Eating Disorders
Anorexia, bulimia, binge eating, and the cluster of conditions around eating and body image.
Reviewed by Shariq Refai, MD, MBA
Eating disorders have specific evidence-based treatments that differ meaningfully from generic mental health care, and they have among the highest mortality rates of any mental health category. This hub exists to make the conditions, the treatments, and the urgency of specialty care visible.
Eating disorders are one of the most under-discussed clusters in mental health and one of the most lethal. Anorexia nervosa has among the highest mortality rates of any mental health condition, in large part because the cluster runs partly on isolation and partly on a relationship with the body that often delays treatment for years.
The category contains several distinct conditions: anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder (ARFID), and other specified feeding and eating disorders (OSFED). The cluster of behaviors (restriction, binge eating, purging, body image distortion, compulsive exercise) varies in combination across the conditions, but all of them respond to specific evidence-based treatment that differs meaningfully from generic mental health care.
This hub maps the conditions, symptoms, and treatments inside the eating disorders category. Treatment is well-evidenced when delivered by clinicians with specialty training: CBT-Enhanced (CBT-E) for adults, family-based treatment (FBT) for adolescents, and (for binge eating disorder specifically) lisdexamfetamine. If you arrived here because of your own situation or because you're worried about someone, the hub is a useful entry point.
Conditions
Anorexia nervosa
What anorexia nervosa is under DSM-5-TR, why it isn't about food or vanity, and what evidence-based treatment looks like across ages.
Strong ConditionBulimia nervosa
What bulimia nervosa is, how it differs from binge eating disorder and anorexia, why it's often hidden, and what treatment looks like.
Strong ConditionBinge eating disorder
What binge eating disorder is under DSM-5, how it differs from bulimia and from overeating, and what evidence-based treatment looks like.
Strong ConditionARFID (avoidant/restrictive food intake disorder)
An eating disorder where someone limits what or how much they eat for reasons other than body image, like sensory issues or fear of choking.
Limited ConditionBody dysmorphic disorder
A condition defined by a painful preoccupation with perceived flaws in appearance that others don't see, or see as slight.
Strong ConditionEating disorders
What eating disorders are, the main types, the myths that delay help, and why recovery is possible.
StrongPlanned coverage (5)
- Other specified feeding or eating disorder (OSFED)
- Atypical anorexia
- Pica
- Rumination disorder
- Orthorexia (not a formal DSM diagnosis but clinically relevant)
Symptoms
Planned coverage (13)
- Restriction
- Binge eating
- Purging
- Body image distortion
- Food fear
- Weight preoccupation
- Compulsive exercise
- Secret eating
- Rapid weight changes
- Food rituals
- Loss of menstrual cycle
- Cold intolerance
- Dental erosion
Treatments
Planned coverage (11)
- Enhanced cognitive behavioral therapy (CBT-E)
- Family based treatment (FBT)
- Interpersonal psychotherapy for eating disorders
- Lisdexamfetamine for binge eating disorder
- SSRIs for eating disorders
- Nutritional rehabilitation
- Levels of care (outpatient, IOP, PHP, residential, inpatient)
- Dialectical behavior therapy for eating disorders
- Maudsley approach (family based)
- Refeeding protocols
- Cognitive behavioral therapy for binge eating disorder
Glossary
Planned coverage (10)
- Refeeding syndrome
- SCOFF questionnaire
- Set point theory
- Atypical anorexia
- Orthorexia
- Eating Disorder Examination (EDE)
- Medical complications of eating disorders
- Levels of care
- BMI limitations in diagnosis
- Refeeding
Treatment Overview
Eating disorders have well evidenced treatment, and the right treatment depends substantially on the specific disorder and the patient's age. For adolescents with anorexia nervosa, family based treatment (sometimes called the Maudsley approach) has the strongest evidence and works for the majority of patients when delivered correctly. For adults with anorexia, treatment usually requires a coordinated team including a medical clinician monitoring weight and labs, a therapist using CBT-E or a similar specialized approach, and a registered dietitian familiar with eating disorder nutrition. For bulimia nervosa and binge eating disorder, CBT-Enhanced (CBT-E) is first line and produces durable remission for many patients. Lisdexamfetamine has FDA approval specifically for moderate to severe binge eating disorder. SSRIs (especially fluoxetine at higher doses) have a role in bulimia treatment, alongside therapy. Anorexia nervosa carries among the highest mortality rates of any mental health condition, and severe cases require medical stabilization (sometimes inpatient) before psychiatric or psychological treatment can begin. Levels of care matter. Most patients start outpatient, but partial hospitalization, residential, or inpatient medical care may be necessary when weight, vital signs, or labs are unsafe. Specialist programs are usually a better fit than general mental health practices for active treatment.
Resources and Support Organizations
The organizations below are independent of Shrinkopedia and the Shrink Network. We list them because they're recognized national resources, not because we have any financial or organizational relationship with them. Most are free at the point of access.
- NEDA (National Eating Disorders Association) National nonprofit with a helpline, support groups, a screening tool, and a treatment provider directory. nationaleatingdisorders.org · Helpline 1-800-931-2237
- ANAD (National Association of Anorexia Nervosa and Associated Disorders) National nonprofit providing peer support, helpline, and treatment referrals. anad.org · Helpline 1-888-375-7767
- F.E.A.S.T. (Families Empowered and Supporting Treatment of Eating Disorders) Parent and family support organization, with strong family based treatment resources. feast-ed.org
- Project HEAL National nonprofit helping people access eating disorder treatment regardless of insurance status or financial means. theprojectheal.org
- Academy for Eating Disorders (AED) Professional society for eating disorder clinicians. Hosts the Worldwide Eating Disorders Provider Locator. aedweb.org
- Eating Disorder Hope Educational resource and treatment center directory. eatingdisorderhope.com
- 988 Suicide and Crisis Lifeline Free, confidential, 24 hours a day in the United States for any mental health crisis. Call or text 988
- SAMHSA National Helpline Free, confidential treatment referral and information service for individuals and families facing mental health or substance use disorders. 1-800-662-4357 (HELP)
- Find Treatment (SAMHSA) Federal directory of evidence based mental health and substance use treatment providers, searchable by location and insurance. findtreatment.gov
Eating disorders most often travel with anxiety (especially OCD), depression, and trauma. These adjacent hubs cover the overlap.
Across the network
How the network covers this topic.
The Shrink Network covers this topic at multiple layers. Below is a quick map of which site does what for this category. For the full cross-network cluster view, see the matching Network Cluster at /clusters/.
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