Bulimia typically involves rapid and out-of-control eating, which may stop when the bulimic is interrupted by another person or the stomach hurts from over-extension, followed by self-induced vomiting or other forms of purging. This cycle may be repeated several times a week or, in more serious cases, several times a day and may directly cause:

- Chronic gastric reflux after eating, secondary to vomiting

- Dehydration and hypokalemia due to renal potassium loss in the presence of alkalosis and frequent vomiting

- Electrolyte imbalance, which can lead to abnormal heart rhythms, cardiac arrest, and even death

- Esophagitis, or inflammation of the esophagus

- Mallory-Weiss tears

- Boerhaave syndrome, a rupture in the esophageal wall due to vomiting

- Oral trauma, in which repetitive insertion of fingers or other objects causes lacerations to the lining of the mouth or throat

- Russell's sign: calluses on knuckles and back of hands due to repeated trauma from incisors

- Perimolysis, or severe dental erosion of tooth enamel

- Swollen salivary glands (for example, in the neck, under the jaw line)

- Gastroparesis or delayed emptying

- Constipation

- Peptic ulcers

- Infertility

- Constant weight fluctuations are common

These are some of the many signs that may indicate whether someone has bulimia nervosa:

- A fixation on the number of calories consumed

- A fixation on and extreme consciousness of ones weight

- Low self-esteem and/or self harming

- Suicidal tendencies

- Low blood pressure

- An irregular menstrual cycle in woman

- Regular trips to the bathroom, especially soon after eating

- Depression, anxiety disorders and sleep disorders

- Frequent occurrences involving consumption of abnormally large portions of food

- The use of laxatives and diet pills

- Unhealthy/dry skin, hair, nails and lips

- A lack of energy

As with many psychiatric illnesses, delusions can occur, in conjunction with other signs and symptoms, leaving the person with a false belief that is not ordinarily accepted by others.

People with bulimia nervosa may also exercise to a point that excludes other activities.

These eating disorders are specified as mental disorders in standard medical manuals, such as in the ICD-10, the DSM-5, or both.

- Anorexia nervosa (AN), characterized by lack of maintenance of a healthy body weight, an obsessive fear of gaining weight or refusal to do so, and an unrealistic perception, or non-recognition of the seriousness, of current low body weight. Anorexia can cause menstruation to stop, and often leads to bone loss, loss of skin integrity, etc. It greatly stresses the heart, increasing the risk of heart attacks and related heart problems. The risk of death is greatly increased in individuals with this disease. The most underlining factor researchers are starting to take notice of is that it may not just be a vanity, social, or media issue, but it could also be related to biological and or genetic components. The DSM-5 contains many changes that better represent patients with these conditions. The DSM-IV required amenorrhea (the absence of the menstrual cycle) to be present in order to diagnose a patient with anorexia. This is no longer a requirement in the DSM-5.

- Bulimia nervosa (BN), characterized by recurrent binge eating followed by compensatory behaviors such as purging (self-induced vomiting, eating to the point of vomiting, excessive use of laxatives/diuretics, or excessive exercise). Fasting and over-exercising may also be used as a method of purging following a binge.

- Muscle dysmorphia is characterized by appearance preoccupation that one's own body is too small, too skinny, insufficiently muscular, or insufficiently lean. Muscle dysmorphia affects mostly males.

- Binge Eating Disorder (BED), characterized by recurring binge eating at least once a week for over a period of 3 months while experiencing lack of control and guilt after overeating. The disorder can develop within individuals of a wide range of ages and socioeconomic classes.

- Other Specified Feeding or Eating Disorder (OSFED) is an eating or feeding disorder that does not meet full DSM-5 criteria for AN, BN, or BED. Examples of otherwise-specified eating disorders include individuals with atypical anorexia nervosa, who meet all criteria for AN except being underweight, despite substantial weight loss; atypical bulimia nervosa, who meet all criteria for BN except that bulimic behaviors are less frequent or have not been ongoing for long enough; purging disorder; and night eating syndrome.

Bulimia nervosa is a disorder characterized by binge eating and purging, as well as excessive evaluation of one's self-worth in terms of body weight or shape. Purging can include self-induced vomiting, over-exercising, and the use of diuretics, enemas, and laxatives. Anorexia nervosa is characterized by extreme food restriction and excessive weight loss, accompanied by the fear of being fat. The extreme weight loss often causes women and girls who have begun menstruating to stop having menstrual periods, a condition known as amenorrhea. Although amenorrhea was once a required criterion for the disorder, it is no longer required to meet criteria for anorexia nervosa due to its exclusive nature for sufferers who are male, post-menopause, or who do not menstruate for other reasons. The DSM-5 specifies two subtypes of anorexia nervosa—the restricting type and the binge/purge type. Those who suffer from the restricting type of anorexia nervosa restrict food intake and do not engage in binge eating, whereas those suffering from the binge/purge type lose control over their eating at least occasionally and may compensate for these binge episodes. The most notable difference between anorexia nervosa binge/purge type and bulimia nervosa is the body weight of the person. Those diagnosed with anorexia nervosa binge/purge type are underweight, while those with bulimia nervosa may have a body weight that falls within the range from normal to obese.

Anorexia nervosa is an eating disorder characterized by attempts to lose weight, to the point of starvation. A person with anorexia nervosa may exhibit a number of signs and symptoms, the type and severity of which may vary and may be present but not readily apparent.

Anorexia nervosa, and the associated malnutrition that results from self-imposed starvation, can cause complications in every major organ system in the body. Hypokalaemia, a drop in the level of potassium in the blood, is a sign of anorexia nervosa. A significant drop in potassium can cause abnormal heart rhythms, constipation, fatigue, muscle damage and paralysis.

Symptoms may include:

- A low body mass index for one's age and height.

- Amenorrhea, a symptom that occurs after prolonged weight loss; causes menses to stop, hair becomes brittle, and skin becomes yellow and unhealthy.

- Fear of even the slightest weight gain; taking all precautionary measures to avoid weight gain or becoming "overweight".

- Rapid, continuous weight loss.

- Lanugo: soft, fine hair growing over the face and body.

- An obsession with counting calories and monitoring fat contents of food.

- Preoccupation with food, recipes, or cooking; may cook elaborate dinners for others, but not eat the food themselves or consume a very small portion.

- Food restrictions despite being underweight or at a healthy weight.

- Food rituals, such as cutting food into tiny pieces, refusing to eat around others and hiding or discarding of food.

- Purging: May use laxatives, diet pills, ipecac syrup, or water pills to flush food out of their system after eating or may engage in self-induced vomiting though this is a more common symptom of bulimia.

- Excessive exercise including micro-exercising, for example making small persistent movements of fingers or toes.

- Perception of self as overweight, in contradiction to an underweight reality.

- Intolerance to cold and frequent complaints of being cold; body temperature may lower (hypothermia) in an effort to conserve energy due to malnutrition.

- Hypotension or orthostatic hypotension.

- Bradycardia or tachycardia.

- Depression, anxiety disorders and insomnia.

- Solitude: may avoid friends and family and become more withdrawn and secretive.

- Abdominal distension.

- Halitosis (from vomiting or starvation-induced ketosis).

- Dry hair and skin, as well as hair thinning.

- Chronic fatigue.

- Rapid mood swings.

- Having feet discoloration causing an orange appearance.

- Having severe muscle tension + aches and pains.

- Evidence/habits of self harming or self-loathing.

- Admiration of thinner people.

With regards to interoception, people with bulimia report reduced sensitivity to many kinds of internal and external sensations. For example, some show increased thresholds to heat pain compared and report the same level of satiety after consuming more calories than do healthy subjects.

Interoception has an important role in homeostasis and regulation of emotions and motivation. Anorexia has been associated with disturbances to interoception. People with anorexia concentrate on distorted perceptions of their body exterior due to fear of looking overweight. Aside from outer appearance, they also report abnormal bodily functions such as indistinct feelings of fullness. This provides an example of miscommunication between body and brain. Further, people with anorexia experience abnormally intense cardiorespiratory sensations, particularly of the breath, most prevalent before they consume a meal. People with anorexia also report inability to distinguish emotions from bodily sensations in general, called alexithymia. In addition to metacognition, people with anorexia also have difficultly with social cognition including interpreting other’s emotions, and demonstrating empathy. Abnormal interoceptive awareness like these examples have been observed so frequently in anorexia that they have become key characteristics of the illness.

Binge eating is the core symptom of BED; however, not everyone who binge eats has BED. An individual may occasionally binge eat without experiencing many of the negative physical, psychological, or social effects of BED. This example may be considered an eating problem (or not), rather than a disorder. Precisely defining binge eating can be problematic, however binge eating episodes in BED are generally described as having the following potential features:

- Eating much faster than normal during a binge perhaps in a short space of time

- Eating until feeling uncomfortably full

- Eating a large amount when not hungry

- Subjective loss of control over how much or what is eaten

- Binges may be planned in advance, involving the purchase of special binge foods, and the allocation of specific time for binging, sometimes at night

- Eating alone or secretly due to embarrassment over the amount of food consumed

- There may be a dazed mental state during the binge

- Not being able to remember what was eaten after the binge

- Feelings of guilt, shame or disgust following a food binge

In contrast to bulimia nervosa, binge eating episodes are not regularly followed by activities intended to prevent weight gain, such as self-induced vomiting, laxative or enema misuse, or strenuous exercise. BED is characterized more by overeating than dietary restriction and over concern about body shape. Obesity is common in persons with BED, as are depressive features, low self-esteem, stress and boredom.

Someone with anorexia athletica can experience numerous signs and symptoms, a few of which are listed below. The seriousness of the symptoms is dependent on the individual, and more symptoms come with the length the athlete excessively exercises. If anorexia athletica persists for long enough, the individual can become malnourished, which eventually leads to further complications in major organs such as the liver, kidney, heart and brain.

- Excessive exercise

- Obsessive behavior with calories, fat, and weight

- Self-worth is based on physical performance

- Enjoyment of sports is diminished or gone

- Denying the over exercising is a problem

Exercise Bulimia can sometimes go unnoticed because exercise is something that is seen as healthy, but just because a person looks healthy does not mean they are. Compulsive exercisers will often schedule their lives around exercise just as those with eating disorders schedule their lives around eating (or not eating). Other indications of compulsive exercise are:

- Missing work, school and other important events in order to work out

- Working out with an injury or while sick

- Working out secretly or away from noticeable sight

- Becoming unusually depressed if unable to exercise

- Working out for hours at a time each day

- Not taking any rest or recovery days

- Defining self-worth in terms of performance

- Justifies excessive behavior by defining self as a "special" elite athlete

- Depression or agitation when unable to work out

- Amenorrhea, the stop of a woman's menstrual cycle

- Isolation from others while working out

- Lack of interest in friends and eating

- Lack of sleep

Binge eating disorder (BED) is an eating disorder characterized by frequent and recurrent binge eating episodes with associated negative psychological and social problems, but without subsequent purging episodes (e.g. vomiting).

BED is a recently described condition, which was required to distinguish binge eating similar to that seen bulimia nervosa but without characteristic purging. Individuals who are diagnosed with bulimia nervosa and binge eating disorder exhibit similar patterns of compulsive overeating, neurobiological features of dysfunctional cognitive control and food addiction, and biological and environmental risk factors. Indeed, some consider BED a milder version of bulimia nervosa, and that the conditions are on the same spectrum.

Binge eating is one of the most prevalent eating disorders among adults, though there tends to be less media coverage and research about the disorder in comparison to anorexia nervosa and bulimia nervosa.

The five OSFED examples that can be considered eating disorders include atypical AN, BN (of low frequency and/or limited duration), BED (of low frequency and/or limited duration), purging disorder, and NES. Of note, OSFED is not limited to these five examples, and can include individuals with heterogeneous eating disorder presentations (i.e., OSFED-other). Another term, Unspecified Feeding or Eating Disorder (UFED), is used to describe individuals for whom full diagnostic criteria are not met but the reason remains unspecified or the clinician does not have adequate information to make a more definitive diagnosis.

- Atypical Anorexia Nervosa: In atypical AN, individuals meet all of the criteria for AN, with the exception of the weight criterion: the individual's weight remains within or above the normal range, despite significant weight loss.

- Atypical Bulimia Nervosa: In this sub-threshold version of BN, individuals meet all criteria for BN, with the exception of the frequency criterion: binge eating and inappropriate compensatory behaviors occur, on average, less than once a week and/or for fewer than 3 months.

- Binge-eating disorder (of low frequency and/or limited duration): In this sub-threshold version of BED, individuals must meet all criteria for BED, with the exception of the frequency criterion: binge eating occurs, on average, less than once a week and/or for fewer than 3 months.

- Purging Disorder: In purging disorder, purging behavior aimed to influence weight or shape is present, but in the absence of binge eating.

- Night Eating Syndrome: In NES, individuals have recurrent episodes of eating at night, such as eating after awakening from sleep or excess calorie intake after the evening meal. This eating behavior is not culturally acceptable by group norms, such as the occasional late-night munchies after a gathering. NES includes an awareness and recall of the eating, is not better explained by external influences such as changes in the individual's sleep-wake cycle, and causes significant distress and/or impairment of functioning. Though not defined specifically in "DSM-5", research criteria for this diagnosis proposed adding the following criteria (1) the consumption of at least 25% of daily caloric intake after the evening meal and/or (2) evening awakenings with ingestions at least twice per week.

Disordered eating describes a variety of abnormal eating behaviors that, by themselves, do not warrant diagnosis of an eating disorder.

Disordered eating includes behaviors that are common features of eating disorders, such as:

- Chronic restrained eating.

- Compulsive eating.

- Binge eating, with associated loss of control.

- Self-induced vomiting.

Disordered eating also includes behaviors that are not characteristic of any eating disorder, such as:

- Irregular, chaotic eating patterns.

- Ignoring physical feelings of hunger and satiety (fullness).

- Use of diet pills.

- Emotional eating.

- Night eating.

- "Secretive food concocting": the consumption of embarrassing food combinations, such as mashed potatoes mixed with sandwich cookies. See also Food craving § Pregnancy and Nocturnal sleep-related eating disorder § Symptoms and behaviors.

Typically the eating is done rapidly and a person will feel emotionally numb and unable to stop eating.

Most people who have eating binges try to hide this behavior from others, and often feel ashamed about being overweight or depressed about their overeating. Although people who do not have any eating disorder may occasionally experience episodes of overeating, frequent binge eating is often a symptom of an eating disorder.

Binge-eating disorder, as the name implies, is characterized by uncontrollable, excessive eating, followed by feelings of shame and guilt. Unlike those with bulimia, those with binge-eating disorder symptoms typically do not purge their food, fast, or excessively exercise to compensate for binges. Additionally, these individuals tend to diet more often, enroll in weight-control programs and have a history of family obesity. However, many who have bulimia also have binge-eating disorder.

→Swollen of salivary glands lead to the change of facial shape

→If gastric juice is flown to the esophagus constantly, it will lead to a corrosion of the wall of esophagus(long term harmful effect)

→If gastric juice is flown to the oral cavity, it will lead to a corrosion of the oral tissue, dissolve the enamel and consequently cause the loss of teeth/increase chances for tooth decay

The three general categories for an EDNOS diagnosis are subthreshold symptoms of anorexia or bulimia, a mixture of both anorexia or bulimia, and eating behaviors that are not particularized by anorexia and bulimia. EDNOS is no longer considered a diagnosis in "DSM-5"; those displaying symptoms of what would previously have been considered EDNOS are now classified under Other Specified Feeding or Eating Disorder.

Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable eating. It is sometimes a symptom of binge eating disorder or compulsive overeating disorder. During such binges, a person rapidly consumes an excessive quantity of food. A diagnosis of binge eating is associated with feelings of loss of control.

Eating disorder not otherwise specified (EDNOS) is an eating disorder that does not meet the criteria for: anorexia nervosa, bulimia nervosa, or binge eating. Individuals with EDNOS usually fall into one of three groups: sub-threshold symptoms of anorexia or bulimia, mixed features of both disorders, or extremely atypical eating behaviors that are not characterized by either of the other established disorders.

People with EDNOS have similar symptoms and behaviors to those with anorexia and bulimia, and can face the same dangerous risks.

EDNOS is the most prevalent eating disorder; about 60% of adults treated for eating disorders are diagnosed with EDNOS. EDNOS occurs in both sexes.

Anorexia athletica (sports anorexia), also referred to as hypergymnasia is an eating disorder characterized by excessive and compulsive exercise. An athlete suffering from sports anorexia tends to over exercise to give themselves a sense of having control over their body. Most often, people with the disorder tend to feel they have no control over their lives other than their control of food and exercise. In actuality, they have no control; they cannot stop exercising or regulating food intake without feeling guilty. Generally, once the activity is started, it is difficult to stop because the person is seen as being addicted to the method adopted.

Anorexia athletica is used to refer to "a disorder for athletes who engage in at least one unhealthy method of weight control". Unlike anorexia nervosa, anorexia athletica does not have as much to do with body image as it does with performance. Athletes usually begin by eating more 'healthy' foods, as well as increasing their training, but when people feel like that is not enough and start working out excessively and cutting back their caloric intake until it becomes a psychological disorder.

Hypergymnasia and anorexia athletica are not recognized as mental disorders in any of the medical manuals, such as the ICD-10 or the DSM-IV, nor is it part of the proposed revision of this manual, the DSM-5. If this were the case, there would be a 10–15% increase in mental disorders in sports. A study at the Anorexia Centre at Huddinge Hospital in Stockholm, Sweden showed that sports anorexia can result in mental disorders. The anxiety, stress, and pressure people with sports anorexia put on themselves (as well as the pressure parents and coaches can put on the athlete) can cause mental disorders.

Purging disorder is an eating disorder characterized by recurrent purging (self-induced vomiting, misuse of laxatives, diuretics, or enemas) to control weight or shape in the absence of binge eating episodes.

Purging disorder differs from bulimia nervosa (BN) because individuals with purging disorder do not consume a large amount of food before they purge. In current diagnostic systems, purging disorder is a form of Other specified feeding or eating disorder (OSFED). Research indicates that purging disorder may be as common as bulimia nervosa or anorexia nervosa in women, that the syndrome is associated with clinically significant levels of distress, and that it appears to be distinct from bulimia nervosa on measures of hunger and ability to control food intake. Some of the signs of purging disorder are frequent trips to the bathroom directly after a meal, frequent use of laxatives, and obsession over one's appearance and weight. Other signs include swollen cheeks, popped blood vessels in the eyes, and clear teeth which are all signs of excessive vomiting.

Overeating is the excess food in relation to the energy that an organism expends (or expels via excretion), leading to weight gaining

and often obesity. It may be regarded as an eating disorder.

This term may also be used to refer to specific episodes of over-consumption. For example, many people overeat during festivals or while on holiday.

Overeating can sometimes be a symptom of binge eating disorder or bulimia.

Compulsive over eaters depend on food to comfort themselves when they are stressed, suffering bouts of depression, and have feelings of helplessness.

In a broader sense, hyperalimentation includes excessive food administration through other means than eating, e.g. through parenteral nutrition.

The differential diagnoses of anorexia nervosa (AN) includes various types of medical and psychological conditions, which may be misdiagnosed as AN. In some cases, these conditions may be comorbid with AN because the misdiagnosis of AN is not uncommon. For example, a case of achalasia was misdiagnosed as AN and the patient spent two months confined to a psychiatric hospital. A reason for the differential diagnoses that surround AN arise mainly because, like other disorders, it is primarily, albeit defensively and adaptive for, the individual concerned.

Anorexia Nervosa is a psychological disorder characterized by extremely reduced intake of food. People suffering from Aneroxia Nervosa have a low self-image and consider themselves overweight.

Common behaviors and signs of someone suffering from AN:

- Forcing oneself to vigorously exercise even in adverse conditions or when their health does not permit it.

- Forcing own self to urinate and excrete waste product from the body.

- Using substituted amphetamines (stimulants that can reduce appetite) to reduce appetite.

- Skin turning yellow

The short-term physical effect associated with dopamine and endogenous opiate release in the brain reward center is low level euphoria, a decrease in both anxiety and emotional pain also known as a “food coma.” The long-term physical effects may vary. The health consequences can be severe.

If a food addict has obesity, it can be associated with the following:

- diabetes

- high blood pressure

- high cholesterol and triglycerides

- osteoarthritis in the knees

- hips and back

- fungal infections in skin folds that are hard to clean

- congestive heart failure

- shortness of breath

- coronary artery disease

- death.

Obesity has been attributed to eating behavior or fast food, personality issues, depression, addiction, and/or genetics. One proposed explanation of epidemic obesity is food addiction.

A food addiction features compulsive overeating, such as binge eating behavior, as its core and only defining feature. There are several potential signs that a person may be suffering from compulsive overeating. Common behaviors of compulsive overeaters include eating alone, consuming food quickly, and gaining weight rapidly, and eating to the point of feeling sick to the stomach. Other signs include significantly decreased mobility and the withdrawal from activities due to weight gain. Emotional indicators can include feelings of guilt, a sense of loss of control, depression and mood swings.

Hiding consumption is an emotional indicator of other symptoms that could be a result of having a food addiction. Hiding consumption of food includes eating in secret; late at night while everybody else is asleep, in the car, and hiding certain foods until ready to consume in private. Other signs of hiding consumption are avoiding social interactions to eat the specific foods that are craved. Other emotional indicators are Inner guilt; which includes making up excuses to why the palatable food would be beneficial to consume, and then feeling guilty about it shortly after consuming.

Sense of loss of control is indicated in many ways which includes, going out of the way to obtain specific foods, spending unnecessary amounts of money on foods to satisfy cravings. Difficulty concentrating on things such as a job or career can indicate sense of loss of control by not being to organize thoughts leading to a decrease in efficiency. Other ways to indicate the sense of loss of control, are craving food despite being full. One may set rules to try to eat healthy but the cravings over rule and the rules are failed to be followed. One big indicator of loss of control due to food addiction is even though one knows they have a medical problem caused by the craved foods, they cannot stop consuming the foods, which can be detrimental to their health.

Food addiction has some physical signs and symptoms. Decreased energy; not being able to be as active as in the past, not being able to be as active as others around, also a decrease in efficiency due to the lack of energy. Having trouble sleeping; being tired all the time such as fatigue, oversleeping, or the complete opposite and not being able to sleep such as insomnia. Other physical signs and symptoms are restlessness, irritability, digestive disorders, and headaches.

In extreme cases food addiction can result in some suicidal thoughts.

Other specified feeding or eating disorder or OSFED is the "DSM-5" category that replaces the category formerly called Eating Disorder Not Otherwise Specified (EDNOS) in "DSM-IV", and that captures feeding disorders and eating disorders of clinical severity that do not meet diagnostic criteria for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), pica, or rumination disorder. OSFED includes five examples: atypical AN, BN (of low frequency and/or limited duration), BED (of low frequency and/or limited duration), purging disorder, and night eating syndrome (NES).

Some of the differential or comorbid medical diagnoses may include:

- achalasia – There have been cases where achalasia, a disorder of the esophagus which affects peristalsis, has been misdiagnosed as AN. It has been reported in cases where there is sub-clinical manifestation of anorexia nervosa and also in cases where the full diagnostic criteria AN have been met.

- acute pandysautonomia is one form of an autonomic neuropathy, which is a collection of various syndromes and diseases which affect the autonomic neurons of the autonomic nervous system (ANS). Autonomic neuropathies may be the result of an inherited condition or they may be acquired due to various premorbid conditions such as diabetes and alcoholism, bacterial infection such as Lyme disease or a viral illness. Some of the symptoms of ANS which may be associated with an ED include nausea, dysphagia, constipation, pain in the salivary glands, early saiety. It also affects peristalsis in the stomach. Acute pandysautonomia may cause emotional instability and has been misdiagnosed as various psychiatric disorders including hysterical neurosis and anorexia nervosa.

- Lupus: various neuropsychiatric symptoms are associated with systemic lupus erythematosus (SLE), including depression. Anorexia and weight loss also may occur with SLE and while rare it may be misdiagnosed as AN.

- Lyme disease is known as the "great imitator", as it may present as a variety of psychiatric or neurologic disorders including anorexia nervosa. "A 12 year old boy with confirmed Lyme arthritis treated with oral antibiotics subsequently became depressed and anorectic. After being admitted to a psychiatric hospital with the diagnosis of anorexia nervosa, he was noted to have positive serologic tests for Borrelia burgdorferi. Treatment with a 14 day course of intravenous antibiotics led to a resolution of his depression and anorexia; this improvement was sustained on 3 year follow-up." Serologic testing can be helpful but should not be the sole basis for diagnosis. The Centers for Disease Control (CDC) issued a cautionary statement (MMWR 54;125) regarding the use of several commercial tests. Clinical diagnostic criteria have been issued by the CDC (CDC, MMWR 1997; 46: 531-535).

- Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare genetic disorder characterized by gastrointestinal dysmotility, severe cachexia progressive external ophthalmoplegia, post-prandial emesis (vomiting after eating), peripheral neuropathy, and diffuse leukoencephalopathy. Onset is prior to age 20 in 60% of cases. ""Miss A" was a 21-year-old Indian woman diagnosed as having treatment-resistant anorexia nervosa." It was subsequently proven to be MNGIE

- superior mesenteric artery syndrome (SMA syndrome) "is a gastrointestinal disorder characterized by the compression of the third or transverse portion of the duodenum against the aorta by the superior mesenteric artery resulting in chronic partial, incomplete, acute or intermittent duodenal obstruction". It may occur as a complication of AN or as a differential diagnosis. There have been reported cases of a tentative diagnosis of AN, where upon treatment for SMA syndrome the patient is asymptomatic.

- Addison's disease is a disorder of the adrenal cortex which results in decreased hormonal production. Addison's disease, even in subclinical form, may mimic many of the symptoms of anorexia nervosa.

- Brain tumors: There are multiple cases were the neuropsychiatric symptoms of a brain tumor were attributed to AN, resulting in misdiagnosis. The tumors in these cases were noted in various regions of the brain including the medulla oblongata, hypothalamus, pituitary gland, pineal gland and the obex.

- Simmond's disease (organic hypopituitarism) – "A 20-year-old Japanese man with a hypothalamic tumor which caused hypopituitarism and diabetes insipidus was mistakenly diagnosed as anorexia nervosa because of anorexia, weight loss, denial of being ill, changes in personality, and abnormal behavior resembling the clinical characteristics of anorexia nervosa"

- Brain calcification either dystrophic calcification or metastatic calcification can present with neuropsychiatric symptoms including those associated with AN and comorbid disorders such as obsessive compulsive disorder.

- cysts that occur in the central nervous system such as dermoid cysts and arachnoid cysts can cause neuropsychiatric symptoms including psychosis.

- Celiac disease is an inflammatory disorder triggered by peptides from wheat and similar grains which cause an immune reaction in the small intestine. "information on the role of the gastrointestinal system in causing or mimicking eating disorders is scarce."(Leffler DA "et al.")

- Gall bladder disease which may be caused by inflammation, infection, gallstones, obstruction of the gallbladder or torsion of the gall bladder – Many of the symptoms of gall bladder disease may mimic anorexia nervosa (AN). Laura Daly, a woman from Missouri, suffered from an inherited disorder in which the gall bladder was not properly attached; the resultant complications led to multiple erroneous diagnoses of AN. Upon performance of a CCK test, standard imaging techniques are done with the patient lying prone, in this instance it was done with the patient in an upright position. The gall bladder was shown to be in an abnormal position having flipped over the liver. The gallbladder was removed and the patient has since recovered. The treatment was performed by William P. Smedley in Pennsylvania.

- colonic tuberculosis misdiagnosed as anorexia nervosa in a physician at the hospital where she worked – "This patient, who had severe wasting, was misdiagnosed as having anorexia nervosa despite the presence of other symptoms suggestive of an organic disease, namely, fever and diarrhea"(Madani, A 2002).

- Crohn's disease: "We report three cases of young 18 to 25 year-old girls, initially treated for anorexia nervosa in a psychiatric department. Diagnosis of Crohn's disease was made within 5 to 13 years."(Blanchet C, Luton JP. 2002)"This disease should be diagnostically excluded before accepting anorexia nervosa as final diagnosis". (Wellmann W "et al.")

- hypothyroidism, hyperthyroidism, hypoparathyroidism and hyperparathyroidism may mimic some of the symptoms of, can occur concurrently with, be masked by or exacerbate an eating disorder and/or various comorbid disorders such as anxiety and depression.

- Insulinomas are (pancreatic tumors) that cause an overproduction of insulin, causing hypoglycemia. Various neurological deficits have been ascribed to this condition including misdiagnosis as an eating disorder.

- Multiple sclerosis (encephalomyelitis disseminata) is a progressive autoimmune disorder in which the protective covering (myelin sheath) of nerve cells is damaged as a result of inflammation and resultant attack by the bodies own immune system. In its initial presentation, MS has been misdiagnosed as an eating disorder.

Emotional eating is defined as overeating in order to relieve negative emotions. Thus, emotional eating is considered a maladaptive coping strategy. If an individual frequently engages in emotional eating, it can increase the risk of developing other eating disorders, like bulimia and anorexia nervosa. Research has also shown that the presence of an existing eating disorder increases the likelihood that an individual will engage in emotional eating. Given the relationship between serious eating disorders and emotional eating behavior, it is important for clinical psychologists and nutritionists to recognize the signs of emotional eating and provide individuals with treatment. Since emotional eating is utilized to manage negative emotions, treatment necessitates learning healthy and more effective coping strategies.