Beyond the Myth: Understanding the Different Types of Eating Disorders
- Congrong Huang
- Mar 24
- 4 min read
"I just need more willpower."
"It's just a phase."
"Why can't they just eat?"
These are just some of the misconceptions that approximately 28.8 million Americans in their life time face as they battle eating disorders—complex mental health conditions with the second highest mortality rate of any psychiatric illness besides opioid addiction. Far from being lifestyle choices, eating disorders are serious biological and psychological conditions that hijack the brain's natural relationship with food and body image.
What Actually Happens in an Eating Disorder?
Imagine your brain's reward system, hunger cues, and body image perception all being rewired simultaneously. This isn't just about food—it's about how the brain processes everything from satisfaction to stress, from self-worth to survival.
Research using advanced brain imaging shows that people with eating disorders experience altered activity in the same neural circuits involved in addiction. The ventral striatum (your brain's reward center) functions differently, making normal eating patterns incredibly difficult to maintain.
Common Types of Eating Disorders
Anorexia Nervosa: The Paradox of Control
"I thought controlling my food gave me power. Instead, it took all my power away." - Anonymous recovery advocate
Anorexia involves intense food restriction coupled with an overwhelming fear of weight gain. What makes it particularly dangerous? A startling statistic according to National Institutes of Health(NIH): someone with anorexia is 9.01 times more likely to die than others in the general population at 5 years.
The brain under anorexia:
Becomes hyperactive in decision-making regions when confronted with food
Shows reduced activity in reward regions after eating
Struggles to accurately perceive body size and shape
Two distinct patterns emerge:
Restricting type: Primarily limiting food intake, usually food high in carbonhydrates or fats
Binge-eating/purging type: Cycles between restriction, binging, and purging behaviors
Bulimia Nervosa: The Hidden Struggle
Bulimia is characterized by cycles of binge eating followed by compensatory behaviors like vomiting, excessive exercise, or laxative abuse. Despite affecting approximately 0.5% of women and 0.1% of men during their lifetime, bulimia often goes undetected for years because weight may remain stable.
The physical toll is severe. Research shows chronic purging can lead to:
Cardiac arrhythmias from electrolyte imbalances
Erosion of dental enamel (appearing within just 6 months of purging behavior)
Inflammation and tears in the esophagus and stomach
Binge Eating Disorder: The Most Common Yet Least Understood
Binge eating disorder(BED) is characterized by recurrent binge eating episodes during which a person feels a loss of control and marked distress over his or her eating. Unlike bulimia nervosa, binge eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge eating disorder often are overweight or obese.
However, Long-term research shows that untreated BED significantly increases the risk of:
Type 2 diabetes
Cardiovascular disease
Metabolic syndrome
Avoidant/Restrictive Food Intake Disorder (ARFID): Not Just Picky Eating
Unlike other eating disorders, ARFID doesn't involve body image concerns. Instead, it's characterized by extremely limited food preferences based on sensory sensitivity, fear of adverse consequences (like choking), or lack of interest in eating.
For years, the largest category of eating disorders was "EDNOS" (Eating Disorder Not Otherwise Specified), now divided into OSFED (Other Specified Feeding or Eating Disorder) and UFED (Unspecified Feeding or Eating Disorder). This includes:
Atypical Anorexia: All the psychological features of anorexia without being underweight—yet research shows the medical complications can be just as severe.
Purging Disorder: Regular purging without binge eating.
Night Eating Syndrome: Consuming at least 25% of daily calories after dinner or during middle-of-night awakenings.
Conclusion
Eating disorders are not failures of willpower or passing phases—they're serious medical conditions that alter brain function and carry the second highest mortality rate among psychiatric illnesses. For the 28.8 million Americans affected, these disorders fundamentally rewire the brain's relationship with food, reward, and body perception.
Whether anorexia, bulimia, binge eating disorder, or ARFID, these conditions require medical intervention, not simplified advice like "just eat." Recovery is possible, but only when we recognize the complex neurobiological and psychological nature of these disorders. By understanding eating disorders as the medical conditions they truly are, we can eliminate stigma and help those suffering receive the comprehensive support they need to heal both mind and body.
Sources:
Wang, A. R. (n.d.). Human habit neural circuitry may be perturbed in eating disorders | science translational medicine. Science Translational Medicine. https://www.science.org/doi/10.1126/scitranslmed.abo4919
Auger, N., Potter, B. J., Ukah, U. V., Low, N., Israël, M., Steiger, H., Healy-Profitós, J., & Paradis, G. (2021, October). Anorexia nervosa and the long-term risk of mortality in women. World psychiatry : official journal of the World Psychiatric Association (WPA). https://pmc.ncbi.nlm.nih.gov/articles/PMC8429328/
“Eating Disorders.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/statistics/eating-disorders. Accessed 24 Mar. 2025.
Dziewa, Magdalena, et al. “Eating Disorders and Diabetes: Facing the Dual Challenge.” Nutrients, U.S. National Library of Medicine, 12 Sept. 2023, pmc.ncbi.nlm.nih.gov/articles/PMC10538145/.
Salman, Ethar J. “Night Eating Syndrome.” StatPearls, U.S. National Library of Medicine, 14 Sept. 2022, www.ncbi.nlm.nih.gov/books/NBK585047/.
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