Understanding Eating Disorders: Anorexia, Bulimia, Orthorexia, Binge Eating Disorder, OSFED, & ARFID
Introduction
Eating disorders are often misunderstood, shaped by harmful stereotypes about who struggles with them and what they “look like.” The truth is, eating disorders can affect anyone—regardless of body size, shape, gender, or background. You can’t tell someone’s struggle by looking at them.
By learning about common eating disorders—Anorexia Nervosa, Bulimia Nervosa, Orthorexia, Binge Eating Disorder, Other Specified Feeding or Eating Disorder (OSFED), Avoidant/Restrictive Food Intake Disorder (ARFID)—we can break these myths and build greater understanding and compassion. If you or someone you care about is struggling, know that help is available, and healing is possible.
1. Anorexia Nervosa
Anorexia Nervosa is characterized by severe food restriction, an intense fear of gaining weight, and a distorted perception of body size or shape.
Signs of Anorexia Nervosa may include:
Dramatic weight loss or avoiding meals altogether.
Obsessing over calories, portion sizes, or specific “safe” foods.
Exercising excessively, sometimes to compensate for eating.
Feeling “bigger” than one actually is, despite evidence to the contrary.
Important Note: Not everyone with anorexia will appear underweight. Individuals at any body size can engage in restrictive eating and experience severe physical and emotional consequences.
2. Bulimia Nervosa
Bulimia Nervosa involves a cycle of binge eating followed by compensatory behaviors to “undo” the eating, such as purging, fasting, or excessive exercise. This pattern is often driven by feelings of shame, guilt, and loss of control.
Signs of Bulimia Nervosa may include:
Eating large quantities of food in a short period, often in secret.
Purging through vomiting, laxatives, or diuretics.
Frequent trips to the bathroom after meals.
Swollen cheeks, tooth damage, or digestive problems from purging.
Important Note: People with bulimia may appear to be at an “average” weight, making it harder for others to recognize their struggle. This does not minimize the seriousness of the condition.
3. Orthorexia Nervosa
While not yet classified as a formal diagnosis, Orthorexia Nervosa describes an obsession with “clean” or “healthy” eating that becomes rigid, restrictive, and anxiety-provoking.
Signs of Orthorexia may include:
Spending excessive time planning, preparing, or researching “healthy” meals.
Avoiding entire food groups due to fears of them being “unhealthy” or “bad.”
Feeling intense guilt or anxiety when deviating from strict food rules.
Judging others’ eating habits or withdrawing socially to avoid “unhealthy” food environments.
Important Note: While focusing on nutrition can be positive, Orthorexia becomes harmful when it compromises physical health, emotional well-being, or social connections.
4. Binge Eating Disorder (BED)
Binge Eating Disorder is the most common eating disorder and is characterized by repeated episodes of eating large amounts of food, often quickly and to the point of physical discomfort. Unlike bulimia, individuals with BED do not engage in compensatory behaviors.
Signs of Binge Eating Disorder may include:
Eating when not physically hungry or eating to numb difficult emotions.
Feeling out of control during binges and unable to stop eating.
Experiencing intense shame, guilt, or distress after binge episodes.
Eating alone or in secret to hide the behavior.
Important Note: Binge Eating Disorder affects individuals of all body sizes, and it’s crucial to remember that weight is not a measure of someone’s struggle or suffering.
5. OSFED: Other Specified Feeding or Eating Disorder
OSFED is a clinical diagnosis for individuals who experience significant eating disorder symptoms but don’t meet the full criteria for anorexia, bulimia, or binge eating disorder. Despite not fitting into traditional categories, OSFED is just as serious and can have a profound impact on a person’s mental and physical health.
Signs of OSFED may include:
Engaging in patterns of disordered eating that cause significant distress or impairment.
Meeting some (but not all) diagnostic criteria for anorexia, bulimia, or binge eating disorder.
Behaviors like frequent food restriction, purging, or binge eating without meeting the frequency or severity thresholds for other disorders.
Intense preoccupation with food, weight, and body image.
Important Note: OSFED is not a “less severe” eating disorder. It is a valid diagnosis and can lead to life-threatening physical complications and emotional distress if left untreated.
6. ARFID: Avoidant/Restrictive Food Intake Disorder
ARFID is an eating disorder characterized by a persistent avoidance of certain foods or restrictive eating patterns, but unlike other eating disorders, it is not driven by concerns about body image, weight, or appearance. Instead, ARFID may develop due to sensory sensitivities, fear of negative experiences like choking or vomiting, or a lack of interest in eating altogether.
Signs of ARFID may include:
Avoiding foods based on texture, color, smell, or taste (e.g., only eating “safe” foods).
Experiencing significant weight loss, nutritional deficiencies, or dependence on supplements to meet nutritional needs.
Intense anxiety or fear related to eating (e.g., fear of choking).
Struggles to maintain adequate nutrition that interfere with physical health or daily life.
Important Note: While ARFID does not typically involve body dissatisfaction, it can have a profound impact on physical health, emotional well-being, and social functioning (e.g., avoiding meals with others).
I want to acknowledge that while I specialize in body image concerns and other eating disorders, I am not trained to treat ARFID. If you recognize these signs in yourself or a loved one, I encourage you to seek care from a professional who specializes in ARFID treatment.
Eating Disorders Don’t Have a “Look”
One of the most damaging myths about eating disorders is that they only affect people who are thin. In reality, individuals of any body size, shape, or weight can experience significant distress, medical complications, and mental health struggles related to disordered eating.
Focusing solely on appearance can lead to missed diagnoses, delayed treatment, and feelings of shame for those who don’t “fit the mold.” Every experience with an eating disorder is valid, and every person struggling deserves care, compassion, and support.
Why Treatment Matters
Eating disorders are serious mental health conditions that often require specialized care. They don’t just affect physical health—they can harm relationships, emotional well-being, and a person’s overall quality of life.
Therapy offers a space to:
Explore the emotional triggers and beliefs fueling disordered eating.
Build a healthier, more compassionate relationship with food and your body.
Challenge harmful cultural messages about appearance, worth, and control.
Reclaim joy, balance, and peace.
Conclusion
Eating disorders like anorexia, bulimia, orthorexia, binge eating disorder, OSFED, and ARFID can impact anyone. They don’t discriminate based on body size, gender, or background. Recognizing the signs and understanding that these struggles are valid—no matter how they “look”—is an important step toward healing.
Change is Possible
If you’re struggling with food, body image, or disordered eating, you’re not alone. I’m here to help you heal and reconnect with yourself in a compassionate, judgment-free space.
