Can you have an eating disorder and look healthy?

Yes. The National Institute of Mental Health says some people who appear healthy are extremely ill. You can't tell from someone's size or weight whether they are struggling, which is why it matters to take worries seriously.

Do only teenage girls get eating disorders?

No. Eating disorders are more common in women and often begin in the teen or young adult years, but they affect people of every age, background, body size and sex, including boys and men.

How do I bring up my concern with someone?

Choose a calm, private moment. Talk about what you have noticed and how much you care, using "I" statements. Avoid comments about weight, size or food, and don't expect them to agree right away. Gently encourage them to see a doctor.

What kind of doctor should we see first?

A primary care provider or pediatrician is a good first step. They can check physical health, which matters because eating disorders can affect the heart and other organs, and refer you to mental health professionals who treat eating disorders.

Can people fully recover from an eating disorder?

Yes. NIMH says eating disorders can be treated successfully and that early detection and treatment are important for recovery. Recovery often takes time and setbacks are common, but they are part of the process, not the end of it.

Is an eating disorder a spiritual problem?

An eating disorder is a medical and mental illness with genetic, biological, psychological and social causes. It is not a sign of vanity, sin or weak faith. Faith and a caring church can support recovery alongside professional treatment.

Where can I find treatment near me?

Start with a doctor, or search FindTreatment.gov. The SAMHSA National Helpline at 1-800-662-4357 is free, confidential and open 24/7, and can refer you to local treatment and support.

Eating disorders: signs, causes, and how to find help

Signs at a glance

Constant worry about weight, body shape or food
Eating alone or in secret
Feeling ashamed, guilty or distressed about eating
Strict food rules, or cutting out more and more foods
Exercising intensely, even when sick, hurt or exhausted
Feeling out of control around food
Pulling away from meals with family or friends
Mood changes such as anxiety, irritability or sadness around food

Everyone has some of these sometimes. What matters is how long they last, how strong they are, and whether they get in the way of daily life. Only a doctor or licensed counselor can diagnose. If you're worried, that's reason enough to ask.

If food, eating or your body has started to feel like a battle you fight alone every day, please hear this first: you are not vain, you are not failing, and you are not beyond help. Eating disorders are real illnesses. They are also treatable, and many people recover. The same is true if you’re reading this because you’re worried about someone you love.

What is an eating disorder?

The National Institute of Mental Health (NIMH) describes eating disorders as serious illnesses marked by severe disturbances in a person’s eating behaviors. Lots of people think about health, weight or appearance sometimes. An eating disorder is different: food, weight or body shape starts to take over a person’s thoughts, feelings and choices, and it harms their health and their life.

Common types include:

Anorexia nervosa: severely limiting food, driven by an intense fear of gaining weight or a distorted view of one’s own body.
Bulimia nervosa: repeated episodes of eating large amounts with a sense of losing control, followed by harmful ways of trying to make up for it.
Binge-eating disorder: repeatedly losing control over eating, without those compensating behaviors. It is the most common of the three in U.S. adults.
Avoidant restrictive food intake disorder (ARFID): limiting how much or what kinds of food someone eats because of anxiety about eating or strong dislike of certain foods, not because of body image.

Eating disorders are serious and can be life-threatening. MedlinePlus notes they can damage the heart and other organs, and NIMH notes that people with eating disorders face a higher risk of suicide. That is why early help matters so much.

What does an eating disorder feel like?

People often describe a loud, critical voice about food and their body that never seems to rest. Eating can bring guilt, shame or panic. Rules about food can feel like safety even as they shrink life down. Some people feel out of control around food and then deeply ashamed. Many hide what’s happening, even from the people closest to them.

Outward signs can include the ones listed on this page: eating alone or in secret, avoiding shared meals, intense exercise even when sick or hurt, and constant talk or worry about weight and shape. But many signs are invisible. You cannot tell whether someone has an eating disorder by looking at their body. NIMH says some people who look healthy are very ill.

How common are eating disorders?

According to NIMH, using U.S. survey data from 2001 to 2003, about 2.8% of adults will have binge-eating disorder at some point in their lives, about 1.0% bulimia nervosa and about 0.6% anorexia nervosa. Among U.S. adolescents aged 13 to 18 (survey data from 2001 to 2004), about 2.7% had an eating disorder at some point.

Eating disorders can affect people of every age, background, body size and sex. MedlinePlus notes they are more common in women and often begin in the teen or young adult years, but they can start in childhood or later in life.

What causes eating disorders?

Nobody chooses an eating disorder, and parents don’t cause them. The exact cause isn’t fully understood. Researchers believe several factors work together: genetic, biological, behavioral, psychological and social. Eating disorders often show up alongside depression, anxiety or substance use, which can make each harder.

Cultural pressure about bodies, teasing, perfectionism and stressful seasons of life can all add weight. None of them is the whole story, and none of them is anyone’s fault.

How are eating disorders treated?

Treatment is tailored to each person and usually involves a team. According to NIMH and MedlinePlus, it may include:

Psychotherapy (individual, group or family) to work on the thoughts, feelings and behaviors around food and body image. For young people, family-based treatment can improve outcomes.
Medical care and monitoring to check and protect physical health.
Nutrition counseling with a qualified professional, to rebuild a healthy, peaceful relationship with food.
Medication in some cases, as decided by a doctor, especially for co-occurring anxiety or depression.
Hospital or residential care when someone is very ill.

Recovery often takes time, and setbacks happen. They don’t erase progress.

How can I help someone with an eating disorder?

Speak up gently. Choose a calm, private moment. Say what you’ve noticed and that you care. Use “I” statements: “I’ve noticed you seem stressed at dinner, and I’m worried about you.”
Leave weight and food out of it. Don’t comment on size, shape or what’s on their plate, even with praise. Talk about the person, not their body.
Expect resistance. Denial and fear are common. Keep the door open and keep caring.
Encourage a doctor’s visit. A primary care provider or pediatrician can check physical health and refer to specialists.
Stay involved in treatment, especially for a child or teen, and look after your own heart along the way.

For help finding treatment, you can search FindTreatment.gov or call the free, confidential SAMHSA National Helpline at 1-800-662-4357 (24/7, treatment referral and information).

When should you get help right away?

Get help now if someone faints, has chest pain or a racing or irregular heartbeat, seems confused, or talks about wanting to die. Call 911 in a medical emergency. For thoughts of suicide, call or text 988. Our Get help now page lists more options.

Faith and eating disorders

Eating disorders tend to shout one message: your worth is what people see. Scripture says something different. When Samuel was sizing people up by how they looked, God corrected him:

“For man looks at the outward appearance, but the LORD looks at the heart.” — 1 Samuel 16:7 (WEB)

Struggling with an eating disorder is not vanity, and it is not a lack of faith. It is an illness, and getting treatment is a faithful, brave step. If you’re a parent, pastor or friend, the most Christlike thing you can do is often simple: stay close, refuse to shame, and help the person get care.

Jesus’ invitation is for the exhausted, including anyone worn out by a war with food and their body:

“Come to me, all you who labor and are heavily burdened, and I will give you rest.” — Matthew 11:28 (WEB)