Behavioral Health

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Eating Disorders


People who intentionally starve themselves suffer from an eating disorder called anorexia nervosa. The disorder, which usually begins in young people around the time or puberty, involves extreme weight loss -- at least 15 percent below the individual's normal body weight. Those experiencing anorexia nervosa also have an intense fear of becoming fat, even though they are underweight. Many people with the disorder look emaciated but are convinced that they are overweight.

Sometimes they must be hospitalized to prevent starvation, yet deny the condition. The illness also causes the menstrual cycle to stop, a condition called amenorrhea. Men with anorexia often become impotent. For reasons not yet understood, individuals suffering from anorexia nervosa become terrified of gaining any weight. Food and weight become obsessions. For some, the compulsiveness shows up in strange eating rituals or the refusal to eat in front of others. It is not uncommon for people with anorexia to collect recipes and prepare lavish gourmet feast for family and friends, but not partake in the meals themselves. They may adhere to strict exercise routines to keep off weight.


People with bulimia nervosa consume large amounts of food and then rid their bodies of the excess calories by vomiting, abusing laxatives or diuretics, taking enemas, or exercising obsessively. Some use a combination of all of these forms of purging. Because many individuals with bulimia "binge and purge" in secret and maintain normal or above normal body weight, they can often successfully hide their problem from others for years. When this activity occurs on average at least twice a week for three months and is also accompanied by excessive concern about body shape and weight, concern about bulimia nervosa is warranted.

Dieting heavily between episodes of bingeing and purging is common; eventually half of those with anorexia will develop bulimia. As with anorexia, bulimia typically begins during adolescence. The condition occurs most often in women, but is also found in men. Many individuals with bulimia, ashamed of their strange habits, do not seek help until they reach their 30s or 40s. By this time, their eating behavior is deeply ingrained and more difficult to change.

Fact Sheet courtesy of:
National Institute of Mental Health
6001 Executive Boulevard, Rm. 8184
MSC 9663 Bethesda, MD 20892-9663