Understanding Eating Disorders: A Guide to Diagnoses and Treatment
Eating disorders are complex mental health conditions that often involve disordered patterns of eating, obsessive thoughts about food, and a complicated relationship with body image. These conditions can affect anyone, regardless of age, gender, body size, race, or background.
It's important to understand that weight alone is not always an indicator of whether someone is struggling with an eating disorder. While many people associate eating disorders with being underweight, that is often not the case. This misconception can lead to delayed diagnosis and treatment because a person's physical appearance might not match society's stereotypical image of an eating disorder.
Regardless of body size, anyone experiencing disordered eating deserves compassionate support and appropriate treatment. Understanding the different types of eating disorders can help you recognize potential warning signs in yourself or someone you love.
Anorexia Nervosa
Anorexia nervosa is one of the most widely recognized eating disorders, though it is also frequently misunderstood. People with anorexia often experience an intense fear of gaining weight and a distorted perception of their body size or shape. These fears can lead to severe restriction of food intake, which may result in malnutrition, medical complications, and significant psychological distress. You can learn more about the physical effects of being malnourished here.
Anorexia takes two primary forms. In the restricting type, weight loss happens through severe limitation of intake alone. In the binge-eating/purging type, periods of restriction cycle with episodes of binge eating and purging behaviors such as vomiting, laxative use, or excessive exercise.
Bulimia Nervosa
Bulimia nervosa is characterized by cycles of binge eating followed by behaviors intended to compensate for the food consumed — most commonly self-induced vomiting, but also laxative misuse, excessive exercise, or fasting. Individuals experiencing bulimia often describe a loss of control during binge episodes, followed by intense guilt, shame, or distress. Because weight often stays in a "normal" range, bulimia frequently goes unnoticed by the people closest to someone struggling.
Binge Eating Disorder (BED)
Binge eating disorder is the most common eating disorder in the United States. It involves recurrent episodes of eating large quantities of food in a short period while experiencing a sense of loss of control — eating rapidly, eating without physical hunger, and feeling significant distress, shame, or guilt afterward. Unlike bulimia nervosa, binge eating disorder does not involve compensatory behaviors such as purging.
Avoidant/Restrictive Food Intake Disorder (ARFID)
Avoidant/Restrictive Food Intake Disorder involves patterns of restrictive eating that go well beyond typical picky eating. The avoidance may stem from sensory sensitivities to taste, smell, or texture; from fear of choking or vomiting; or simply from a profound lack of interest in food. Unlike other eating disorders, ARFID is not driven by body image concerns or a desire to lose weight — but it can still lead to nutritional deficiencies, weight loss, and real difficulty functioning in daily life.
Other Specified Feeding or Eating Disorder (OSFED)
OSFED is a diagnosis given when someone experiences significant distress related to eating behaviors but does not meet the full criteria for anorexia, bulimia, or binge eating disorder. This diagnosis recognizes that eating disorders do not always fit neatly into strict diagnostic categories and it is every bit as serious as the conditions it sits beside.
The most common example is atypical anorexia: all of the features, fears, and medical risks of anorexia nervosa in a person whose weight remains in or above the "normal" range. Someone with atypical anorexia may be restricting severely and losing significant weight from their body's own baseline while never appearing underweight to others. Because of weight stigma, it's often the diagnosis missed the longest — sometimes while the very behaviors driving it are praised.
Orthorexia
Orthorexia is not currently recognized as an official diagnosis in the DSM-5, but the term is increasingly used to describe an obsessive focus on eating "healthy" or "clean" foods. What begins as an interest in nutrition can harden into eliminated food groups, rigid rules, anxiety around ingredients and preparation, and a sense of moral virtue or guilt attached to food choices. Over time, this fixation on dietary purity can interfere with daily functioning and relationships and contribute to nutritional deficiencies and significant distress.
Eating Disorders Are Treatable
Eating disorders are serious conditions, but recovery is possible with the right support and treatment looks different depending on the diagnosis, the person's age, and how the illness is showing up.
For adults, treatment typically centers on specialized individual therapy — approaches like CBT-E, DBT, ACT, Body Trust, and relational, trauma-informed work — often alongside a team that can include a dietitian who specializes in eating disorders and medical monitoring when needed.
For adolescents, the picture has its own urgency: most eating disorders first emerge during the teen years, and early treatment matters most — outcomes are meaningfully better when eating disorders are treated in their first months and years. For teens with restrictive eating disorders, Family-Based Treatment (FBT) is the leading evidence-based approach. You can learn more about our adolescent eating disorder therapy here.
Treatment also comes in different intensities, from weekly outpatient therapy to structured day programs and residential care. Most people do well outpatient; if you're unsure what level of support fits your situation, we've written about how that decision gets made here.
If you're seeking eating disorder therapy in Westchester, or virtually acriss New York, New Jersey, and Connecticut, working with clinicians who understand the complexities of these conditions can make an important difference in recovery. At Body Liberation Collective, our therapists specialize in helping adolescents and adults heal their relationship with food, body, and self through compassionate, trauma-informed care. You can learn more about our approach to eating disorder therapy here.
FAQs About Eating Disorders
What is the most common eating disorder? Binge eating disorder is the most common eating disorder in the United States.
Can someone have an eating disorder without being underweight? Yes. Many people with eating disorders exist in a wide range of body sizes — atypical anorexia, for example, involves the same seriousness and medical risks as anorexia nervosa at any weight
When should someone seek eating disorder therapy? If thoughts about food, weight, or body image are interfering with daily life, that's reason enough. When you reach out to a specialized practice, they should assess what's going on and recommend a clear path, you don't need a diagnosis, or certainty, first.
Ready to Begin Your Healing Journey?
If you or someone you care about may be struggling with disordered eating, reaching out for support can be a powerful first step. Our practice works with adolescents and adults navigating eating disorders, body image concerns, and the emotional challenges connected to food and self-worth.
Contact us today to schedule a consultation with one of our therapists and begin your path toward healing.