weight, relying on weight loss as an indicator is tricky. For example, children with ARFID may not appear to ‘lose weight’, but have struggled to keep pace with expected increases in height or weight throughout most of their lives.  Others may be at an expected or higher than expected weight, but still suffer the consequences of poor nutrition due to limited variety.

Unlike the other eating disorders, distorted body image or an intense fear of gaining weight aren’t core symptoms. Athletes with ARFID may be more prone to medical complications, as they often face higher energy needs than the general population.

There are three main ARFID profile types: 

• Lack of interest in eating (poor appetite, needs prompting to eat at ‘regular’ times)

• Sensory sensitivity (i.e. has a hard time with certain textures or smells, and 

• Fear of aversive consequences (i.e. choking or vomiting). 

While persons with ARFID may have symptoms that fit best with one primary profile type, they fit with two, or even all three. ARFID is different from age-appropriate, or ‘normal’ picky eating, because the symptoms are causing problems with health and social functioning. 

ANOREXIA NERVOSA

Anorexia Nervosa is characterized by calorie restriction and weight loss (or lack of appropriate weight gain in kids, adolescents and young adults). Most also have an intense fear of gaining weight, and a distorted body image. Some might also exercise compulsively, vomit, take laxatives, or binge eat. As part of the disorder, someone with anorexia nervosa may be unable to acknowledge the seriousness of the illness. Anorexia nervosa can occur in athletes in all sports and body weights. While anorexia nervosa can be common in males, it may look a bit different, as male athletes are often striving for more muscle mass rather than thinness (stay tuned for more about “Bigorexia” in a future blog post). 

BULIMIA NERVOSA

Bulimia Nervosa is described as a repeated cycle of binge eating and compensatory behaviors (vomiting, fasting, excessive/compulsive exercising, fasting, laxative or diuretic use). During binge eating episodes a person may feel out of control, and like they can’t stop eating. Most persons with Bulimia also struggle with distorted body image, and fear of gaining weight. 

BINGE EATING DISORDER

Binge Eating Disorder became an eating disorder diagnosis in 2013, and is characterized by repeated episodes of eating large amounts of food in a discrete period of time (ex: 2 hour period). This might mean eating beyond fullness (frequently), eating too fast, eating when not hungry, and eating ‘in secret’. Similar to Bulimia, persons may feel out of control during binge eating episodes, accompanied by feelings of guilt, shame or disappointment. Unlike Bulimia, though, persons with Binge Eating Disorder don’t engage in regular use of compensatory behaviors. 

OSFED

OSFED, or Other Specified Feeding or Eating Disorders, captures individuals who did not meet the strict diagnostic criteria for Anorexia Nervosa, Bulimia Nervosa, or Binge Eating Disorder, but still struggled with eating disorder behaviors, and suffered similar consequences that are just as severe. OSFED is the most common eating disorder. 

The most common example fitting within the “OSFED” category is Atypical Anorexia Nervosa, which refers to an individual with all symptoms of Anorexia Nervosa, other than being ‘average’ or ‘above average’ weight. The ‘atypical’ label is misleading, given OSFED’s status as the most prevalent diagnosis, and given that behaviors aren’t different from Anorexia Nervosa. Atypical Anorexia Nervosa is just as dangerous as Anorexia Nervosa, and is often overlooked or dismissed, due to misconceptions about who gets eating disorders.

UFED

UFED, or Unspecified Feeding or Eating Disorder, fits in situations where a person has eating disorder symptoms that are causing them problems or distress, but they aren’t quite fitting the criteria for the other diagnoses, or, there isn’t enough information to make a proper diagnosis.  

Eating disorders are serious and persistent psychiatric illnesses, and they are treatable, especially with early intervention and evidence-based treatments. If you or someone you know may be struggling with an eating disorder, feel free to reach out. 

You can also visit the National Eating Disorder Association (NEDA) website for more information, or to try their brief eating disorder screening tool.