Recognizing & Supporting Patients with Eating Disorders: A Guide for Nursing Students
As we wrap up Eating Disorder Awareness Month, it’s essential for nursing students to understand the complexities of eating disorders beyond the commonly known ones. Early recognition and intervention can save lives, so let’s break down three important disorders you may encounter in clinical practice:
1️⃣ Binge Eating Disorder (BED)
BED is characterized by recurrent episodes of consuming large quantities of food in a short period, accompanied by feelings of loss of control. Unlike bulimia nervosa, individuals with BED do not engage in compensatory behaviors like purging. This disorder can lead to various health issues, including obesity, depression, and anxiety. Treatment often involves counseling and medication to address both the psychological and physical aspects of the disorder.
What It Is:
Recurrent episodes of eating large quantities of food in a short period
Feeling out of control during binge episodes
Unlike bulimia, no compensatory behaviors (e.g., purging)
Symptoms to Watch For:
✅ Frequent complaints of eating past fullness
✅ Emotional distress, shame, or guilt after eating
✅ Weight fluctuations (but not always present)
✅ High risk of obesity, diabetes, and cardiovascular disease
Treatment Options:
💊 Cognitive Behavioral Therapy (CBT) – gold standard for treatment
💊 Medications such as SSRIs or Vyvanse for impulse control
💊 Nutritional counseling and meal planning
2️⃣ Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID involves a persistent avoidance of certain foods or a restriction in overall food intake, not driven by body image concerns but often due to sensory sensitivities or past negative experiences with food. This can result in significant nutritional deficiencies and growth issues, particularly in younger individuals. Symptoms include extreme pickiness, avoidance of specific textures or colors, and a lack of interest in eating. Treatment approaches may include therapy to address underlying anxieties and sensory aversions.
What It Is:
Extreme food avoidance or restriction, but not due to body image concerns
Often related to sensory sensitivities, fear of choking, or past trauma
Symptoms to Watch For:
✅ Severe pickiness (avoidance of specific textures, colors, or smells)
✅ Failure to meet nutritional needs – weight loss, fatigue, poor growth in children
✅ Nutrient deficiencies (iron, B12, protein malnutrition)
✅ Anxiety around eating or refusal to eat in social settings
Treatment Options:
💊 Exposure therapy to increase food variety
💊 Dietitian-guided nutritional support to prevent deficiencies
💊 Occupational therapy for sensory-based food aversions
💊 Psychotherapy to address underlying fears
3️⃣ Other Specified Feeding or Eating Disorders (OSFED)
OSFED encompasses eating disorders that don't meet the exact criteria for other specific disorders but still pose significant health risks. Examples include atypical anorexia nervosa, where individuals meet all criteria for anorexia but maintain a normal weight, and purging disorder, characterized by purging behaviors without binge eating. Research indicates that individuals with OSFED can experience levels of severity and treatment outcomes comparable to those with threshold eating disorders, underscoring the need for appropriate recognition and intervention.
What It Is:
A category for individuals who don’t meet full criteria for anorexia, bulimia, or BED but still have serious eating disorder symptoms
Examples: Atypical Anorexia Nervosa (severe restriction but normal BMI) or Purging Disorder (self-induced vomiting without binging)
Symptoms to Watch For:
✅ Obsessive thoughts about food, weight, or body shape
✅ Extreme dieting, fasting, or purging behaviors
✅ Dizziness, fainting, bradycardia, or electrolyte imbalances
✅ Significant distress but no full anorexia or bulimia diagnosis
Treatment Options:
💊 CBT & Dialectical Behavior Therapy (DBT) for emotional regulation
💊 Medical monitoring for complications (electrolyte imbalance, cardiac issues)💊 Nutritional rehabilitation with supervised refeeding plans
💊 Support groups for long-term recovery
Why This Matters for Nursing Students
💡 Early identification of eating disorders improves patient outcomes
💡 Holistic care – Look beyond weight to mental health & nutritional status
💡 Patient advocacy – Nurses play a key role in supporting recovery & reducing stigma
As future healthcare professionals, your awareness of these conditions can make a life-changing impact on your patients. If you suspect an eating disorder in a patient, compassionate screening and referral to specialists is the first step toward recovery.
Recognizing and understanding these disorders is vital for early intervention and effective treatment. If you or someone you know is struggling with an eating disorder, seeking professional help is a courageous and essential step toward recovery.
RESOURCES:
Author - Saving Grace Medical Academy Ltd
Jason T
Retired EMT - Heart & Stroke Foundation Senior Instructor