Medically reviewed by Dr. Alicia Moreno, PhD
Co-Occurring Disorders Editor & Mental Health · Last reviewed January 2025

Eating disorders are serious mental health conditions with significant medical consequences. They carry the highest mortality rate of any mental health disorder. According to the NIMH, approximately 0.6% of U.S. adults have anorexia nervosa, 0.3% have bulimia nervosa, and 1.2% have binge eating disorder — though eating disorders are substantially more prevalent among women and in younger age groups.

Medical Disclaimer — Eating Disorders

Eating disorders involve serious medical risks and require specialized clinical assessment and treatment. If you or someone you know may have an eating disorder, please seek evaluation from a qualified healthcare provider or contact the National Alliance for Eating Disorders Helpline at 1-866-662-1235.

Anorexia Nervosa

Anorexia nervosa is characterized by restriction of energy intake relative to requirements, leading to significantly low body weight; intense fear of gaining weight; and disturbed perception of one's body weight or shape. Two subtypes exist: the restricting type (food restriction and/or excessive exercise) and the binge-purge type (restrictive eating plus periodic binge eating or purging).

Anorexia has the highest mortality rate of any psychiatric disorder, with deaths attributable both to medical complications (cardiac arrhythmias from electrolyte imbalances, organ failure) and to suicide. Medical complications include bradycardia, orthostatic hypotension, osteoporosis, amenorrhea, lanugo, and refeeding syndrome during nutritional rehabilitation.

Bulimia Nervosa

Bulimia nervosa involves recurrent episodes of binge eating (eating a large amount of food in a discrete period with a sense of lack of control) followed by compensatory behaviors to prevent weight gain — most commonly self-induced vomiting, but also laxative abuse, diuretics, fasting, or excessive exercise. Binge-purge cycles occur at least once weekly for three months. Medical complications include electrolyte abnormalities, dental erosion, esophageal damage, and parotid gland enlargement.

Binge Eating Disorder

Binge eating disorder involves recurrent episodes of binge eating without regular compensatory behaviors. It is the most prevalent eating disorder, affecting individuals across a wide weight range. It is associated with significant distress, impaired quality of life, and elevated rates of depression, anxiety, and substance use disorders.

Eating Disorders and Addiction

Co-occurrence rates between eating disorders and substance use disorders are significant, particularly for alcohol and stimulant use. Both conditions involve dysregulation of reward systems and impulse control, and both frequently co-occur with trauma and mood disorders. See our article on eating disorders and addiction.

Treatment

Evidence-based treatments vary by diagnosis. For anorexia, weight restoration and nutritional rehabilitation must precede or accompany psychotherapy — psychotherapy is less effective in severely malnourished states. Family-Based Treatment (Maudsley Approach) has the strongest evidence base for adolescents with anorexia. For bulimia, CBT has the most extensive evidence base. For binge eating disorder, CBT, Interpersonal Therapy (IPT), and Dialectical Behavior Therapy (DBT) all have evidence. Lisdexamfetamine (Vyvanse) is the only FDA-approved medication for moderate-to-severe BED.

Specialized eating disorder treatment is essential — general mental health settings are often not equipped to manage the medical complexity these patients present.