Eating Disorders

Eating disorders are serious mental and physical health conditions, which impact over 28.8 million Americans—9% of the U.S. population. They have the second highest fatality rate among behavioral health conditions ( surpassed only by opioid overdose) in the country, resulting in over 10,000 deaths each year. Eating disorders impact every aspect of life. They disrupt a person’s relationship with food, exercise, body image, identity, and can damage physical, mental, emotional, and financial health. At their most severe, they can lead to psychosis, malnourishment, dehydration, chronic body stress, heart complications, feeding and eating difficulties, septicemia, infection, and organ failure.

Common eating disorders include anorexia, bulimia, binge-eating disorder, orthorexia, and Avoidant Restrictive Food Intake Disorder (ARFID). Many other types of disordered eating exist, and survivors and advocates are continuously fighting for their recognition. Eating disorders often co-occur with other mental health conditions, such as body dysmorphia, gender dysphoria, anxiety, and depression.

Women, LGBTQ+ people, people of color, and youth (as young as 5 years old) are more often and more strongly impacted by eating disorders. Men, boys, and people with average or above average Body Mass Indexes, however, most commonly go undiagnosed (less than 6% of people with eating disorders are medically diagnosed as “underweight”). Youth of color and LGBTQ+ youth are two of the most impacted groups. Black teenagers are 50% more likely than white teenagers to experience symptoms of bulimia, but Black, Indigenous, and People of Color are half as likely to be diagnosed and treated with an eating disorder than white people. Some surveys estimate that over 50% of LGBTQ+ youth have been diagnosed with an eating disorder and up to 75% of LGBTQ+ youth have struggled with disordered eating at some point in their lives.

Since 1950, the reported prevalence of eating disorders has been steadily on the rise. A wide range of factors—both individual and environmental–contribute to the development of eating disorders, including food insecurity, trauma, lack of control, genetics, peer pressure, family histories, and chronic dieting. Popular culture, fad dieting, and media portrayals of increasingly thin, filtered, and photoshopped bodies are all considered major factors in the increasing pervasiveness of eating disorders. Diagnosis and treatment are also complicated by stigma, lack of understanding (including among providers), lack of access to care, insurance limitations, inconsistent definitions of disordered eating, contradictory data, and limited research.

Since the onset of COVID-19, uncertainty and stress have contributed to a sharp increase in disordered eating across the country, especially for youth. The National Eating Disorder Association’s helpline has experienced a 40% increase in call volume, and hospitals have seen a 25% increase in the number of adolescent eating disorder patients. For those who have been able to access care, the COVID-era transition to telehealth has been significantly more difficult (74% of recent survey respondents with eating disorders found telehealth to be less effective than in-person treatment, partially due to the ability to “hide” their symptoms from providers).

Adequate access to appropriate mental health and healthcare are two cornerstones of treatment and prevention for people struggling with disordered eating. Other major systemic factors—such as food security, LGBTQ+ acceptance, racial justice, media representation, and youth belonging—must also be recognized as critical to addressing eating disorders. Improving health outcomes for people with eating disorders will require nationwide improvements to treatment access, expansion of health insurance coverage, increases to mental health and youth programming, and greater emphasis on eating disorder research, prevention, and education. Media, creators, and influencers must work to increase diversity and representation, including body shape and size, race, color, disability, gender, and orientation. Locally, we can improve health outcomes by educating ourselves and our communities about the types of eating disorders, what eating disorders really look like, the serious public health consequences, and the disproportionate impacts on LGBTQ+ youth and youth of color.