Eating Disorders are Often Stigmatized. They Should Not Be.

eating disorder

Nearly 30 million Americans will experience an eating disorder within their lifetime, and eating disorders are the second deadliest mental illness, only behind opioid overdose. Approximately 26% of people with eating disorders attempt suicide, and 10,200 deaths each year are the direct result of an eating disorder.

“Eating disorders are still highly stigmatized, and many people believe that it is a lifestyle choice,” said Kelley Chilson, PsyD, a psychologist at Penn Highlands Behavioral Health Outpatient Center in DuBois. “An eating disorder is a complex mental and physical disorder that anyone can develop. It is a serious condition that impacts many areas of one’s life including physical, psychological and social functioning.

“Eating disorders are behavioral conditions that are often characterized by obsessions with food, disturbance in eating behaviors and distressing thoughts and emotions surrounding one’s body and food,” said Dr. Chilson.

There are three primary types of eating disorders: anorexia nervosa, bulimia nervosa and binge eating disorder. However, Dr. Chilson states, “I find it helpful to think of eating behaviors as occurring on a spectrum. Attempting to fit eating behaviors into a specific category or diagnosis can be tricky because it often results in minimizing behaviors that are creating real difficulties for people. For example, you might recognize that you spend a lot of time thinking about what you eat each day, or even feel guilty after eating certain foods, but since this alone does not technically meet criteria for an eating disorder, you are left feeling like maybe it is not a problem.”

What is anorexia nervosa?

Anorexia nervosa, commonly called anorexia, has the highest mortality rate of all eating disorders. Anorexia is usually characterized by a reduction in eating, a fear of gaining weight, a distorted perception of weight and ultimately a low body weight. Many people who suffer from anorexia see themselves as overweight, even when they are underweight and or malnourished.

Symptoms of anorexia may include:

  • Low body weight
  • Abnormal blood counts
  • Fatigue
  • Insomnia
  • Dizziness or fainting
  • Bluish discoloration of the fingers
  • Hair that thins, breaks or falls out
  • Soft, downy hair covering the body
  • Absence of menstruation
  • Constipation and abdominal pain
  • Dry or yellowish skin
  • Intolerance of cold
  • Irregular heart rhythms
  • Low blood pressure
  • Dehydration
  • Swelling of arms or legs

What is bulimia nervosa?

While anorexia is usually characterized by a low body weight and restrictive eating. People with bulimia alternate between restrictive eating and binge eating followed by compensatory behaviors to prevent weight gain such as self-induced vomiting, misuse of laxatives or diuretics or excessive exercise.

Like individuals with anorexia, however, patients with bulimia are often also excessively preoccupied with thoughts of food and weight. Individuals with bulimia can be slightly underweight, normal weight or overweight.

Symptoms of bulimia may include:

  • Preoccupation with body shape and weight
  • Fear of gaining weight
  • Eating abnormally large amounts of food in one sitting
  • A sense of loss of control while eating
  • Forcing yourself to vomit
  • Using laxatives, diuretics or enemas after eating
  • Fasting, restricting calories or avoiding certain foods between binges
  • Electrolyte imbalances
  • Dental abnormalities

What is binge eating disorder?

Individuals who experience binge-eating disorder consume large amounts of food within a discrete period of time and feel as though they are unable to stop.

“I often describe this to patients as feeling like a car without brakes,” said Dr. Chilson.

Importantly, with binge eating disorder, periods of overeating are not followed by compensatory behaviors such as self-induced vomiting. Most people engage in overeating from time to time, though some people significantly overeat regularly and feel like it is out of their control. Many people with binge eating disorder are overweight, but those who are not can still suffer from binge eating disorder.

Symptoms of binge-eating disorder may include:

  • Eating unusually large amounts of food in a short period of time (for example, two hours)
  • Feeling like you have a lack of control while eating
  • Eating when you are full or not hungry
  • Eating rapidly
  • Eating alone or in secret
  • Feeling depressed, disgusted, ashamed, guilty or upset about your eating
  • Frequently dieting, possibly without weight loss

When should I see a doctor?

If you are concerned that you or a loved one are experiencing symptoms of a disordered eating, talk to your primary care provider. If symptoms are extreme, seek medical attention immediately. Often times, symptoms do not fit neatly into one of the above mentioned diagnoses. If your eating behaviors or beliefs about food are causing you continued stress or impacting your day-to-day functioning, it is appropriate to reach out to a medical or mental health professional.

Penn Highlands Healthcare offers comprehensive mental health services, including inpatient and outpatient services for children ages 5 and up, adults and seniors. If you or someone you love is struggling with an eating disorder, mental health disorder or a stressful life event, the Penn Highlands team of psychiatrists, clinical psychologists, a neuropsychologist, physician assistants, licensed clinical social workers and licensed professional counselors can help. To learn more, visit