Which eating disorder is most commonly diagnosed?

Prevalence

• Approximately one million Australians are living with an eating disorder in any given year; that is, 4% of the population.1
• Many more people experience disordered eating (i.e., behaviours consistent with an eating disorder such as restrictive dieting, binge eating, vomiting, laxative use) that do not meet criteria for an eating disorder.2 Approximately a third (31.6%) of Australian adolescents engage in disordered eating behaviours within any given year.3
• Eating disorder symptoms are on the rise with at least weekly binge eating increasing almost six-fold since the late 1990s and strict dieting increasing almost four-fold4 with parallel increases in other behavioural and cognitive eating disorder symptoms (e.g. increased dieting, decreased quality of life).5
• Of people with an eating disorder, 3% have anorexia nervosa, 12% bulimia nervosa, 47% binge eating disorder (BED) and 38% other eating disorders.1
• There is limited research on the prevalence of eating disorders among Aboriginal and Torres Strait Islander peoples. However, emerging research suggests that Aboriginal and Torres Strait Islander peoples experience eating disorders and body image issues at a similar or higher rate than non-Indigenous people.6

Co-occurring conditions

A person with an eating disorder is at increased risk of experiencing another mental health or medical condition at the same time (known as a comorbidity). Comorbid conditions experienced by people living with eating disorders may be connected to their eating disorder symptoms and behaviours, for example osteoporosis.

For other comorbidities, the direction and mechanisms underlying any connection are unclear and a focus of future research.

Mental health 

Research suggests that over 80% of adults diagnosed with an eating disorder have at least one more psychiatric disorder.7 The most common psychiatric comorbidities associated with eating disorders include:

• mood disorders (e.g. major depressive disorder)
• anxiety disorders (e.g. generalised anxiety disorder, social anxiety)
• post-traumatic stress disorder (PTSD) and trauma
• substance misuse
• personality disorders (avoidant, borderline, obsessive compulsive)
• sexual dysfunction
• non-suicidal self injury

Medical

The following comorbidities have been shown to have an increased prevalence in people living with an eating disorder compared with the general population:

• Type 1 and 2 diabetes
• Polycystic ovarian syndrome (PCOS)
• Weak or fragile bones (e.g., osteopenia, osteoporosis)
• Low blood pressure (hypotension)
• Digestive issues (e.g., irritable bowel syndrome)
• Joint pains
• Headache and migraine
• Menstrual problems (e.g., loss of menstruation)
• Sleep problems

1. Deloitte Access Economics. Paying the price: The economic and social impact of eating orders in Australia. Australia: Deloitte Access Economics; 2012. 
2. Hay P, Mitchison D, Collado AEL, González-Chica DA, Stocks N, Touyz S. Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population. J Eat Disord. 2017;5(1):1-10. 
3. Sparti C, Santomauro D, Cruwys T, Burgess P, Harris M. Disordered eating among Australian adolescents: prevalence, functioning, and help received. Int J Eat Disord. 2019;52(3):246-54. 
4. Da Luz F, Sainsbury A, Mannan H, Touyz S, Mitchison D, Hay P. Prevalence of obesity and comorbid eating disorder behaviors in South Australia from 1995 to 2015. Int J Obes 2017;41(7):1148-53 
5. Mitchison D, Hay P, Slewa-Younan S, Mond J. Time trends in population prevalence of eating disorder behaviors and their relationship to quality of life. PLoS One. 2012;7(11):e48450. 
6. Burt A, Mitchison D, Dale E, Bussey K, Trompeter N, Lonergan A, et al. Prevalence, features and health impacts of eating disorders amongst First-Australian Yiramarang (adolescents) and in comparison with other Australian adolescents. J Eat Disord. 2020;8(1):1-10. 
7. Udo T, Grilo CM. Psychiatric and medical correlates of DSM‐5 eating disorders in a nationally representative sample of adults in the United States. Int J Eat Disord. 2019;52(1):42-50.

At least 30 million people in the United States live with an eating disorder. Most of these individuals have one of the three most common eating disorders: anorexia, bulimia or binge eating disorder.

Eating disorders are serious but treatable illnesses that are linked to severe changes in eating patterns and behaviors. According to Johns Hopkins University, eating disorders can develop in children as young as age 12. While most commonly seen in women, approximately 10 million men in America will experience an eating disorder during their lifetime.

Eating disorders have multiple causes. Stressful events, including broken relationships, physical illnesses or other significant life changes can all trigger the start of an eating disorder. Eating disorders may often develop in people with pre-existing psychiatric illnesses, such as depression, anxiety or substance abuse. Some studies suggest that eating disorders may also have a genetic component.

Without treatment, eating disorders can lead to greater medical complications and can be life-threatening. This introduction will help you gain a better perspective of the most common eating disorders, including anorexia, bulimia and binge eating disorder.

Article at a Glance:  

• Eating disorders are caused by many factors and can be life-threatening.  
• Anorexia nervosa symptoms include avoiding eating around people, compulsive exercising, and obsessive calorie counting.  
• Bulimia nervosa is a condition that involves purging food by vomiting or using laxatives. 
• Binge eating is the most common eating disorder in the U.S. and often seen in obese people.  
• There are additional types of eating disorders that are physically and emotionally damaging.

1. Anorexia Nervosa

Anorexia nervosa affects approximately 0.5 percent of women. Individuals with anorexia suffer from self-starvation, where a significant weight loss of 15 percent or more of healthy body weight is seen.

People who have anorexia nervosa (often just called “anorexia”) have an extreme fear of weight gain and often diet and exercise excessively. These individuals have a distorted body image and believe themselves to be overweight despite being significantly underweight.

To lose weight, people with anorexia either stop eating altogether or use methods such as laxatives, diuretics or self-induced vomiting. These behaviors are unhealthy and can quickly take control of an individual’s life. The good news is that with treatment, in-person or teletherapy, a person can gain a greater understanding of their self-worth, develop healthier eating habits and stop further medical complications.

Symptoms of anorexia include:

• Noticeable weight loss
• Hiding weight loss with baggy clothing
• Obsession with calorie counting and dieting
• Refusal to eat certain foods or food categories
• Avoiding eating around other people
• Compulsive exercising
• Cessation of menstrual cycles
• Denial that thinness is a problem

2. Bulimia Nervosa

Bulimia nervosa, commonly known as “bulimia,” is a serious disorder in which a person overeats and then “purges” to get rid of the food. These unhealthy methods include inducing vomiting or abusing laxatives. When those with bulimia binge, they may feel a lack of control over their behavior. Compared to people with anorexia, those with bulimia usually maintain a healthy or normal weight rather than being severely underweight. However, these individuals have the same fear of gaining weight and poor idea of self-image as people with anorexia.

Symptoms of bulimia include:

• Chronic sore throat and swollen glands in the neck and jaw from frequent vomiting
• Dental problems like decay, sensitivity and worn enamel from exposure to stomach acid
• Frequent acid reflux
• Intestinal irritation from laxative abuse
• Dehydration
• Electrolyte imbalance from improper levels of calcium, sodium, potassium and other minerals

3. Binge Eating Disorder

According to The National Institute of Diabetes and Digestive and Kidney Diseases, binge eating disorder is the most common eating disorder in the United States. People suffering from this disease often lose control over their eating, but not exhibit purging behaviors characteristic of bulimia. Binge eating disorder is mostly seen in people who are obese, as opposed to average weight (seen with bulimia) or underweight (seen with anorexia) individuals. The dangers of binge eating are different from the dangers of bulimia and anorexia but can be just as challenging and life-threatening. Some of the most common risks associated with this condition include high blood pressure, heart disease and psychological symptoms like guilt and shame.

Signs of binge eating include:

• Presence of large quantities of empty food wrappers or containers
• Disappearance of large amounts of food in a short period
• Food hoarding or storing food in strange places
• Wearing loose clothing to hide weight gain
• Avoiding eating around other people
• Attempting to diet to lose weight, but not being able to do so

Other Types of Eating Disorders

In addition to the anorexia, bulimia and binge eating disorder, there are other types of eating disorders which may not be as common. These include pica, rumination disorder and night eating syndrome.

• Individuals with pica feel an intense urge to consume certain non-food items, such as clay, dirt or paint.
• Individuals with rumination disorder regurgitate food that has previously been swallowed.
• With night eating syndrome, individuals wake up at night and overeat regularly.

Related Topic: Pica treatment

Eating disorders are mental illnesses that are not only emotionally damaging but can also pose a significant threat to physical health. Thankfully with treatment, there is hope to reverse these complications.

If you or someone you love is coping with co-occurring substance use and eating disorders, treatment is available. The Recovery Village provides comprehensive care for co-occurring addiction and mental health conditions, including online counseling and teletherapy. Finding the right treatment program for the person with substance addiction and an eating disorder is essential for recovery, and we’re here to help whenever you need us. Reach out today for more information.

Editor – Megan Hull

Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

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