Feeding and Eating Disorders

Feeding and eating disorders are characterized by eating behavior that results in health or psychosocial problems. Anorexia nervosa is characterized by restrictive eating that leads to dangerously low body weight and disturbances in self-perceived shape or weight. Bulimia nervosa is a disorder that includes episodes of binge eating and compensatory behaviors (e.g., purging, exercising) in individuals who are unduly influenced by shape and weight. Avoidant/restrictive food intake disorder (ARFID) is a newly defined disorder that describes rigid eating behavior that results in weight loss, nutritional deficiency, or psychosocial problems in individuals who are not preoccupied with shape or weight.

Anorexia affects 0.4% of females, while bulimia affects 1% to 1.5% of females. Though males can be affected by these disorders, it is much more uncommon and prevalence rates are not well defined.

Some individuals with anorexia nervosa may be able to continue to participate in social events, school, or work, while others became very socially isolated and unable to function in these settings and in expected roles (e.g., as a student, worker, parent).

Key features of bulimia nervosa include patterns of eating objectively large amounts of food in which an individual experiences the inability to stop their eating (a loss of control) combined with compensatory behaviors such as purging (i.e., self-induced vomiting), exercise, laxative or diuretic abuse to prevent weight gain. Individuals with bulimia maintain weight in the normal-to-overweight range. Bulimia is associated with medical symptoms related to the compensatory behaviors including potentially life-threatening fluid and electrolyte abnormalities, gastrointestinal tract damage and cardiac arrhythmias. Individuals with bulimia may be able to conceal behaviors and maintain social, academic and occupational functioning, while others cannot maintain function across these domains.

The key features of avoidant/restrictive food intake disorder (ARFID) are food avoidance or decreased food intake that leads to weight loss, nutritional deficiency or impaired functioning. The avoidance may be related to sensory issues or in anticipation of unpleasant experiences such as choking or vomiting. ARFID may be associated with lack of interest in eating, rigidity, and other features of anxiety or mood disorders. Individuals with this disorder may not be able to participate in social aspects of eating or may cause significant developmental or family disturbance when the pattern of eating limits ability to eat in different settings.