5 Types of Eating Disorders We Don't Talk About
When we think of eating disorders, usually the first types that come to mind are anorexia and bulimia. And while we should definitely continue to talk about these types of eating disorders, oftentimes they are the only EDs that get discussed — especially in the media. Too often we overlook the other types of eating disorders people can struggle with.
To open up this conversation, we’ve listed five eating disorders we don’t often hear about. Before beginning, we want to preface by saying this list is not an exhaustive one, and you can read more about eating disorders on the National Eating Disorders Awareness (NEDA) website.
Here are some eating disorders we need to start talking about:
1. Binge Eating Disorder
According to NEDA, binge eating disorder (BED) is an eating disorder characterized by recurrent episodes of bingeing on large quantities of food. People with BED often feel a loss of control during the binge and can experience shame and guilt afterwards. Though we don’t often talk about BED, it is the most common eating disorder in the United States.
Because BED doesn’t get a lot of awareness — and because gaining weight is so stigmatized — people struggling are sometimes left to believe they simply “lack willpower” or are just “lazy.” This is something Mighty contributor Selena Mills wrote about in her piece, “The Common Eating Disorder No One Is Talking About.”
Articles and resources for people struggling with anorexia and bulimia are plentiful, while I’ve found support for those with BED is minimal. I thought I was greedy, or had no self-control. This lack of discussion and awareness had a polarizing effect on me. (Not anymore!)
Food was my first “addiction” and has remained my last. It started when I was very young, I would sneak into the kitchen and grab whatever I could to self-soothe away the various crap my tender, young heart, body and brain endured. Cookies in the closet. Chips in the dark under the covers. Completely zoning out — or what is clinically described as “blacking out” — during meal and snack-times, going for seconds constantly, etc. I remember getting in epic trouble at a particular foster homes and was often treated like a glutton. No one ever took the time to realize there was something seriously wrong, or get proper help/care for the kid who was in a world of pain.
According to the Binge Eating Disorder Association (BEDA), treatment for BED typically involves working with trained therapists and physicians to address past trauma, family dynamics and any underlying mood disorders. Self-compassion is also key for lasting recovery.
Other stories about binge eating disorder from our community:
Though at this point in time it is not officially recognized in the Diagnostic and Statistical Manual (DSM), orthorexia is an eating disorder based on an obsession with “healthy” eating and lifestyle. Common behaviors of this disorder include compulsive checking of ingredient lists and nutritional labels, cutting out an increasing number of food groups (ex: all sugar, all carbs, all dairy, all meat, etc.) and preoccupation with eating food items deemed “healthy” or “pure.”
Mighty contributor Emily Murray wrote about her own struggle with orthorexia and how it began in her piece, “How I Knew I Was Struggling With an ‘Eating Disorder in Disguise.’”
It usually starts with the innocent desire to adapt a healthier lifestyle. We may read things on the internet that confuse us yet convince us. We might buy into things that don’t even make sense. We often pay the extra $2.20 for the organic products. We might spend hours reading labels at the grocery stores and scanning restaurant menus before going out. Eventually, all of that may stop. We might stop buying processed foods all together. We often refuse to go out to eat with friends or family, insisting we’ve already eaten. We can become fixated on the quality and purity of our food, and if that food doesn’t meet our standards, we might not eat or purge after the fact to rid our bodies of all uncleanliness.
This can manifest itself in all forms — from exercising, stricter eating or even fasting. This lifestyle is often rigid, lifeless and moralistic. We may become prideful of how “good” we eat compared to other people. We might receive affirmation about how healthy our diets are and how other people wish they were like us. If they only knew. And despite what many people believe, despite what I believed for a few years, this type of eating usually isn’t healthy. If anything, it’s the opposite.
At this point in time, there are no clinical treatments designed specifically for orthorexia, but many ED experts rely on treatments that help patients with anorexia and obsessive-compulsive disorder (OCD). These treatments may involve exposure to certain “fear foods” and psychotherapy.
Other stories about orthorexia from our community:
Diabulimia is a term applied to someone with diabetes (typically type I) struggling with an eating disorder. Diabulimia is characterized by purposely restricting insulin in order to lose weight.
Mighty contributor Claire Kearns wrote about her own experience with diabulimia in her piece, “What You Should Know Before You Make Assumptions About Diabulimia.”
It’s not a choice. It is not a decision made with any rationality. Someone with an eating disorder and diabetes is not choosing to not take their insulin just because they can’t be bothered or want to throw their toys out the pram (in this case syringes and test strips!). They are not just being ungrateful for that crucial life source which is now so luckily available. The discovery of injectable insulin to treat diabetics is meaningful to everyone that has to rely on it to survive. But with a mental illness, with an eating disorder, survival is not a priority. It’s also not just “another label” that can be lumped in with other conditions — it has characteristics that require treatment to be specifically tailored.
In treatment for diabulimia, it is important that a patient sees a doctor who has knowledge of both diabetes and eating disorders. In addition, it’s often important for a patient to see specialized clinicians such as an endocrinologist and a mental health professional who specializes in treating patients with eating disorders.
Other stories about diabulimia from our community:
4. Other Specified Feeding and Eating Disorders (OSFED)
Previously known as Eating Disorder Not Otherwise Specified (EDNOS), OSFED includes people struggling with eating disorders that do not meet the strict diagnostic criteria of anorexia or bulimia. Unfortunately because of its “catch-all” status, it can be wrongly viewed as “less serious” than other eating disorders, making it so that some people struggling are denied coverage for treatment.
This is something Mighty contributor Lily Mae Blaisdale has experience with. In her piece,”We Cannot Continue to Deny Treatment to People With EDNOS” she shares why she was refused treatment.
“There’s nothing we can do to help you at your BMI.”
I turned to leave, but before I reached the door, I’d turned around and said, “You know what this means, right?”
She knew. There was nothing she could do to help me. Not until I was thinner…
Because my weight was in the healthy BMI range, this particular service could not offer me any help, despite my troubled mind and increasingly self-destructive behavior…
What it meant? It meant the demon inside my head had plenty of fuel. “You’re too fat. Too fat to have an eating disorder. Too fat for anyone to care. You should prove to them how sick you are. You just wasted nearly two hours of their time when they could have been helping somebody who actually needed help instead of you. That’s it. You’re done.”
As Blaisdale shared, being denied treatment for any eating disorder can lead to feelings of needing to appear “sicker” to be taken seriously. People with OSFED are struggling with significant, life-threatening eating disorders and we can’t afford to turn these patients away. Treatment interventions that can benefit individuals struggling with OSFED may include seeing a doctor/nutritionist, cognitive behavioral therapy (CBT) and psychiatric medication.
Other stories about OSFED/EDNOS from our community:
5. Avoidant Restrictive Food Intake Disorder (ARFID)
Avoidant restrictive food intake disorder (ARFID) was previously known as “selective eating disorder.” It is an eating disorder similar to anorexia because it involves limiting amount and types of food eaten, but differs because it does not involve any distress about body shape or size, or fears of fatness. Oftentimes, it includes individuals we might be tempted to describe as “picky” eaters — but it’s so much more than that.
This is something Mighty contributor Veronica Synster explained in her piece, “What I Want Others to Know About Avoidant/Restrictive Food Intake Disorder.”
Those who have ARFID can’t just “try new foods…” Imagine going to a restaurant with a five-page menu and finding none of your safe foods. Safe foods are foods people with ARFID feel comfortable with eating because they are familiar with them.
The exact cause of ARFID is unknown. Some believe it is born out of a fear of choking or vomiting. For me, I believe it came from my birth circumstances. Before I was adopted out of Russia at a very young age, the baby food given to me wasn’t good…
[AFRID is] not simply “being a really picky eater.” I’m well aware of starving children and am not trying to be “selfish” with my eating choices, so please don’t try to guilt or shame me into eating. I’ll sit there at the dinner table for hours just staring at the food. I’m hungry, but my eating disorder has so much control over me that I simply can’t eat. Picky eaters typically outgrow their picky habits by the time they’re in their twenties. For someone with ARFID, this problem might persist beyond that age range.
Treatment for ARFID is still being researched and understood due to its relatively new categorization as an eating disorder. According to Eating Disorder Hope, some treatments that have had success include forms of exposure therapy and cognitive behavioral therapy (CBT).
Other stories about AFRID from our community:
If you are struggling with an eating disorder we don’t often hear about, you aren’t alone. If you are in crisis, please call the National Eating Disorders Association Helpline at 1-800-931-2237.