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Types of eating disorders

There are three types of eating disorders that are currently in the Diagnostic and Statistical Manual,  fourth edition (DSM-IV-TR; a manual used by certain mental health professionals to diagnose mental illnesses): anorexia nervosa, bulimia nervosa, and ‘eating disorder not otherwise specified’ (i.e. the individual does not meet the diagnostic criteria for either anorexia or bulimia but exhibits disordered eating). Currently under consideration for the next edition of the DSM (DSM-V) is the addition of binge eating disorder as a fourth type of eating disorder. 

Anorexia nervosa

The essential features of anorexia nervosa are that the individual is significantly below normal body weight, intensely fearful of gaining weight or becoming fat, and takes extreme measures to avoid any weight gain. Some individuals will restrict the amount they eat, purge (for example, self-induced vomiting, misuse of laxatives, diuretics, or medications), or exercise excessively. 

Individuals with anorexia may be described as one of two subtypes:

  • Restricting type: this subtype describes those who use dieting, fasting or excessive exercise to lose weight.

  • Binge-eating/purging type: this subtype describes those who regularly binge eat or purge (or both).

Related psychological symptoms

  • depression
  • social withdrawal
  • irritability
  • insomnia
  • diminished interest in sex
  • obsessive-compulsive tendencies (both related and unrelated to food)
  • perfectionism
  • need to control his/her environment
  • inflexible thinking
  • emotionally restrained
  • feeling ineffective

Related physical symptoms
Many of the physical signs and symptoms of anorexia are a consequence of the starvation. Physical symptoms related to anorexia include:

  • emaciation
  • amenorrhea (loss of menstrual cycle)
  • constipation
  • abdominal pain
  • cold intolerance
  • fatigue
  • dehydration
  • hypotension (low blood pressure)
  • hypothermia
  • dry skin
  • luango (a fine downy hair all over their body)
  • bradycardia (slow heartbeat)
  • peripheral edema (swollen tissues, usually in limbs)
  • yellowing of the skin
  • enlargement of salivary glands
  • erosion of teeth enamel
  • scars on hands or fingers from contact with teeth when vomiting
  • anemia
  • impaired renal (kidney) function
  • cardiovascular problems
  • osteoporosis
  • death

Often times, individuals with eating disorders are brought to medical attention due to some of the above physical consequences.

Bulimia nervosa

Bulimia nervosa is characterized by a cycle of binge eating followed by inappropriate compensatory methods to prevent weight gain. Binging is when an individual eats a large amount of food in a very short period of time. There is often the feeling of not having control over one’s eating behaviour. Typically, the individual will eat sweet and/or high-calorie food. Binges usually occur in secrecy. They are sometimes planned, and other times occur without planning. Binges are often triggered by difficult feelings, problems in a relationship, feelings related to one’s body or body image, or feelings of intense hunger following a prolonged fast. Binging often temporarily reduces these difficult feelings, but is then typically followed by a resurgence of difficult feelings (for example, depression, shame, self-hate or anxiety).

In addition to binging, individuals use inappropriate compensatory behaviours to prevent weight gain. Examples of purging behaviours include self-induced vomiting, misuse of laxatives, enemas, or medications, and excessive exercise. Self-induced vomiting is the most common form of purging.

Related psychological symptoms

  • depression
  • low self-esteem
  • anxiety
  • higher rates of substance abuse or dependence
  • self-critical
  • low self-worth
  • impulsivity
  • mood swings
  • difficulty concentratin

Related physical symptoms

  • electrolyte imbalance
  • dehydration
  • swollen glands
  • puffy cheeks
  • broken blood vessels under the eyes
  • sore throat
  • erosion of teeth enamel
  • gum problems
  • muscle cramps
  • fatigue
  • scars on hands or fingers from contact with teeth when vomiting
  • rupture of esophagus
  • mouth ulcers
  • cardiovascular problems
  • death

Binge eating disorder

Binge eating disorder is characterized by periods of uncontrolled eating of large amounts of food, but is not followed by purging (as it is with bulimia nervosa). The individual often feels out of control and ashamed about the binges. While there may not be any purging, some individuals often engage in dieting or fasting. Triggers for a binge often include feelings of depression, loneliness or feeling overwhelmed due to personal life circumstances (for example, the loss of an important relationship, loss of one’s job). The body weight of those with binge eating disorder can range from normal to severely obese. As with anorexia nervosa and bulimia nervosa, binge eating disorder often develops as a way to manage or dampen difficult feelings. Binging allows the person to avoid feelings such as anger, depression, anxiety, emptiness, guilt, as well as other feelings. Often it leads to a vicious cycle: one binges because they feel badly inside, followed by feelings of guilt and shame, then a period of dieting or fasting, followed by another binge.


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  • A publication of:
  • Women's College Hospital