How do people develop eating disorders

eating disorder

What is an eating disorder?

Eating disorders are one of the most common mental illnesses in adulthood. Most of those affected develop it as adolescents or young adults. Often the disorder persists for several years and in some cases even for a lifetime.

In Germany, around 14 in 1,000 women and five in 1,000 men are affected. According to an analysis by the Kaufmännische Krankenkasse (KKH) in 2019, eating disorders have increased steadily in recent years. Doctors distinguish three main forms: binge eating disorder (binge eating), bulimia (eating vomiting addiction) and anorexia (anorexia). There are also patients who suffer from a mixed form.

Binge eating disorder (binge eating disorder)

"With chips, I can only stop eating when the bag is empty." Almost everyone knows that. Doctors only speak of a binge eating disorder or binge eating disorder if people have had such binge eating regularly and over a long period of time. Affected people sometimes consume 2000 calories and more in an hour - as much as others over the course of the day.

People with binge eating disorder are almost always very overweight. Some start dieting again and again or go on fasting days, which are then usually thwarted by the next binge eating.

People with binge eating disorder feel uncontrollable about what and how much they eat during the seizure. Often times, they can't stop until they have a stomach ache.

After the seizures, those affected usually feel depressed. They feel disgusted with themselves and feel guilty. When the frustration gets too big, the only consolation is again the food - a vicious circle. Those affected usually eat alone out of shame and hide the seizures from friends and family.

In Germany, around one to five percent of the population is affected. Experts state that around 25 percent of "binge eaters" are men. This means that their proportion is significantly higher than for other eating disorders. Those affected usually develop the disorder between the ages of 20 and 30.

It is not only compulsive eating and obesity that troubles those affected, they often also suffer from depression, insomnia and stress. The disease can also cause diabetes, cardiovascular disease, and high blood pressure.

The risk of cancer also increases because the adipose tissue favors various cancer-causing mechanisms in the body. It produces, for example, an excess of estrogen, which doctors blame for breast cancer and uterine lining cancer. Fat cells also produce the hormone leptin, which stimulates cell growth and thus increases the risk of cancer.


The word bulimia is derived from the Greek and can be translated as "ox hunger". The symptoms of this disorder are initially similar to those of binge eating: regular food cravings in which sufferers eat large portions.

The difference is that you get rid of your stomach contents as quickly as possible after these binge eating. Depending on which means they choose, doctors differentiate between the purging and non-purging types.

People with the purging type of bulimia go to the toilet after the binge eating and throw up. Some also take laxatives or diuretics to keep them from gaining weight.

People with the non-purging type, on the other hand, do excessive exercise and adhere to strict diets and fasting periods after the binge eaters.

If you take both types together, about 1.3 to 1.7 percent of women and 0.1 to 0.5 percent of men are affected. In contrast to binge eating disorder, bulimia usually develops earlier, between the ages of 15 and 19.

Unlike people with binge eating disorder or anorexia, people with bulimia do not initially see their disorder. They often have a normal weight or are slim, because by vomiting they ensure that their body can hardly use the masses of calories they eat.

Despite their normal weight, people with bulimia usually find themselves too fat. They care a lot about how they look and are very afraid of gaining weight.

Because they are ashamed of their eating disorder, those affected usually keep it a secret. Sometimes even close friends don't know about it.

In addition to the psychological stress, people who vomit regularly for months or years often suffer from heartburn and risk the esophagus becoming inflamed as a result of the artificially induced backflow of gastric acid. The lack of nutrients can lead to cardiovascular disorders, hair loss and difficulty concentrating.

The surface of the tooth is also attacked by the stomach acid in the mouth, which quickly leads to tooth decay. The constant vomiting, laxatives and diets can lead to severe deficiency symptoms, which in the worst case can be life-threatening.

Anorexia (anorexia)

Doctors speak of "anorexia nervosa" or anorexia when a person eats so little in the long term that they lose weight and develop underweight. The disorder usually develops very early in puberty.

Fewer people suffer from anorexia than from binge eating or bulimia: less than one percent of people in Germany are affected. Only about every eleventh patient is a man. On the other hand, anorexia is all the more dangerous: Ten to 15 percent of all those affected die.

The disease usually begins seemingly harmless: those affected want to lose a few kilograms, become slimmer, more beautiful. Because they are often very determined, it is not difficult for them to reduce their calorie intake.

No sugar, no fat, hardly any carbohydrates: Many people with anorexia only allow themselves certain types of fruit or vegetables, such as apples or cucumber. Those affected often develop rituals. They count calories, weigh themselves several times a day and despair when they haven't lost any further weight. Others cut their food very small or chew particularly slowly.

Even if people with anorexia are severely underweight, they feel too fat. The perception of your body is disturbed.

Many exercise excessively and try to get as much exercise as possible. Some people also vomit voluntarily and use laxatives to further reduce their weight. The difference to bulimia is that they do not have binge eating.

Once those affected are very emaciated, they also experience unpleasant physical side effects from their addiction. They feel weak, have headaches, are constantly cold, and lose hair. The heart beats more slowly and women have no menstruation.

In extreme cases, the so-called lanugo hairs grow on the back or face - a fine down that the body develops to protect itself from heat loss.

To this day, anorexia is considered a typical disease for women or girls. But the number of men and boys affected is growing. Experts suspect a high number of unreported cases because men with anorexia find it particularly difficult to admit their disorder to themselves and to others.