Eating Disorders and Disordered Eating

Eating disorders are serious mental conditions characterized by disturbed eating behavior and attitudes toward weight and shape, including anorexia nervosa, bulimia nervosa, and binge-eating disorder. They typically emerge in adolescence and young adulthood, disproportionately affect females, and carry some of the highest mortality and chronicity among mental disorders.

Definition

Feeding and eating disorders are characterized by persistent disturbances in eating or eating-related behavior that alter food consumption or absorption and impair physical health or psychosocial functioning, encompassing anorexia nervosa, bulimia nervosa, and binge-eating disorder among others.

Scope

This entry covers the principal eating disorders and the broader spectrum of disordered eating as they present in adolescence: their defining features, epidemiology, and recognized treatment evidence such as family-based treatment for anorexia nervosa. It is reference-educational and provides no individualized clinical or dietary advice.

Core questions

• How do anorexia nervosa, bulimia nervosa, and binge-eating disorder differ in their core features?
• Why do eating disorders typically emerge during adolescence, and who is most affected?
• What treatment approaches have the strongest evidence in adolescents?

Key concepts

• Anorexia nervosa
• Bulimia nervosa
• Binge-eating disorder
• Disordered eating spectrum
• Body image disturbance
• Family-based treatment
• Medical complications and mortality

Mechanisms

Eating disorders are understood as arising from an interaction of genetic and temperamental vulnerability, sociocultural pressures around weight and shape, and neurobiological changes that may be reinforced by starvation or binge-purge cycles. Disturbed body image and overvaluation of weight and shape are central maintaining features. These accounts describe the dominant biopsychosocial model in the literature rather than a single causal pathway.

Clinical relevance

Eating disorders are associated with serious medical complications and elevated mortality, and early recognition is widely emphasized because duration of illness relates to outcome. The entry describes recognized treatment evidence, such as family-based treatment for adolescent anorexia nervosa, as background on how these conditions are managed; it does not provide individualized clinical or nutritional advice.

Epidemiology

Eating disorders most often have onset in adolescence and young adulthood and are substantially more common in females, though they occur across sexes. Anorexia nervosa carries one of the highest mortality rates of any mental disorder, while bulimia nervosa and binge-eating disorder are more prevalent; subthreshold disordered eating is more common still.

History

Anorexia nervosa was described in the medical literature of the nineteenth century, and bulimia nervosa was delineated as a distinct disorder in the late twentieth century, with binge-eating disorder formalized more recently. Treatment research in adolescents has increasingly emphasized family involvement, and family-based treatment for anorexia nervosa, evaluated in trials by Lock, Le Grange, and colleagues, became a leading evidence-based approach for young people.

Debates

Family-based versus individual treatment for adolescent anorexia nervosa

Randomized evidence supports family-based treatment as a leading approach for adolescent anorexia nervosa, but its relative advantage over individual therapies and which patients benefit most remain matters of continued study.

Key figures

• Janet Treasure
• James Lock
• Daniel Le Grange
• Ulrike Schmidt

Seminal works

• treasure-2020
• lock-2010

Frequently asked questions

What are the main eating disorders?

The principal eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder; disordered eating that does not meet full criteria is also common in adolescents.

Why is early recognition emphasized in eating disorders?

Eating disorders can cause serious medical complications and carry elevated mortality, and longer duration of illness is associated with poorer outcomes, so timely recognition is widely stressed.