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The Horrors of Eating Disorders

  • April C
  • Apr 8, 2025
  • 7 min read

Eating Disorders

February is the month to be aware of eating disorders. Unfortunately for Canada, eating disorders have the highest mortality rate of any mental illness overall. As a society, we are completely unaware of the risks and need to be more conscious of the dangers of these disorders as they truly cause permanent health issues and possibly death. However, to understand, we need to learn about them.

Types of Eating Disorders + Symptoms

First, let’s look into the types of eating disorders that the DSM-5 defines. The majority of us are most familiar with anorexia and bulimia but there are a lot more horrors to discover about eating disorders. 

Anorexia Nervosa

Anorexia Nervosa is the most well-studied eating disorder of the bunch and is most common in adolescent women compared to men. 


The characteristics include:

  • Extremely underweight

  • Severe fear of weight gain

  • Body dysmorphia

    • Denial of being seriously underweight

  • Persistent compensatory behaviours to avoid gaining weight

  • Preoccupation with food and weight

  • Two Types:

    • Restricting Type

      • Fasting or excessive exercise

    • Binge and Purge Cycle

      • Eating large amounts of food and purging by self-induced vomiting or laxative/diuretic use


Anorexia Nervosa commonly co-occurs with other disorders such as bipolar, depressive and anxiety disorders. OCD or similar symptoms can often be associated with individuals with the eating disorder due to specific rituals needing to be performed. Substance abuse disorders can also be comorbid with Anorexia Nervosa.

Bulimia Nervosa

In the population, bulimia is more common than anorexia and generally starts in late adolescence or late adulthood.


The characteristics include:

  • Eating large amounts of food in a short period

  • Loss of control during binge eating

  • Binge eating is followed by compensatory behaviour to prevent weight gain

    • Laxatives/diuretics usage

    • Restricted eating

    • Excessive exercise

  • Fear of gaining weight despite weighing normal range

  • Swollen salivary glands

  • Tooth decay

  • Acid reflux

  • Severe dehydration

  • Electrolyte imbalances

  • Hormonal disturbances


The difference between Bulimia Nervosa and Anorexia Nervosa is the fact that those with bulimia can be underweight, normal weight, or slightly overweight. They are generally able to maintain a healthy weight compared to those with anorexia despite their unhealthy habits.


Most of those who have bulimia generally experience at least one other mental disorder or multiple comorbidities. Some disorders that may be comorbid with Bulimia Nervosa are bipolar, depressive, anxiety and substance abuse disorders. For those with bipolar, there tends to be a mood disturbance that begins at around the same time or follows the development of Bulimia Nervosa. There is also a percentage of people who have symptoms that meet the criteria for certain personality disorders, mainly Borderline Personality Disorder.

Binge-Eating Disorder

BED is the most common eating disorder and usually begins in adolescence. ⅓ of those with BED are male.


The characteristics include:

  • Eating large amounts of food in a short period

  • Loss of control during binge eating

  • Feeling guilt about binge eating

  • No compensatory or purging behaviours


The difference between BED and Bulimia Nervosa is the fact that BED patients don’t have the binge and purge cycle, they just binge.


The most common comorbid disorders tend to be bipolar, depressive, anxiety and substance abuse disorders (similar to the previous disorders mentioned). These comorbidities are linked to the severity of binge eating and not to obesity.

Avoidant or Restrictive Food Intake Disorder


ARFID commonly happens during infancy, toddlerhood and adolescence and can occur in the first seven years of life. There are times when it persists into adulthood. 


The characteristics include:

  • Significant weight loss

  • Significant nutritional deficiency

  • Dependence on enteral feeding or oral nutritional supplements

  • Marked interference with psychosocial functioning


ARFID does not include picky eating or restriction of foods due to religious beliefs or lack of availability. However, it does include a loss of interest in eating and an intense dislike for specific food characteristics.


The most common comorbid disorders are anxiety, obsessive-compulsive and neurodevelopmental disorders such as autism, ADHD and intellectual disabilities.

Pica


Pica is common among pregnant women, children and people with intellectual disabilities.


The characteristics include:

  • Persistence eating of nonnutritive or nonfood substances 

    • The eating of these substances is inappropriate to the developmental level of the individual

  • The eating behaviour is not culturally supported or socially normative practice

  • Craving nonfood items such as soil, chalk, soap, ice, etc


Pica is commonly comorbid with autism spectrum disorder and intellectual developmental disorder. However, to a lesser degree, disorders such as schizophrenia and obsessive-compulsive disorder may comorbid with Pica. The eating disorder can also be associated with trichotillomania (hair-pulling disorder) and excoriation (skin-picking disorder) where they would then ingest the hair or skin. It can also be commonly associated with ARFID due to the strong distaste of certain sensory components of foods. There should be a consideration of certain medical issues such as gastrointestinal complications, poisoning, infection and nutritional deficiency when assessing someone with Pica.

Rumination


A new addition to disordered eating that may be developed in infancy.


The characteristics include:

  • Constant regurgitation of food

    • May be re-chewed, re-swallowed, or spat out

  • Weight loss 

  • Malnutrition

  • The repeated behaviour is not attributable to an associated gastrointestinal or medical condition


It can be a comorbid condition with Anorexia Nervosa and can be concurrent with other mental disorders or medical conditions. 

Purging Disorder


The characteristics include:

  • Vomiting

  • Excessive exercise

  • Using laxatives/diuretics

  • No binge-eating episodes

  • Metabolic disturbances

  • Electrolyte imbalances

  • Oral bleeding

  • Swollen parotid glands

Night Eating Syndrome


The characteristics include:

  • Overeating

  • Awakening from sleep often

  • Strong associated with sleep disturbance

Atypical Anorexia Nervosa


The characteristics include:

  • Similar characteristics to Anorexia Nervosa

    • BMI is in the ‘adequate’ range for the individual

Subthreshold Bulimia Nervosa and Binge Eating Disorder


The characteristics include:

  • Not meeting the ideal definition of Bulimia Nervosa and BED

Orthorexia


The characteristics include:

  • Obsessive focus on healthy eating

  • May eliminate entire food groups due to the fear of them being unhealthy

Eating Disorder Causes

Now that we know what types of eating disorders exist, how do they happen? While there is the factor of comorbidity, there are many social issues that influence these disorders. 


These may but aren’t limited to:

  • Stressful life events

    • Abuse/Trauma

    • Bullying

  • Relationship Difficulties

  • Physical Illness

    • Type 1 Diabetes

  • Need for Perfection

  • Poor Body Image

    • Low Self-Esteem

  • Social Pressure

    • Certain Culture Values

    • Family

    • Social Media*

  • Struggles with Coping

  • Sports

    • Certain Weight Expectations

    • Excessive Exercise


* I would like to discuss the media. While the media can be amazing with how accessible it is to us, it can also be extremely dangerous for our mental health as it isn’t always constantly regulated. The content on there is persistent and can include many hidden messages that affect our body image. This includes people body-checking, demonizing certain foods and shaming people. We rely on and use the media a lot which is why we need to be aware of the effects and the causes of eating disorders to be careful.

Eating Disorder Treatments

If you or someone you know is struggling with an eating disorder, look at this article to become aware of the types. Notice the symptoms and seek help if you really find it affecting your or someone else’s health. Treatments for eating disorders include:

Psychotherapy

  • Can be provided for those who are participating as outpatient

    • Can be treated as an inpatient service if severe

  • Enhanced Cognitive Behaviour Therapy (CBT-E) for all eating disorders

    • Anorexia Nervosa requires more sessions compared to Bulimia Nervosa and BED

  • Family-based Treatment (FBT)

    • More promising in managing Anorexia Nervosa among children and adolescents

    • May also be adapted for Bulimia Nervosa and ARFID

  • Interpersonal Psychotherapy

    • A CBT alternative for Bulimia Nervosa or BED

  • Maudsley Anorexia Nervosa for Adults (MANTRA) 

  • Focal Psychodynamic Therapy (FPT)

    • For adults

  • Dialectical Behaviour Therapy (DBT

    • Common for Bulimia Nervosa and BED

  • Acceptance and Commitment Therapy (ACT)

    • Addressing maladaptive cognitions and behaviours that are associated with eating disorders

  • Neuromodulation Modalities

    • Repetitive transcranial magnetic stimulation

    • Deep brain stimulation

    • These are under study as a treatment for eating disorders

Pharmacotherapy

  • Fluoxetine

    • FDA-approved drug for the treatment of Bulimia Nervosa and BED

  • Antidepressants

    • Has little role in Anorexia Nervosa unless it coexists with a depressive disorder

  • Antipsychotics or Mood Stabilizers

    • May help treat coexisting disorders

Nutritional Counselling

  • Looks into the nutritional aspects of health

    • Treatment for all eating disorders to maintain a nutritional balance in individuals

Aftercare and Monitoring

  • Those who recover from eating disorders and see weight gain might experience anxiety or depressive symptoms

  • Those with Anorexia Nervosa can relapse 20% to 30% after first inpatient admission

    • Compared to 50-75% for over one admission

  • Psychotherapy takes place to help sustain progress

Websites and Organizations


Global: Academy for Eating Disorders - AED


Their mission is to advance eating disorder prevention, education, treatment and research by expanding the community globally of professionals.


Global: Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T)


The organization works to help families navigate the challenges of their loved one’s eating disorder.


Services:

  • 30 Days Program

  • Caregiver Skills Toolkit

  • Monthly Webinars

  • F.E.A.S.T. of Knowledge Conference

  • Family Guides


Email (not a helpline): info@feast-ed.org


North America: Project HEAL


They work to create a world for people with eating disorders to have opportunities and resources to heal.


Email (not a helpline): contact@theprojectheal.org


The United States: The National Eating Disorders Association - NEDA https://www.nationaleatingdisorders.org/


They work to advance research, spread awareness and build a community for Americans who experience eating disorders.


Canada: National Eating Disorder Information Centre (NEDIC)


They provide information, resources, referrals and support to Canadians who are affected by an eating disorder.


Helpline: 1-866-NEDIC-20 nedic@uhn.ca

  • 9 AM - 9 PM (Mon to Thurs)

  • 9 AM - 5 PM (Fri)

  • 12 PM - 5 PM (Weekends)

Helplines

USA:

NEDA: 1-800-931-2237 

  • They have an online chat available for international users


ANAD (National Association of Anorexia Nervosa and Associated Disorders) 

  • 1-888-375-7767

Canada:

NEDIC: 1-886-633-4220


Kids Help Phone: 1-800-668-6868

  • Has a live chat

  • Text CONNECT to 686868

  • For youth support

United Kingdom

BEAT Eating Disorders:

  • England: 08080 801 0677

  • Scotland: 0808 801 0432

  • Wales: 0808 801 0433

  • Northern Ireland: 0808 801 0434

Australia

Butterfly Foundation Hotline: 1 800 33 4673

  • Has an online chat

New Zealand

EDANZ (Eating Disorders Association of New Zealand): 0800 2 EDNAZ

  • Or (09) 5222 679

India

Vandrevala Foundation for Mental Health (Eating Disorder & Mental Health Support):

  • 9999 666 555

South Africa

(SADAG) South African Depression and Anxiety Group: 

  • Suicide Crisis Helpline: 0800 567 567

  • CIPLA Mental Health Helpline: 0800 456 789

  • Substance Abuse Helpline: 0800 12 13 14

Germany

ANAD Deutschland: (0)89 219 097-0

France

Autrement: 1 4539 46 37

Spain

Asociación Española Contra la Anorexia y la Bulimia: 93 454 91 09

Italy

Consult@noi: 800 180 969

Conclusion

Wow, that was a long article to read. Congratulations for making it this far and please share your thoughts on this topic or others with Locker SYS. Despite all the information, it’s really important to be aware and I applaud you for even taking the time to read this. Locker SYS is here for you and you are not alone. 


References


American Psychiatric Association. (2022). Feeding and Eating Disorders. In Diagnostic and 

Statistical Manual of Mental Disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Balasundaram, P., & Santhanam, P. (2025). Eating disorders. In StatPearls. StatPearls 

Solomon, C. (2023, January 31). February is Eating Disorder Awareness Month. Prairie 

What causes an eating disorder? (n.d.). Kelty Eating Disorders. Retrieved February 12, 2025, 

 
 
 

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