If you have unhealthy thoughts, feelings, or behaviors about food and your body, you may have an eating disorder. You may intensely focus on food, your body weight, and your shape. You may see fat where others just see skin and bones. 

You may overeat, eat too little or eat in a way that harms your health. You can be underweight, normal weight, or overweight and have an eating disorder. People of any gender can have an eating disorder.

Eating disorders are serious, often fatal, mental health issues. Most people think of eating disorders as something that starts in teen girls. But eating disorders also plague adults and men—they can strike any gender at any age.

Sometimes, eating disorders come with an obsession with exercise, clean eating, or extreme diet and supplement regimes.

Carilion treats all types of eating disorders. These are the 4 main types.

Anorexia nervosa

You may have anorexia nervosa, also called anorexia, if you:

• Avoid food
• Eat very small amounts of food
• Eat very small amounts of certain foods
• Are dangerously underweight
• Have a distorted body image
• Obsess about your weight and weigh yourself often

When you have anorexia, you starve your body of the calories and nutrition it needs. Starvation can put you at risk of dying. Anorexia also puts you at risk of self-harm and suicide.

Anorexia nervosa has 2 subtypes:

• Restrictive anorexia: This is when you severely limit the amount and type of food you eat.
• Binge-purge anorexia: You may severely limit the amount and type of food you eat. But you may then “binge” eat large amounts of food quickly. You then “purge” by vomiting, using laxatives, or taking diuretics. 

Bulimia nervosa

You may have bulimia nervosa, or bulimia for short, if you:

• Frequently binge eat and purge
• Follow binge eating with fasting, excessive exercise, or both

In extreme cases, binging can cause an electrolyte imbalance that raises the risk of stroke or heart attack. 

Binge-eating disorder

Binge-eating disorder is the most common eating disorder in the U.S. With binge eating disorder, you lose control over how much you eat. You may frequently eat unusually large amounts of food.

The difference between bulimia and binge eating disorder is the latter doesn’t typically include a purge, fast, or exercise after a binge. Because of this, you may be overweight or obese. 

Avoidant restrictive food intake disorder

If you have avoidant restrictive food intake disorder (ARFID), you were probably labeled a picky eater. ARFID was once called selective eating disorder. It means you limit the amount and type of food to a small number of “safe foods.”

You may start as a “normally” picky eater but end up with fewer and fewer foods you will eat. Unlike anorexia, however, ARFID doesn’t include an extreme fear of gaining weight or a distorted body image.

Kids with ARFID may not grow and develop as they should. As an adult, you may not get enough calories for your basic bodily functions. Or you may be missing key nutrients from your diet, causing health issues. 

If you have an eating disorder, you may also have anxiety, depression, or substance use disorder. Recovery from eating disorders is often a long road, but it's possible.

Outpatient therapy

Most people with eating disorders get talk therapy at one of our outpatient clinics.

Therapy options for eating disorders include:

• Cognitive behavioral therapy: This talk therapy teaches you to recognize distorted or unhelpful thinking patterns. It can also help you change how you think and view yourself.
• Family-based therapy: Family-based therapy teaches your family members about your eating disorder. Family support helps you get the calories and nutrition you need.
• Nutritional counseling: Our nutrition experts work with you to help you develop a healthy relationship with food. They go over your nutritional needs and help with meal planning.

Medicines

Mental health medicines, such as antidepressants, may help you manage anxiety and depression related to your eating disorder. They can also help talk therapy work better.

You may also need medicines for health issues that come from your eating disorder. Your primary care team can help with nutritional gaps and other health issues. 

Inpatient care

Eating disorders can cause many physical and medical health issues. If your complications are severe, you may need hospital care. We provide inpatient therapy for eating disorders, medical care, and monitoring when symptoms become severe.

Emergency mental health care

Eating disorders can increase your risk of self-harm and suicide. For people with anorexia, suicide is the second leading cause of death. If you or a loved one is in crisis, call Carilion CONNECT at 540-981-8181 or toll-free at 800-284-8898. You can also call or text 988 Suicide and Crisis Lifeline. Learn more about emergency mental health care.