Eating disorders are among the most underestimated mental illnesses. Those affected aren't suffering from a lack of discipline or a failed attempt at dieting. Eating disorders are complex, serious illnesses that affect the body, the mind, and social relationships all at once. They don't develop overnight, and they don't simply go away on their own.
And yet the stereotypes stubbornly persist: that eating disorders are a phase, a lifestyle problem, or something that only affects young women. The reality is different. People of any age, gender, and background can be affected. And the earlier an eating disorder is recognized, the better the chances of recovery.
What exactly are eating disorders?
Eating disorders are mental illnesses in which a person's relationship with food, with their own body, and often with themselves is fundamentally disturbed. Eating, or not eating, becomes the central theme in the person's life. It's about far more than weight or appearance. Behind an eating disorder there are almost always deeper issues: a need for control, suppressed feelings, a fragile sense of self-worth, or traumatic experiences.
Eating disorders are not a conscious choice. No one freely chooses to suffer from anorexia, bulimia, or binge eating. They're coping strategies that at some point take on a momentum of their own and become an illness.
The different forms of eating disorders
Eating disorders show up in different forms. The lines between them are blurry, and mixed forms are common.
Anorexia nervosa: People with anorexia severely restrict how much they eat and have a distorted perception of their body. Even when significantly underweight, they see themselves as too fat. A constant fear of gaining weight dominates daily life. Anorexia has the highest mortality rate of any mental illness.
Bulimia nervosa: Recurring binges are offset by compensatory behaviors such as vomiting, laxatives, or excessive exercise. People with bulimia often have a normal weight, which makes the illness invisible from the outside. The shame is enormous.
Binge eating disorder: Regular binges without any compensating behavior afterward. People eat large amounts in a short time and experience a loss of control while doing so. Intense guilt and self-loathing follow. Binge eating disorder is the most common eating disorder of all.
ARFID (avoidant/restrictive food intake disorder): People avoid certain foods because of sensory sensitivity, a fear of choking, or a general lack of interest in eating. Unlike anorexia, there's no underlying worry about weight or body shape. ARFID often affects children but can occur at any age.
Orthorexia: A compulsive fixation on supposedly healthy eating. The rules grow ever stricter, and the list of permitted foods ever shorter. What starts as mindful eating can develop into a serious restriction that brings social isolation and malnutrition in its wake.
Recognizing the warning signs, in yourself and others
Eating disorders often develop gradually. That's exactly why it's important to know the early warning signs. In yourself, the following signs can point to a problematic development:
Thoughts constantly circling around food, calories, or your own body
Rules around eating grow stricter and stricter and start to shape your whole day
Meals get avoided, put off, or eaten in secret
Feelings of guilt after eating, or a sense of losing control
Withdrawing socially, especially around shared meals
A change in how you move: exercise becomes a compulsion rather than a joy
In family members and friends, you might notice: sudden weight loss or sharp fluctuations, frequently disappearing after meals, growing irritability around the subject of food, striking rituals around what they eat, or a retreat from social activities.
How eating disorders develop: the biopsychosocial model
There is never a single cause of an eating disorder. Research today works from the biopsychosocial model: biological, psychological, and social factors act together and influence one another.
Biological: Genetic predisposition plays a significant role. Twin studies show that the risk of an eating disorder is markedly higher when there's a family history. Changes in brain chemistry, particularly involving serotonin and dopamine, can also make one more likely.
Psychological: Low self-worth, perfectionism, difficulties regulating emotions, or traumatic experiences such as bullying, abuse, or neglect all increase vulnerability. People often use their eating behavior, without realizing it, as a way to cope with difficult feelings.
Social and cultural: Societal beauty ideals, comparison on social media, comments about weight and body shape within the family, or performance pressure can set off or sustain the development of an eating disorder. Certain fields, such as dance, modeling, and competitive sport, are considered especially high-risk.
The role of control and emotions
Many people describe their eating disorder as the one area where they have control. When life feels overwhelming, when relationships hurt or their own feelings grow too big, controlled eating offers a sense of safety, or at least the appearance of one. It becomes a strategy for dealing with the unbearable.
But this control is deceptive. Because at some point the eating disorder controls the person, not the other way around. The vicious cycle of restriction, binges, shame, and renewed attempts at control becomes a prison. That's precisely why it's so important to learn other ways of regulating emotions in therapy, ways that don't come at the expense of your own body.
Physical consequences: when the body sounds the alarm
Eating disorders aren't only a psychological burden; they can seriously damage the body. The consequences depend on the type and duration of the illness, but they affect nearly every organ system:
Cardiovascular problems from electrolyte imbalances, which in the worst case can become life-threatening
Osteoporosis and fractures from long-term nutrient deficiency
Damage to the teeth and chemical burns to the esophagus from regular vomiting
Hormonal disruptions, loss of menstruation, and fertility problems
Gastrointestinal complaints, chronic constipation, and digestive problems
Trouble concentrating, exhaustion, and low, depressive moods caused by malnutrition
Many of these consequences are reversible with timely treatment. The longer an eating disorder goes on, however, the harder physical recovery becomes.
Treatment: why a multidisciplinary approach is essential
In most cases, treating an eating disorder calls for several disciplines working together. A single approach on its own is rarely enough. A well-established multidisciplinary team typically includes:
Psychotherapy: The heart of treatment. Cognitive behavioral therapy, psychodynamic approaches, and body-oriented methods help people understand the underlying patterns and develop new ways of handling feelings and stress.
Nutritional counseling: Specialized dietitians help build healthy eating habits. It's not about diet plans, but about gradually normalizing eating and easing the fears around certain foods.
Medical care: Regular check-ups monitor blood values, cardiovascular function, and nutritional status. In severe cases, inpatient treatment may be necessary.
Complementary therapies: Art and music therapy, mindfulness training, or body therapy can support the healing process and open up a new relationship with one's own body.
Recovery is possible, but it takes time
One of the most important things people affected need to hear: recovery is possible. Many people recover fully from an eating disorder. But the path there is rarely a straight line. Relapses are part of the recovery process and are not a sign of failure.
Recovery isn't only about reaching a stable weight or eating regularly again. It means developing a new relationship with your own body, allowing feelings in, and finding other ways to cope with stress. That takes patience, professional support, and often the willingness to let yourself be vulnerable.
Some people say their recovery took months; for others, it's something they live with for years. What matters is this: every step counts, even the small ones.
Supporting someone with an eating disorder
For family and friends, the situation is often barely less distressing than it is for the person affected. You want to help but feel helpless. Well-meant advice like "Just eat normally" falls short and can even hurt.
What really helps:
Raise your observations with the person gently, without accusations or diagnoses
Listen, without rushing to offer solutions
Avoid comments about weight, appearance, or eating habits
Read up on the illness so you can better understand what the person is going through
Offer to come along, for example to an initial consultation with a therapist
Watch your own limits, too, and get support for yourself when you need it
One important thing to know: you can't cure someone else's eating disorder. But you can create an environment in which healing becomes easier.
Specialized treatment in Austria
Austria has a range of places to turn to for people with eating disorders. Specialized centers offer outpatient and inpatient treatment programs tailored to the particular needs of those affected. Hospitals such as the AKH Vienna, the University Hospital Innsbruck, and the Krankenhaus der Barmherzigen Schwestern in Linz have their own dedicated eating disorder units.
There are also outpatient counseling services such as the Vienna Eating Disorders Hotline (0800 20 11 20, free and anonymous) and the Netzwerk Essstörungen in Tyrol. You can find therapists in private practice who specialize in eating disorders through professional associations or platforms like matchyourtherapy.at, where you can filter specifically for this focus.
In Austria, the cost of psychotherapy is partly covered by the public health insurers. Insurance-covered therapy spots, however, often come with waiting times. Many therapists offer reduced social rates. The important thing: don't let bureaucratic hurdles discourage you. The first step is always worth it.
