Twenty million American women have suffered from an eating disorder at some point in their life. These diseases are technically mental-health issues, but the physical consequences can be profound. Poor nutrition starves the body and can lead to heart irregularities and kidney problems.

“The rate of mortality among young women with eating disorders is much higher than any other mental illness,” says psychiatrist Dr. Mehri Moore, founder and medical director of the Moore Center, an eating disorders treatment facility in Bellevue.

Historically, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) has officially recognized two types of eating disorders: anorexia nervosa, characterized by severe food intake restriction and an intense fear of gaining weight, and bulimia, which involves bingeing on large amounts of food and then vomiting, abusing laxatives, or overexercising. 

A third type, binge eating disorder, appears in the new edition of the DSM, released in May. Those with binge eating disorder eat abnormally large amounts of food in a short period of time and feel a lack of control over their binges, but don’t engage in purging behaviors like bulimics.

Those suffering from eating disorders come in all shapes and sizes. Anorexics are often extremely thin (a refusal to maintain at least 85 percent normal body weight is one diagnostic criterion), bulimics are typically average weight, and binge eaters are often overweight or obese. That means the most reliable warning signs are behavioral, such as compulsively reading labels, counting calories, being obsessed with or inflexible around food, and refusing to eat in front of others. 

Treatment for an eating disorder typically involves a team of professionals, including a dietitian, therapist, psychiatrist, and family physician. Some treatment programs also incorporate new approaches such as yoga, which allows relaxation, mindfulness, and body awareness that can help eating disorder sufferers realign their disordered thoughts and behaviors related to food. Researchers at Seattle Children’s Hospital found that teens who participated in an eight-week yoga program in addition to standard treatment had fewer eating disorder symptoms several weeks after the program ended, compared to those who received standard care alone.

Recovery is definitely achievable, but because so many women battle eating disorders for decades, it can take a long time to get to that point. All the more reason to know the warning signs and seek help as soon as possible.