Eating Disorder FAQs

Eating Disorder FAQs

Our culture tells us that we have to change our bodies. TV, movies magazines… all sell us products trying to make us different from how we are. To me, Walden feels like an oasis of sanity. They only thing they’re “selling” here is kindness.
Former Patient

What is anorexia?
Anorexia nervosa is a psychological disorder characterized by an aversion to eating and fear of gaining weight.

How can I tell if someone in my family has anorexia?
Individuals with anorexia often lie or take other extreme measures to avoid eating. They often make excuses for not eating, such as claiming to diet, saying they have become vegetarians or vegans, or saying they are fasting for religious reasons.

What causes anorexia?
While more research is needed before we understand the causes of anorexia and other eating disorders, we now know that several factors can contribute to its development . While there is no single root cause, people with anorexia generally are affected by one or more of the following contributing factors:

  • Genetic predisposition
  • Chemical imbalance
  • History of a traumatic event
  • Family disruption and/or dysfunction
  • Sensitivity to cultural messages about the “ideal body”

Surprisingly, individuals with the disorder report that their anorexic behavior started out simply as a way to improve themselves. Anorexia often starts with a diet, which may be meant to help the person regain self-esteem and control. Some people perceive anorexia as a way to cope with problems when they feel out of control.

How common is anorexia?
The National Institute of Mental Health estimates that 1% of women and adolescent girls are anorexic. The percentage is much lower for men and adolescent boys, who account for less than 10% of reported cases of anorexia and bulimia, although the incidence in males is increasing. In the U.S., more than 1,000 women die from anorexia annually.

How do eating disorders relate to a person’s control over his or her life?
Eating disorders often start out as a diet as a way to regain self-esteem and control. Anorectics try to regain control by denying themselves food. Bulimics purge food to re-establish control.

What is bulimia?
Bulimia is a condition where sufferers typically purge food they have eaten by self-induced vomiting, use of laxatives or other means. Some do not purge, but compensate for eating by over-exercising or fasting. Purging is not necessarily used to lose weight. It may be used to demonstrate control or for punishment.

How can I tell if someone in my family has bulimia?
It is more difficult to identify someone who is bulimic than it is to identify someone who is anorexic. Most bulimics are not underweight and many are overweight, because of binge eating.

What causes bulimia?
While more research is needed before we understand the causes of bulimia and other eating disorders, we now know that several factors can lead to bulimia. While there is no single root cause, we believe that people with bulimia have a chemical imbalance in the brain that affects their behavior.

Genetics is also a major factor, as are cultural ideals about body image.

A traumatic event, which may have taken place years before bulimia manifests itself, may also have an impact. Such events may include sexual abuse or rape, emotional abuse, parents’ divorce, death of a loved one or a history of being teased or ridiculed.

Bulimia often starts with a diet, which may be meant to help the person regain self-esteem and control. Restriction, such as severe dieting, often plays a major role. When people deprive themselves of food, they may respond by binging. Feeling guilt for breaking their diet, they may then purge. Once a cycle of binging and purging is established, it is difficult to break.

Some people perceive bulimia as a way to cope with problems when they feel out of control.

How common is bulimia?
A larger percentage of people have bulimia than have anorexia. Approximately 4% of college-aged women are bulimic. About 20% of bulimics are male.

What are the health consequences of bulimia?
Long-term, it can lead to laxative addiction; electrolyte imbalances, which can cause heart failure; ulcers; bowel damage; inflammation and sometimes tearing of the esophagus, and tingling in the hands and feet. Depression is common among individuals with eating disorders.

What is binge-eating disorder?
Binge eating disorder is characterized by recurring episodes of binge eating. The two central features of binge eating are:

  • Consuming more food in a distinct period of time than most people would and
  • Feeling out of control during the time that the food is being consumed.

Binge eating episodes are typically characterized by:

  • Rapid eating
  • Eating despite feeling uncomfortably full
  • Eating alone to avoid embarrassment about eating behavior
  • Eating when not physically hungry
  • Feeling shame, guilt and disgust after eating

Binge eating disorder also may have a negative impact on how a person functions and may cause feelings of distress.

People struggling with binge eating disorder do not compensate for food consumed through self-induced vomiting, excessive exercise, misuse of laxatives and/or diuretics, caloric restriction or fasting. These behaviors are a sign of another disorder, bulimia nervosa.


What qualifies as “recurrent”?
In general, if a person is binge eating two or more days per week for six or more months, the behavior is considered to be recurrent. Note that this description focuses on the number of days binge eating occurs, not the number of episodes.

Some people report patterns of binge eating episodes that are not technically recurrent, because they occur on less than two days a week, but these patterns are still of concern. For example, someone might binge on one day every two or three weeks, but on that one day, there might be a high number of binge eating episodes.

Considering this, if a person binges in a pattern that does not perfectly match the definition of recurrent, but is of some regularity and causes some distress (see discussion of distress below), a consultation with a professional could be beneficial. Occasional overeating a few times a year, such as at holidays or special events, is not considered recurrent.

What does “more food than most people” mean?
This is a difficult phrase for many people to understand, but is a defining feature of binge eating disorder. To understand this phrase, consider the context within which you eat. If you eat more food than most other people would under the same circumstances and in the same amount of time, the eating behavior is likely a binge. It is common for many people to report that, now and again, they eat a large meal at a holiday party or eat more than usual when at a social event that offers food in abundance. This is not necessarily a binge. Rather, the increased consumption is a function of the context within which the eating takes place.

NOTE: In addition to considering the specific context within which eating is taking place, it is important to remember that “most people” refers to the general population, not necessarily the people you are eating with, as this group is only a small subset of the general population and could be a group of people who struggle with disordered eating themselves.

How is “feeling out of control” defined?
The majority of people who struggle with binge eating disorder say they feel out of control during binge episodes. Feeling out of control means feeling as though you cannot stop eating, despite feeling increasingly uncomfortable, not physically hungry or both.

In addition, many people with binge eating disorder report feeling a loss of control over what they eat and how much of it they consume. This loss of control is not a typical experience for people who occasionally overeat and this feature of binge eating disorder often helps differentiate between the average person who overindulges from time to time and someone struggling with binge eating disorder.

What does “negatively impacted functioning” mean?
This term refers to situations in which eating behavior patterns have an impact on important aspects of a person’s life in a way that is disruptive and unsatisfying over a longer period of time than would be the case for a person who occasionally overeats.

Many people with binge eating disorder say they feel preoccupied with food and planning where they will purchase or find food for a planned binge. Others report preoccupation, but with less planning and more spontaneous binge eating behavior.

Either way, preoccupation with poor body image, low self-esteem, and a number of health concerns is common after a binge episode. As a result, it is common for people with binge eating disorder to report that their eating patterns interrupt their ability to manage work responsibilities, maintain social connections, think clearly and objectively, and maintain emotional and physical wellness.

What are “feelings of distress”? 
The majority of people with binge eating disorder are significantly upset about their binging behavior. Most have severe shame and guilt about their binge eating. Many also report extreme self-disgust.

There is usually a strong desire among people with binge eating disorder to stop the behavior and regain a sense of balance in their lives. This is notably different from the average person who overeats on occasion. This person typically experiences much less emotional turmoil and does not tend to feel the same level of helplessness and hopelessness following an eating episode. For those with binge eating disorder, feelings of distress are intense and can be debilitating.

These binges are not usually accompanied by purging, although occasional purging is not unknown. People who suffer from binge-eating disorder are usually overweight and obesity can be a very real problem.

How common is binge eating?
Binge eating is very common. About one in five young women report that they have had binge-eating problems. Unlike anorexia and bulimia, binge eating is relatively common in men, who make up about 40% of binge-eating cases.

Can people have more than one eating disorder?
Yes. In fact, bulimia often leads to anorexia and anorexia often leads to bulimia. About half of all anorectics eventually develop symptoms of bulimia.