Resources For Eating Disorders And Intuitive Eating

I find myself suggesting resources all the time to clients and healthcare professionals to help everyone learn more about eating disorders, intuitive eating, and health at every size. I figured it’s time to share these valuable books/podcasts/e-courses with all of you.  It doesn’t matter if you are a client, family member, or healthcare professional- we ALL have a lot to learn.


Top Resources for Eating Disorders

International Federation of Eating Disorder Dietitians

International Association of Eating Disorder Professionals

National Eating Disorder Association


Life Without Ed, by Jenni Schaefer

8 Keys to Recover from an Eating Disorder, by Carolyn Costin

Overcoming Binge Eating, by Christopher Fairburn

Almost Anorexic, by Jennifer Thomas

(Find these in your podcast app or itunes!)

The Recovery Warrior Show

The Eating Disorder Recovery Podcast

Resources for Health at Every Size and Intuitive Eating

Registered Dietitians for Body Confidence

The Health at Every Size Community

The Association for Size Diversity and Health

Intuitive Eating Community


Intuitive Eating by Evelyn Tribole and Elyse Resch

Intuitive Eating Workbook

Health at Every Size by Linda Bacon

Body Respect by Linda BaconBody Kindness by Rebecca Scritchfield

Savvy Girl, A Guide to Eating by Sumner Brooks and Brittany Deal

(Find these in your podcasts app or itunes!)

Love, Food

Body Kindness

Food Psych

Dietitians Unplugged

Life, Unrestricted

The Body Love Project


EDRDPro Symposium:15 experts (myself included!!) presenting on eating disorders, HAES, and intuitive eating! The symposium begins April 28th.

Kylie Mitchell’s IMMAEATTHAT “How to Eat” Course 

Christy Harrison’s Intuitive Eating Fundamentals Course


Sharing My Recovery Story

It’s Eating Disorders Awareness week! This week always holds a very special place in my heart because I feel like our community comes together in a big way to support eating disorder treatment. This year is extra special for me because I’m sharing my own recovery story on Christy Harrison’s Food Psych podcast, Episode #91!

Spearheaded by the National Eating Disorders Association (NEDA), the goal of National Eating Disorders Awareness (#NEDAwareness) Week is to shine the spotlight on eating disorders and put life-saving resources into the hands of those in need. This year’s theme is It’s Time to Talk About It and we’re encouraging everyone to get screened. Take a 3 minute screening here offered by NEDA.

In honor of #NEDAawareness week, I want to highlight eating disorder treatment and recovery. Recovery is possible and I wouldn’t be able to do what I do without seeing the stories of hope, love, survival, and resilience. I am so proud of all my “recovery warriors” and so honored to be a part of your journey.

Sharing My Recovery Story

Help is available and you are not alone. Here are some ideas to reach out for support.

1. Talk to a parent, friend, family member, or healthcare professional.  Reaching out for help and being honest with another person about what’s going on is extremely hard to do. But this is often the start of finding treatment and can be the most important step in getting help.

2. Seek online resources. The NEDA helpline is often the first stop for many people who want to get treatment. Call, email, click to chat, or even text!! to get help that you need. NEDA also provides guides and toolkits for parents, coaches, educators, and medical professionals.

3. Find an Eating Disorders Dietitian. The International Federation of Eating Disorder Dietitians (IFEDD) community is filled with ED-savvy dietitians who are ready to help heal your relationship with food. Find one by zip code here.

4. Talk to a therapist. Eating disorders are about food and feelings. A therapist can help you navigate the difficult emotions that arise when talking about disordered eating. The best directory for finding a therapist is Psychology Today.

5. If you are local, please reach out to me if you need help finding a professional. Not all healthcare professionals are ED-trained but I know a lot of them in Rockland and surrounding areas!! Please know that I keep all information private and confidential and will honor that to anyone needing help or support.


Hearing stories about eating disorder recovery can be uplifting and positive for anyone going through treatment or in recovery. Here are my favorites!

NEDA Faces of Recovery

Recovery Warriors

Project Heal on Recovery

I was honored to be a guest on Christy Harrison’s podcast Food Psych #91 talking about my own journey and how I ended up as an anti-diet dietitian. I’ve been thinking that I should share my recovery story for so long and it was finally the right time. Back when I first started my private practice Eat With Knowledge, clinicians being so open about themselves wasn’t really a “thing”. But so many people have since “come out” and I think it’s made a huge impact on our profession, the awareness and education of eating disorders, and have impacted clients in such a positive way. So here is my story!!! All the way back to high school, through college and the ups and downs of my recovery, into intuitive eating and then in pregnancy and postpartum. Spoiler alert: I am pregnant again (!!) and talk about how I’m feeling now. In the spirit of being vulnerable I was open and honest about everything. Listen in itunes, your podcast app, or on Christy’s website.

The Hidden Faces of Eating Disorders

I am so excited to announce that I will be presenting at the FNCE nutrition conference October 16-18th 2016!

FNCE is the official Food and Nutrition Conference and Expo of the Academy of Nutrition and Dietetics. I will be speaking on “The Hidden Faces of Eating Disorders” with Julie Duffy Dillon and Rebecca Scritchfield. We hope to bring more awareness to eating disorders treatment within the “hidden” populations of pregnancy, mid-life, and type 2 diabetes. Hopefully I can help spread the word that no client should ever feel ashamed for getting treatment for disordered eating.

When most people think of eating disorders, the image that typically comes to mind is a teenage girl or a young woman who is battling either anorexia or bulimia. Although younger females do make up a significant portion of the eating disorder population, an eating disorder does not discriminate. In fact, statistics show that at least 30 million people of all races and genders in the United States suffer from an eating disorder. This newsletter will focus on three populations that have less visibility than the “typical” disordered eater: pregnant females, women in mid-life, and people with type 2 diabetes.

Eating Disorders in Pregnancy
While strange food cravings are common during pregnancy (hello, pickles and ice cream!), some eating behaviors can become dangerous for both mom and baby. Anorexia, defined as an intense fear of weight gain coupled with a restriction of food intake, is especially harmful during pregnancy. This phenomenon has even been dubbed “pregorexia” and can occur as a new eating disorder or as a relapse when a previously recovered female discovers she is newly pregnant. Some pregnant women also develop or relapse into bulimia, which is vomiting, laxative abuse, and over-exercising, or binge eating disorder, which is uncontrollably eating large amounts of food. Bingeing is common because “cravings” act as an excuse to binge on otherwise “forbidden” foods – especially if the woman was a chronic dieter prior to pregnancy. Body image issues may also play a role in the development of a pregnancy-related eating disorder, as women experience many body changes, food cravings, and hormonal shifts during this time.

Eating Disorders in Mid-Life
Women in mid-life experience many changes such as a slower metabolism due to menopause, empty nest syndrome, and sometimes career and relationship disruptions. These changes, combined with society’s relentless emphasis on being thin/fit/healthy, often cause middle-aged women to feel dissatisfied with their appearance. Disappointment with their figures can lead to various manifestations of disordered eating, from a diet-binge cycle to orthorexia, which is an unhealthy fixation with eating healthy or “clean” foods. It’s helpful for these women to seek out new coping skills for dealing with all of the changes that they experience during mid-life, and understand the natural changes that a body goes through during mid-life.

Eating Disorders in Type 2 Diabetes
People with type 2 diabetes often hear advice from well-meaning friends, family, and even health professionals that they need to “just lose some weight,” “cut out carbs,” “never eat sugar,” or “just have sugar-free snacks!” While these tips might seem helpful, they often end up being way too restrictive which may ultimately lead someone down the path to a binge eating disorder. It’s important to understand the realistic advice on living with type 2 diabetes and to approach a healthy diet as a healthy lifestyle.


The “hidden faces” of eating disorders are not just limited to these populations.  Hidden faces are everywhere and we need to work together to bring treatment to people that need it.

Preventing Eating Disorders in Adolescents

*Just a quick note/trigger warning that the article described uses the word “obesity”. Many people find this word stigmatizing and I personally do not use this word when speaking about clients. When the word “obesity” is used, it’s in a direct quote from someone other than me.

Many professionals have concerns that the “war on obesity” is fueling eating disorders (EDs). Increased focus on weight, dieting, regimented exercise, and shameful body-image messages are usually present in many weight-loss programs. However, when prevention efforts are done with a focus on lifestyle, rather than weight, it may be possible for adolescents to avoid developing disordered eating behaviors. Eating disorder experts jumped for joy when The American Academy of Pediatrics (AAP) released new guidelines, this September, for the “prevention of obesity and eating disorders in adolescents”. These guidelines all contain concepts that many eating disorder professionals have endorsed for a long period of time.

Cross-sectional and longitudinal observational studies have identified the following specific behaviors associated with both obesity and EDs in adolescents:

  1. Dieting—Dieting is defined as calorie restriction for weight loss. We know that dieting leads to increased thoughts about food and bingeing. Weight gain almost always happens after the diet is “over”, because dieting can slow metabolism, and alter true hunger and fullness cues. We also know that dieting is a predisposition to eating disorders.
  2. Decreased Family Meals—Family meals can be protective against disordered eating because parents may catch eating issues earlier. Having family mealtime is also important for nutrient quality. Eating together as a family, with parents leading the way and serving as role models, is associated with increased fruit and vegetable consumption.
  3. Weight Talk—Talking about weight in the household almost always increases disordered eating. It could be talking to the child or adolescent about his or her weight , or it could be a parent talking about his or her own weight issues.
  4. Weight Teasing—Teasing may contribute to unhealthy food behaviors and bingeing. Overweight and obese adolescents are much more susceptible to teasing than kids with a “normal” weight.
  5. Body Dissatisfaction—1/2 of all teenage girls and 1/4 of all teenage boys are dissatisfied with their body. These statistics are alarming because an unhealthy body image leads to disordered eating and unhealthy behaviors. Adolescents with healthy body image are less likely to report weight concerns and behaviors.

Physicians are encouraged to focus less on weight and more on healthy family-based lifestyle modifications. The following guidelines are appropriate for physicians, but all healthcare professionals may benefit from supporting these ideas.

  1. Discourage dieting, skipping meals, and diet pills. Encourage healthy eating and physical activity that can be maintained in the long-run. Focus on healthy living and healthy habits, rather than on weight.
  2. Promote a positive body image. Do not encourage body dissatisfaction as a reason for weight-loss or dieting.
  3. Encourage frequent family meals
  4. Discourage families from talking about weight. Instead discuss healthy eating and being active to stay healthy. Facilitate healthy eating and physical activity at home.
  5. Inquire about history of teasing and bullying in overweight and obese teenagers, and address the issue with their parents.
  6. Carefully monitor weight loss in an adolescent who needs to lose weight, to ensure that the adolescent does not develop the medical complications of semi-starvation.

Reference:  Golden N, Schneider M, Wood C (2016). Preventing Obesity and Eating Disorders in Adolescents. Pediatrics: published online August 22, 2016.

See the full-text pdf research article here:

Update on Orthorexia

I recently attended the iaedp conference in Florida.  What an amazing few days of education, networking, connecting with colleagues, and WARM weather!

While there, I had the honor of attending a talk on Orthorexia Nervosa: Past, Present & Future of the most Controversial Eating Disorder by Steven Bratman, MD, MPH, Amanda Mellowspring, MS, RDN, CEDRD, and Jessica Setnick, MS, RD, CEDRD.

Orthorexia usually begins as an exuberant interest in healthy food.  This itself is not an eating disorder, but in susceptible individuals can transform into disordered eating.  Certain risk factors may be: adoption of a highly restrictive diet, a parent that has a high interest in “healthfoodism”, childhood illness involving diet and/or digestive issues, medical problems that can’t be addressed by medical science, traits of perfectionism, OCD, extremism, and fear of disease.  This style of eating can turn problematic when certain foods are idealized as semi-magical foods while others are demonized as evil (aka sugar! I hear that all the time…) Someone can start to develop a decreased food variety, as well as cut out entire food groups (aka vegan or paleo).  Eventually breaking some of these diet “rules” can lead to fear of disease and sense of impurity accompanied by anxiety and shame.  Basically, food becomes a primarily source of self-worth, happiness, and meaning.  Dr. Bratman has developed criteria to be published soon in the Eating Behaviors journal with Tom Dunn, PhD.


Proposed Diagnostic Criteria for Orthorexia Nervosa:

Criterion A. Obsessive focus on “healthy” eating, as defined by a dietary theory or set of beliefs whose specific details may vary; marked by exaggerated emotional distress in relationship to food choices perceived as unhealthy; weight loss may ensue, but this is conceptualized as an aspect of ideal health rather than as the primary goal.  As evidenced by all the following:

  1. Compulsive behavior and/or mental preoccupation regarding affirmative and restrictive dietary practices* believed by the individual to promote optimum health.**
  2. Violation of self-imposed dietary rules causes exaggerated fear of disease, sense of personal impurity and/or negative physical sensations, accompanied by anxiety and shame.
  3. Dietary restrictions escalate over time, and may come to include elimination of entire food groups and involve progressively more frequent and/or severe “cleanses” (partial fasts) regarded as purifying or detoxifying. This escalation commonly leads to weight loss, but the desire to lose weight is absent, hidden or subordinated to idealization about healthy food.

*Dietary practices may include use of concentrated “food supplements.”

**Exercise performance and/or fit body image may be regarded as an aspect or indicator of health.

Criterion B. The compulsive behavior and mental preoccupation becomes clinically impairing by any of the following:

  1. Malnutrition, severe weight loss or other medical complications from restricted diet
  2. Intrapersonal distress or impairment of social, academic or vocational functioning secondary to beliefs or behaviors about healthy diet.
  3. Positive body image, self-worth, identity and/or satisfaction excessively dependent on compliance with self-defined “healthy” eating behavior


In addition to these criteria, the published article also includes the following paragraph:

Other traits are commonly associated with ON in the literature. While the authors feel that these are not essential to making the diagnosis, they may help confirm it. These include obsessive focus on food choice, planning, purchase, preparation, and consumption; food regarded primarily as source of health rather than pleasure; distress or disgust when in proximity to prohibited foods; exaggerated faith that inclusion or elimination of particular kinds of food can prevent or cure disease or affect daily well-being; periodic shifts in dietary beliefs while other processes persist unchanged; moral judgment of others based on dietary choices; body image distortion around sense of physical “impurity” rather than weight; persistent belief that dietary practices are health-promoting despite evidence of malnutrition.

Cite as: Dunn, T.M & Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating Behaviors, 21, 11 -17.


Is this you?  Amanda and Jessica both talked about ways to counsel these clients that may be a little different from typical eating disorder treatment.  We also discussed ethical issues relating to this treatment.

2016-02-20 11.37.36


2016-02-20 11.57.49


2016-02-20 12.03.27

Bottom line, if any disordered eating is getting in the way of you living your life to the fullest, treatment can help.

Registered Dietitian Nutritionist Day- Why I LOVE what I do

Happy Registered Dietitian Nutritionist Day!  I am so grateful that I choose this career path all the way back when I was 18 years old enrolled in Nutritional Sciences at Penn State University.  I really had no idea what a career in dietetics “meant”, but I loved food and nutrition and especially the mental/behavior change part of the puzzle in overall health.  Fast forward 12 years, after 4 years in school, 1 year at Johns Hopkins Bayview Medical Center for my dietetic internship, and many jobs later, I now own my own business and keep evolving as a dietitian.  My interests have changed over the course of 7 (!!) years working in the field, but I am still so passionate about the role of a dietitian in health, especially eating disorders.  Happy Registered Dietitian Day to all my colleagues and clients.  Thank you for allowing me to be a part of your life and help guide you to health and happiness with food 🙂  Here are my top 10 reasons why I love being a Registered Dietitian Nutritionist:

1.  I get to help people change their relationship with food into a positive relationship rather than a negative relationship

2.  I get to see people get excited about food, rather than fearful and scared

3.  I help people overcome eating disorders and change the way they feel about eating

4.  I see the difference that nutrition makes in your mood and attitude about yourself

5.  I see hunger and satiety signals come back in people that lost them for years

6.  I work with people to get to the root of the problem of emotional eating, rather than “covering it up”

7.  I help clients fuel their bodies the right way for physical activity

8.  If you have any other medical conditions like diabetes, heart disease, high blood pressure we work on that too!!

9.  Nutrition science is always changing and I love how there are no “right” answers some of the time.  What we’re discovering now about nutrition is cutting edge information and that’s exciting!

10. I love having an amazing network of dietitians to work with.  If I’m not the best fit you, I can almost guarantee that I know someone who is!!  My network of dietitians expands across the county!!  :)

Eating Disorders Awareness Week 2015

Thanks to NEDA for a successful campaign to increase ED awareness.  Eating Disorder Awareness Week in Photos:

Illusions Social Media Image


Diversity Social Media Image


Athletes Social Media Image


Bullying Social Media Image


Diet Social Media Image


Doctor Social Media Image


Parents Social Media Image

National Eating Disorders Awareness Week 2014

This week is National Eating Disorders Awareness week!  This year’s theme is “I had no idea”.

All this week I will be blogging about various ED topics.  Remember if you need help, reach out right away.  My approach to treatment is very individualized and private.

From the NEDA website:

What is an Eating Disorder?

Eating disorders – such as anorexia, bulimia, and binge eating disorder can include extreme emotions, attitudes, and behaviors surrounding weight and food issues. According to the American Psychiatric Association’s Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these are the basic characteristics of some of the most common types of eating disorder:

Anorexia Nervosa:

  • Restricting food intake to below the requirements for a particular individuals physical requirements
  • Intense fear of weight gain and obsession with weight and continual behaviors to prevent weight gain
  • Inability to recognize true body shape or recognize the seriousness of condition
  • May or may not use binge eating and/or purging behaviors

Bulimia Nervosa:

  • Eating an unusually large amount of food at one time followed by compensatory behaviors (such as vomiting, taking laxatives and/or excessive exercise) to prevent weight gain
  • A feeling of being out of control during the binge-eating occurrence
  • Self-judgment largely based on weight and shape

Binge Eating Disorder:

  • Recurrent situations of eating an unusually large amount of food at one time
  • A feeling of being out of control during the behavior
  • May have feelings of shame or guilt towards eating which can lead to eating alone
  • May eat until the individual is beyond full to the point of discomfort

Note: There are several other types of feeding or eating disorders outlined in the DSM-5. Many people may not have every symptom of a disorder, but may still receive a feeding or eating disorder diagnosis. If you or your loved one is experiencing significant discomfort surrounding food that interrupts basic functions but does not meet the above criteria, you should still seek professional help.

Is it an Eating Disorder?

A popular misconception about eating disorders is that if someone has one, it will be obvious by their low weight and starvation habits. However, those suffering from eating disorders can be of any weight and are often adept at hiding their illness. To help with early detection, here is a brief list of eating disorder signs, symptoms and behaviors to keep an eye out for as they may be indicative of a bigger problem:

  • Makes frequent comments about feeling “fat” or overweight
  • In general, behaviors and attitudes indicate that weight loss, dieting and control of food are becoming primary concerns
  • Evidence of binge eating, including disappearance of large amounts of food in short periods of time or lots of wrappers and containers indicating consumption or large amounts of food
  • Evidence of purging behavior, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
  • Develops food rituals (e.g. eats only a particular food or food group, excessive chewing, doesn’t allow foods to touch, etc.)
  • Skips meals or takes small portions of food at regular meals
  • Hides body with baggy clothes
  • Maintains excessive, rigid exercise regimen—despite weather, fatigue, illness or injury—because of the need to “burn off” calories
  • Drinks excessive amounts of water and/or uses excessive amounts of mouthwash, mints and gum

How Can I Help?

When initiating a conversation with someone who may have an eating disorder, it is important to remain supportive, non-judgmental and let them know that they are not alone. Here are some recommended Dos and Don’ts of talking to someone about their eating disorder:


  • Learn the difference between facts and myths about weight, nutrition and exercise
  • Ask what you can do to help
  • Listen openly and reflectively; be patient and non-judgmental
  • Talk with the person in a kind way, when you are not angry, frustrated or upset
  • Explain the reasons for our concerns, without mentioning specific eating behavior
  • Ask if he/she is willing to explore these concerns with a healthcare professional who understands eating disorders
  • Remind your loved one that many people have successfully recovered from an eating disorder


  • Invade privacy and contact the patient’s doctors, friends or others to check up behind his/her back
  • Demand weight changes (even is clinically necessary for health)
  • Insist the person eat every type of food at the table
  • Make eating, food, clothes or appearance the focus of conversation
  • Offer more help than you are qualified to give


NEDA Week 2013: Treatment for Eating Disorders

So you were just diagnosed with an eating disorder or more likely… now you think you may have an eating disorder.  What do you do?


First things first, tell someone.  It’s much easier to have someone by your side to go through it alone.  If you feel comfortable, tell a family member or friend that you are struggling with food choices- whether it be restricting, purging, bingeing, or obsessive thoughts about food.  Next, know how important it is to get professional help.  It’s really hard (and takes MUCH longer) to “recover” (if you recover at all) from an eating disorder on your own rather than do it with professional help.


Everyone is different and the “recovery process” is different for everyone.  But when it comes down to it, recovering from an eating disorder is all about education, patience, challenging the eating disorder thoughts, getting out of your comfort zone, going up and down (recovery is NOT a linear line) but eventually breaking free from your disordered thoughts.  One of the most important aspects to recover is proper nutrition.  Not only for your hard working brain, but for your physical body.


The team approach with eating disorders or emotional eating is so important.  Chances are you are going to need some pretty important people by your side to help you figure things out and they are all important for a reason.  Here are all of the members of your team to help you recover and WHY they are needed:

  1. Therapist:  A therapist helps you figure out the disordered eating thoughts, why they’re occurring and how to challenge them.  There are usually underlining issues of depression, anxiety, and stress that go hand-in-hand with eating disorders or emotional eating.  I always like to say “you brain isn’t working the right way” when you have an eating disorder or emotional eating, and therapy helps you “fix” your brain so it can become healthy again.
  2. Dietitian:  A dietitian that specializes in the treatment of eating disorders (me!!) helps you find an appropriate meal plan that meets your needs.  At first, we find something that “works” for you in the short-term but eventually we can challenge you with fearful foods in a way that doesn’t make them “fearful” anymore.  I never EVER want emotional eaters or binge eaters to “diet”, I feel that just sets clients up for more bingeing.  We talk about the hunger scale, finding hunger/satiety cues, what’s “normal eating”, and what your goals are with food and recovery.  We talk about eating out, preparing food, grocery shopping, and what is going to work for you in a way that keeps you healthy.
  3. Doctor:  Your doctor will monitor all labs and medical issues related to an eating disorder
  4. Psychiatrist:  Sometimes medications are needed to help alleviate depression, anxiety.  Some medications can target anorexia and some can target binge eating.
  5. Personal trainer:  Some eating disorders can include disorder patterns of exercise.  A personal trainer can help you figure out a plan for exercise that’s right for you and your body.
  6. Your support system:  Perhaps this is the most important component for recovery.  Eating disorders can be very isolating and that’s why it’s important to have a support system in place.


Remember, first step is tell anyone you can trust.  Second step find a health professional to talk to.  That person will help you find the rest of your team.  Remember, if you’re struggling you need help.  You’re worth it!


NEDA Week 2013: What is an eating disorder?

All About Eating Disorders (Taken From the NEDA website)

Binge Eating Disorder

Binge Eating Disorder (BED) is a type of eating disorder not otherwise specified and is characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.


  • Frequent episodes of eating “large” (subjective) quantities of food in short periods of time.
  • Feeling out of control over eating behavior during the episode.
  • Feeling depressed, guilty, or disgusted by the behavior.
  • There are also several behavioral indicators of BED including eating when not hungry, eating alone because of embarrassment over quantities consumed, eating until uncomfortably full, feeling stress/tension that is only relieved after eating, or feeling “numb” when eating on “autopilot”.

Health Consequences of Binge Eating Disorder

The health risks of BED may include high blood pressure, high cholesterol levels, heart disease, type 2 diabetes

About Binge Eating Disorder

  • The prevalence of BED is estimated to be approximately 1-5% of the general population (3-15 million people)
  • Binge eating disorder affects women slightly more often than men–estimates indicate that about 60% of people struggling with binge eating disorder are female, 40% are male
  • BED is often associated with symptoms of depression.
  • People struggling with binge eating disorder often express distress, shame, and guilt over their eating behaviors.

Anorexia Nervosa

Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.


  • Resistance to maintaining body weight at or above a minimally normal weight for age and height.
  • Intense fear of weight gain or being “fat,” even though underweight.
  • Disturbance in the experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight.
  • Loss of menstrual periods in girls and women post-puberty.

Warning Signs

  • Dramatic weight loss.
  • Preoccupation with weight, food, calories, fat grams, and dieting.
  • Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.).
  • Frequent comments about feeling “fat” or overweight despite weight loss.
  • Anxiety about gaining weight or being “fat.”
  • Excessive, rigid exercise regimen–despite weather, fatigue, illness, or injury, the need to “burn off” calories taken in.

Health Consequences of Anorexia Nervosa

Anorexia nervosa involves self-starvation.; The body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This “slowing down” can have serious medical consequences:

  • Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing.  The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
  • Reduction of bone density (osteoporosis), which results in dry, brittle bones.
  • Muscle loss and weakness.
  • Severe dehydration, which can result in kidney failure.
  • Fainting, fatigue, and overall weakness.
  • Dry hair and skin, hair loss is common.
  • Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

About Anorexia Nervosa

  • Anorexia affects approximately .5-1% of the population (1-3 million people)
  • Approximately 90-95% of anorexia nervosa sufferers are girls and women.
  • Between 5-20% of individuals struggling with anorexia nervosa will die.  The probabilities of death increases within that range depending on the length of the condition.
  • Anorexia nervosa has one of the highest death rates of any mental health condition.

Bulimia Nervosa

Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.


  • Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior.
  • Regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
  • Extreme concern with body weight and shape.

Warning Signs of Bulimia Nervosa

  • Evidence of binge eating, including disappearance of large amounts of food in short periods of time or finding wrappers and containers indicating the consumption of large amounts of food.
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
  • Excessive, rigid exercise regimen–despite weather, fatigue, illness, or injury, the compulsive need to “burn off” calories taken in.
  • Unusual swelling of the cheeks or jaw area.
  • Calluses on the back of the hands and knuckles from self-induced vomiting.
  • Discoloration or staining of the teeth.
  • Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions.
  • Continued exercise despite injury; overuse injuries.

Health Consequences of Bulimia Nervosa

Bulimia nervosa can be extremely harmful to the body.  The recurrent binge-and-purge cycles can damage the entire digestive system and purging behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions.  Some of the health consequences of bulimia nervosa include:

  • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death.  Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation

About Bulimia Nervosa

  • Bulimia nervosa affects 1-2% of adolescent and young adult women (3-6 million people)
  • Approximately 80% of bulimia nervosa patients are female.
  • People struggling with bulimia nervosa usually appear to be of average body weight.
  • Many people struggling with bulimia nervosa recognize that their behaviors are unusual and perhaps dangerous to their health.
  • Bulimia nervosa is frequently associated with symptoms of depression and changes in social adjustment.

Eating Disorders Not Otherwise Specified (EDNOS)

Many people can still have eating disorder issues but not fit into a specific category.  It’s still important to get help for these eating disorder symptoms.  Often many clients find themselves in this group.

Examples of EDNOS

  • Menstruation is still occurring despite meeting all other criteria for anorexia nervosa.
  • All conditions are present to qualify for anorexia nervosa except the individual’s current weight is in the normal range or above.
  • Purging or other compensatory behaviors are not occurring at a frequency less than the strict criteria for bulimia nervosa
  • Purging without Binging—sometimes known as purging disorder
  • Chewing and spitting out large amounts of food but not swallowing

Together we can increase awareness and help all people struggling with an eating disorder get the help they need.