This article is for educational purposes only and is not a substitute for professional medical advice. If you are in crisis, call or text 988 or visit your nearest emergency department.

Quick take: Eating disorders are medical and psychological conditions—not choices. Early detection saves lives. Care usually combines medical monitoring, nutrition therapy, and evidence-based psychotherapy (FBT for adolescents; CBT-E for adults; DBT skills for binge/purge behaviors). Some medications help specific diagnoses/symptoms. If medical instability is suspected, seek urgent assessment.

The major types (plain English)

• Anorexia Nervosa (AN): restrictive intake and/or over-exercise → low weight or significant weight suppression; intense fear of weight gain; body-image disturbance.
• Bulimia Nervosa (BN): recurrent binge eating with sense of loss of control + compensatory behaviors (vomiting, laxatives, fasting, over-exercise); weight may be normal.
• Binge-Eating Disorder (BED): recurrent binges without compensatory behaviors; significant distress.
• ARFID (Avoidant/Restrictive Food Intake Disorder): restrictive intake not driven by shape/weight concerns (e.g., sensory issues, fear of choking, low interest in eating) → weight loss/nutritional deficiency or psychosocial impairment.
• OSFED: clinically significant eating-disorder symptoms that don’t fit the above categories exactly (still serious and treatable).

Red flags (for you or someone you love)

• Rapid weight change, dizziness/fainting, feeling cold, hair loss, missed periods/low testosterone
• Rigid food rules (good/bad foods), skipping meals, secret eating, disappearing after meals
• Over-exercise despite injury/exhaustion; social withdrawal around food
• Dental enamel loss, swollen salivary glands, calluses on knuckles (purging)
• Medical instability: syncope, chest palpitations, severe dehydration, confusion,
  bradycardia/hypotension, very low BMI or rapid loss at any BMI → urgent care

At CHARIS MIND & BODY WELLNESS, we coordinate with primary care and dietitians from day one. Safety drives level-of-care decisions (outpatient vs. IOP/PHP vs. inpatient).

Why eating disorders happen (a practical map)

• Biology: genetic loading, temperament (anxiety, perfectionism, harm avoidance), neurobiology of reward/satiety
• Psychology: body image concerns, trauma, OCD traits, emotion regulation difficulties
• Environment: diet culture, weight stigma, sport/performance pressures, social media
• Reinforcement loops: starvation and purging temporarily numb distress—then worsen it

What actually helps

1. Medical & nutritional stabilization (first priority)
   • Vitals, labs (electrolytes, CBC, thyroid, phosphorus), re-feeding risk monitoring in malnourished patients
   • Structured meal plans to restore adequate intake; gradual re-feeding when indicated
   • Close monitoring of bone health, heart rate/blood pressure, and menstrual function

   Close monitoring of bone health, heart rate/blood pressure, and menstrual function

2. Psychotherapy (matched to diagnosis and age)
   • FBT (Family-Based Treatment) for adolescents with AN/BN: parents temporarily take the lead in re-feeding and interrupting symptoms; responsibility returns to the teen over phases.
   • CBT-E (enhanced CBT) for adults across diagnoses: addresses over-valuation of shape/weight, dietary restraint, binges/purges, and body-image work with regular eating.
   • DBT skills for emotion regulation and binge/purge urges (distress tolerance, urge surfing).
   • Exposure work (fear foods, eating in public, mirror exposure) reduces avoidance and anxiety.
   • ARFID-specific: sensory exposures, fear-hierarchies (e.g., choking), and appetite stimulation strategies.
3. Medications (adjuncts, diagnosis-specific)
   • Fluoxetine (higher doses) reduces bulimic binges/purges and relapse risk
   • Lisdexamfetamine can help BED (binge frequency)—prescribed carefully within a comprehensive plan; watch sleep/appetite, BP/HR, and misuse risk.
   • Olanzapine (AN) may reduce ruminative anxiety and support weight restoration in some patients.
   • Avoid bupropion in BN/BED with purging due to seizure risk.
     (Medications support therapy/nutrition; they are not stand-alone cures.)
4. Family, school, and sport coordination
   • Written safety and return-to-sport plans
   • School accommodations for meal/snack times and medical visits
   • Family sessions to shift from criticism/monitoring battles to supportive structure

Family sessions to shift from criticism/monitoring battles to supportive structure

• Atypical AN: significant malnutrition and medical risk at any BMI—watch weight suppression and vitals, not just the scale number.
• Males & gender-diverse patients: often under-recognized; emphasize performance goals, muscle dysmorphia, and stigma-aware care.
• Co-occurring OCD/trauma: integrate ERP/trauma care with nutritional rehabilitation.
• Diabetes (ED-DMT1): insulin restriction is high-risk—requires tight medical–behavioral coordination.

A compassionate week-one plan

1. Schedule a medical check (vitals, labs) if red flags are present.
2. Move toward regular eating: 3 meals + 2–3 snacks with supervision/support.
3. Identify two fear foods and begin graded exposures with a support person.
4. Start a body image journal (facts vs. feelings; non-appearance values).
5. Pause extreme exercise; substitute gentle movement if medically cleared.
6. Loop in one support (family/friend) with a clear role (mealtime support or appointment buddy).

Bottom line: Eating disorders are medical illnesses that recover best with early, coordinated care—medical, nutritional, and psychological. Recovery is realistic. If this resonates, seek an eating-disorder–informed evaluation—with CHARIS MIND & BODY WELLNESS or a trusted local team.