When you hear the phrase “eating disorder,” what do you imagine? Perhaps a young woman, maybe a teenage girl, who is very thin and looks ill? That describes some people with eating disorders, but the range of these illnesses and who they affect is much wider than that. At least 30 million people in the U.S., of all ages and genders, have an eating disorder. Many more struggle with food and body image. All of them can be helped, but treatment and support are needed.

3 Main Types of Eating Disorders

Anorexia Nervosa

People with anorexia see themselves as overweight even when they are severely underweight. They dramatically restrict their calorie intake and eat only small amounts of very particular foods, and they’re obsessed with weight and weighing themselves. Gaining weight, even a healthy amount, is a terrifying thought for someone with anorexia. Over time, people with anorexia not only become very thin, but they also experience a range of physical symptoms including brittle hair and nails, severe constipation, low blood pressure, infertility, organ failure, and brain damage. Of all mental health issues, anorexia has the highest mortality rate, because of complications from starvation and suicide. About 1 in 100 American women will suffer from anorexia at some point, and the risk appears to be largely genetic.

Bulimia Nervosa

Bulimia is harder to spot than anorexia because people with bulimia often maintain what appears to be a relatively “normal” weight. Bulimia is characterized by binges of very large amounts of food, in which the eater feels out of control, followed by purging through vomiting or the use of laxatives or diuretics. Some people may follow a binge with excessive exercise or fasting. People with bulimia often suffer from a chronic sore throat, decaying teeth, acid reflux, intestinal problems, dehydration and an electrolyte imbalance, which can result in a stroke or heart attack. Bulimia is slightly more common than anorexia, affecting 1.5 percent of American women at some point. Like anorexia, genetics plays a role. About 10 percent of people with bulimia also struggle with substance abuse, usually alcohol.

Binge-Eating Disorder

This is the most common eating disorder in the United States, affecting nearly 3 percent of the population. People with binge-eating disorder regularly eat very large amounts of food in a short time and feel a lack of control over their eating. Unlike bulimia, they do not attempt to purge the food. They eat when they’re not hungry and eat until — and beyond — physical discomfort. Sometimes people with this condition eat in secret to hide their problem, and they may feel depressed, guilty and disgusted with themselves after a binge. Many people with binge-eating disorder are overweight or obese; others appear to be at a healthy weight despite their eating habits.

Other Eating Disorders

• Avoidant/Restrictive Food Intake Disorder (ARFID): This relatively new diagnosis was previously called a selective eating disorder. People with ARFID limit the amount of types of food they consume, like with anorexia, but there is no fear of being overweight or distress about body size. They may avoid food for other reasons, such as sensory issues or fear of choking or vomiting.
• Pica: This disorder involves eating things that are not food, such as paper, soap or pebbles. People with pica often have mental disorders that impair functioning, such as schizophrenia.
• Rumination Syndrome: In this condition, people unintentionally and repeatedly regurgitate food from the stomach, chew it again, and then either swallow it again or spit it out. This is usually done within 30 minutes of eating and is subconscious behavior. It’s associated with infants and people with developmental disabilities, but it can occur in other populations, too.
• Other Specified Feeding and Eating Disorders (OSFED): This catchall category includes people who do not meet the criteria for anorexia or bulimia but still have a life-altering eating disorder.

If you or someone you know has an eating disorder, the first step is to see a medical professional. There are stigmas and old stereotypes that prevent people from getting support. We understand the complicated relationships with food, exercise, and appearance – talk with your doctor about your concerns.

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