9 Eating Disorders You’ve Probably Never Heard Of

Eating disorders describe mental conditions characterized by detrimental eating behavior and emotions towards food and body image. While most eating disorders involve inadequate food intake leading to low weight, eating disorders can also present with overeating, excessive exercising, and even eating non-food items that cause weight gain and malnutrition.

Here are several eating disorders you’ve probably never heard of. These disorders fall under the classification of eating disorders not otherwise specified (EDNOS) because they do not meet the criteria for the well-known anorexia nervosa, bulimia nervosa, or binge eating disorders.    

Eating disorders can come in many forms
Eating disorders can come in many forms

Anorexia Athletica (Compulsive Exercising)

Anorexia athletica is an eating disorder marked by the compulsive need to exercise. Someone with anorexia athletic has an unhealthy obsession with exercise. They plan their entire lives around it, as deterrents like illness and injury do not interfere with their physical activity. When unable to exercise, they experience strong feelings of guilt.

Although exercise is part of a normal, healthy lifestyle, exercise becomes dangerous when the body is not given sufficient time to heal exercise-related injuries, when the heart is affected, or when females lose their menstrual cycle. The body begins to break down muscle mass for energy. The U.S. Department of Health and Human Services recommends up to 60 minutes of exercise per day.

Symptoms of Anorexia Athletica (Compulsive Exercising)

  • Anxiety
  • Depression
  • Fear of weight gain and fat
  • Low self-esteem
  • Diminished enjoyment from sports

Avoidant Restrictive Food Intake Disorder (ARFID)

Avoidant restrictive food intake disorder is a newly recognized eating disorder in which a person severely avoids food and limits caloric intake. Although the condition is most prevalent in children, it can also occur in adults. Food restriction prevents children from proper growth and adults from fully functioning in day-to-day life.

Avoidant restrictive food intake disorder may present as sensory sensitivity, which is the avoidance of certain food groups or food textures (i.e. meat, fruits, vegetables). Individuals show little interest in eating, usually reporting gastrointestinal distress or low appetite. These abnormal food behaviors sometimes occur after an episode of choking or vomiting.  

The Difference Between ARFID and Anorexia Nervosa

Like anorexia nervosa, avoidant restrictive food intake disorder involves food restriction. However, those with avoidant restrictive food intake disorder do not have a fear of weight gain, body shape, or size. Fear, if present, is a fear of food aversion. The condition tends to develop in young childhood and improves with age, whereas anorexia typically begins in adolescent females and often persists into adulthood.

Symptoms of Avoidant Restrictive Food Intake Disorder

Despite being a mental disorder, avoidant restrictive food intake disorder has a range of psychological and physical symptoms. Physical symptoms are the result of malnutrition after avoiding food for prolonged periods.

  • Avoidance and/or food restriction
  • Significant weight loss
  • Vitamin deficiencies
  • Poor psychosocial functioning
  • Hair loss
  • Feeling cold
  • Sleep disturbance
  • Dry skin
  • Muscle weakness
  • Impaired immune function
  • Dizziness and fainting
  • Gastrointestinal distress (i.e. constipation, stomach pain)
  • Trouble concentrating
  • Hormonal irregularities (i.e. abnormal menstruation/loss of cycle)

Compulsive Over Eating (COE)

Compulsive over eating is consuming more calories than required to remain healthy. It is similar to binge eating disorder, but those with compulsive over eating do not always excessively eat at every meal. While they have moments of eating large portions in one sitting, eating small amounts throughout the day can be a sign of compulsive over eating if caloric intake exceeds what is healthy. The behavior is typically a response to emotional stress. Over eating is how they cope with unwanted feelings and traumatic events.

9 Eating Disorders You’ve Probably Never Heard Of

Symptoms of Compulsive Over Eating (COE)

When compulsive overeating is untreated, it takes its toll on mental and physical health. Consuming more calories than considered healthy is associated with obesity, which causes serious physical diseases like heart disease, kidney disease, and stroke.

  • Eating when not hungry
  • Obesity and fluctuation in weight
  • Frequent, unsuccessful dieting
  • Hiding food
  • Social isolation
  • Poor self-esteem
  • Mood swings
  • Depression
  • Feelings of guilt, shame, or disgust
  • Preoccupation with food
  • Loss of sex drive
  • High cholesterol
  • High blood pressure
  • Sleep apnea
  • Fatigue
  • Risk of heart disease, stroke, and kidney disease

Diabulimia

The term “diabulimia” is a combination of diabetes and bulimia. Diabetes is a chronic condition affecting how the body manages blood sugar. In type 1 diabetes, the body destroys the cells in the pancreas that produce insulin. Bulimia is an eating disorder with episodes of binging and purging. Thus, diabulimia describes a type 1 diabetic who restricts insulin to lose weight.

Managing diabetes entails strict control of food, numbers, and weight to maintain a normal blood sugar level. Diabetics have a higher risk for developing an eating disorder than the general population.

Symptoms of Diabulimia

Restricting insulin wreaks havoc on a type 1 diabetic’s body. The disorder and uncontrolled diabetes can easily become a medical emergency.

  • Consistently elevated A1C of 9.0 or higher
  • Neglecting diabetes management (i.e. skipping appointments, not filling prescriptions, not checking blood sugars or giving insulin)
  • Fear of low blood sugars
  • Increase or decrease in diet
  • Poor body image
  • Excessive exercise
  • Fluctuations in weight
  • Persistent thirst
  • Frequent yeast infections
  • Low electrolytes
  • Fatigue
  • Nausea and vomiting
  • Blurry vision
  • Dry skin
  • Poor wound healing
  • Muscle atrophy
  • Dehydration
  • Diabetic ketoacidosis

Gourmand Syndrome

Gourmand syndrome is a rare, benign eating disorder characterized by a preoccupation with food six to twelve months after damage to the right hemisphere of the brain. Specific symptoms include sustained cravings, a new interest in “fine dining,” and alterations in taste. Studies published in the American Academy of Neurology revealed that 34 out of the 36 patients had a lesion on the right brain hemisphere in the basal ganglia, limbic structures, and cortical areas which control motivation and emotion. Tumors and strokes in these locations occasionally cause the same disordered eating patterns. In severe cases, gourmand syndrome can progress into eating disorders such as bulimia.

Muscle Dysmorphic Disorder

(Bigorexia)

Muscle dysmorphic disorder is actually a form of body dysmorphic disorder. However, disordered eating is a significant aspect of the condition. Individuals with muscle dysmorphic disorder are consumed with the obsession of becoming lean and muscular. They are unsatisfied with their muscular physique and go to great lengths to build muscle mass. This results in devoting many hours at the gym, following detrimental dieting plans, taking countless dietary supplements, or resorting to other detrimental methods to gain muscle like steroid-use. The disorder afflicts athletes, young males, and some females.

Symptoms of Muscle Dysmorphic Disorder

  • Over-exertion or overtraining in weightlifting
  • Obsessive about exercise and building muscle mass
  • Mood swings
  • Disordered eating (i.e. excessive protein supplements, vitamins, or dieting)
  • Risk of substance abuse
  • Prioritizing excessive above all
  • Making derogatory remarks regarding size

Night Eating Syndrome

Night eating syndrome is far beyond the infrequent midnight snack. Night eating syndrome combines disordered eating with irregular sleeping patterns. At least one-quarter of caloric intake is consumed after dinner. Those with night eating syndrome have insomnia—difficulty falling and staying asleep and awake throughout the night two or more times per week. Depression and mood swings that worsen at night, a lack of an appetite during the day, and being unable to fall asleep without fulfilling the urge to eat are common signs. Obesity and its physical complications are consequences of of night eating syndrome if left untreated.  

Orthorexia Nervosa

Orthorexia nervosa is an eating disorder marked by the unhealthy obsession with healthy eating. Individuals with orthorexia analyze the health of every ingredient in the food they consume. They rigidly abide by their diets while unnecessarily cutting out entire food groups because of the belief that the food is “impure” or will harm their health.  A sense of accomplishment comes with eating good foods, but feel shame and guilt after eating “bad” foods.

Orthorexia nervosa begins with the intention to adopt a healthy lifestyle by eating nourishing foods and engaging in regular exercise. In orthorexia, those intentions become an obsession and negatively affect physical, social, and emotional functioning.  

Symptoms of Orthorexia Nervosa

  • Anxiety over the “purity” of food (i.e. Is it healthy?)
  • Eliminating food groups (i.e. meat, sugar, dairy, etc.)
  • Weight loss
  • Malnutrition
  • Avoidance of eating out or eating food prepared by others
  • Criticizing the food choices of others
  • Fear of illness
  • Overspending on food
  • Fasting (i.e. fad diets, juice cleanses, etc.)
  • Feeling “out of control” when ingredients in the food are unknown

Pica

Pica is an eating disorder in which someone regularly eats non-food items with no nutritional value. Examples are clay, paper, feces, hair, charcoal, ash, soap, paint, chalk, wool, and rocks. To meet the criteria, eating non-food items must persistently occur over a month or longer and falls out of the societal norm. Experts are fascinated by the phenomena that is pica. The disorder is documented to occur from stress and pregnancy. Most often, malnutrition and iron deficiency causes the disorder. Supplementing deficient vitamins or minerals reverses the condition when brought on by malnutrition.

Symptoms of Pica

Consuming non-food items is obviously dangerous. Not only is it emotionally distressing, but pica can have life-threatening medical complications.

  • Bowel obstruction
  • Tears in the stomach
  • Vitamin deficiencies
  • Malnutrition
  • Poisoning
  • Parasites (i.e. if eating soil, dirt, etc.)

Rumination Disorder

Rumination disorder is a condition in which an individual spits up food from their stomach, rechews it, and then swallows it again or spits it out. The process takes place up to 30 minutes after a meal, but within 10 minutes is typical. Rumination disorder is thought to be secondary to increased abdominal pressure and related to conditions like gastroparesis (paralysis of the stomach/delayed gastric emptying), gastroesophageal reflux disease, and bulimia nervosa.

The largest complication of rumination disorder is damage to the esophagus from regurgitation. However, acidity from regurgitated food causes bad breath and dental erosion. Those with rumination disorder complain of abdominal pain, fullness, nausea, and have malnutrition.

References

Leone, J. E., Sedory, E. J., & Gray, K. A. (2005). Recognition and treatment of muscle dysmorphia and related body image disorders. Journal of athletic training, 40(4), 352–359.