Eating Disorders are Mental Health Conditions: Awareness and Collaboration Matter

By Simone Seitz and Caroline Rutledge, Carolina Resource Center for Eating Disorders

Eating disorders are often misunderstood or left out of broader mental health conversations. Too frequently, they are framed as issues of choice, discipline, or appearance rather than what they truly are: serious, complex, and potentially fatal mental health conditions.

For organizations like NAMI NC and the communities they serve, understanding eating disorders as mental health illnesses is essential. Eating disorders frequently co-occur with anxiety, depression, trauma-related disorders, obsessive-compulsive disorder, and substance use disorders. Without awareness and identification, they can escalate quickly—often silently—and with devastating consequences.

The Stakes Are High—But Early Intervention Saves Lives

With 1 death every 52 minutes occurring in the U.S. as a direct result of an eating disorder, eating disorders have the second-highest mortality rate of any mental illness.

Without treatment, up to 20% of individuals with serious eating disorders die.

With appropriate treatment, mortality drops significantly—to approximately 2–3%.

Early identification and timely care save lives!

Disordered Eating Matters—Because It Can Be a Precursor

Awareness of disordered eating behaviors (which includes dieting) is critical because these behaviors often function as precursors to eating disorders.

Disordered eating exists on a spectrum and may include:

• Rigid food or exercise rules
• Guilt or shame when unable to maintain those rules
• Preoccupation with food, body, or exercise that negatively affects quality of life
• Compulsive eating
• Compensatory behaviors such as restriction, fasting, purging, laxative or diuretic use, or excessive exercise
• Use of weight-loss supplements or appetite suppressants

Checking in with both behaviors and intentions around food and movement can help determine whether someone is developing an unhealthy relationship. While not everyone who has disordered eating or diets develops an eating disorder, dieting is one of the strongest known risk factors, particularly for individuals with a biological vulnerability.

Eating Disorders Are Not Choices

Eating disorders may involve observable behaviors, but they are far more than behaviors alone. They are psychiatric illnesses with strong biological components, and they can be life-threatening. Research shows that eating disorders are 50–80% genetically influenced. They are not choices, phases, or failures of willpower.

When someone is struggling with an eating disorder, behaviors tend to occur with greater frequency, rigidity, and intensity. What often distinguishes disordered eating from an eating disorder is the degree of obsession with food, exercise, and body-related thoughts. These thoughts can become all-consuming and may include fixation on:

• Calories, ingredients, and measurements
• “Good” versus “bad” foods
• Body size and shape
• Type, duration, or frequency of exercise
• Feelings of failure when rigid rules are not maintained
• Avoidance of social situations involving food or body exposure

It is important to understand that symptoms can overlap, evolve, or change over time—and may still be medically and psychologically dangerous even when they do not fit neatly into diagnostic categories.

Eating Disorders Do Not Have a “Look”

Eating disorders occur in all bodies. They do not discriminate by age, gender, race, class, sexual orientation, or ethnicity. Appearance alone is never a reliable indicator of whether someone is struggling, and neither is a person’s weight.

Signs that may indicate a serious concern include:

• Dieting, weight loss, or food control becoming primary life concerns
• A progressively narrowing range of preferred or “safe” foods
• Eliminating entire food groups
• Obsessive focus on “clean,” “pure,” or “healthy” eating
• Self-esteem overly tied to body image
• Extreme concern with body size or shape
• A perceived need to “burn off” calories
• Excessive or rigid exercise despite illness, injury, or fatigue
• Intense anxiety or distress when unable to exercise
• Physical signs such as dry skin, brittle nails, lanugo, muscle weakness, difficulty concentrating, or feeling cold most of the time
• Noticeable weight fluctuations
• Guilt, shame, or disgust after eating
• Evidence of binge eating, sometimes followed by compensatory behaviors
• Withdrawal from friends or previously enjoyed activities

Click here for a more comprehensive list of ED signs and symptoms.

If thoughts about food, weight, exercise, or body shape are taking up a disproportionate amount of mental space, seeking professional help for early detection is strongly encouraged.

GLP-1 Medications and Emerging Mental Health Risks

As appetite-suppressing medications such as GLP-1 receptor agonists become increasingly common, it is critical to understand their potential implications—especially for individuals with disordered eating or eating disorder histories.

These medications suppress hunger cues and externally regulate eating behavior. For vulnerable individuals, this can:

• Reinforce restriction
• Disrupt natural hunger and fullness signals
• Trigger relapse or new onset of eating disorders
• Lead to higher-acuity illness

Because long-term mental health outcomes are not yet fully understood, screening, education, and ongoing monitoring are essential whenever these medications are considered.

Why Collaboration Between Nonprofits Matters

No single mental health nonprofit organization can address the full scope of needs alone. Collaboration between nonprofits like NAMI North Carolina and Carolina Resource Center for Eating Disorders (CRC for ED) is essential to increasing awareness, reducing stigma, and ensuring people find help sooner.

NAMI’s broad reach in our state—combined with CRC for ED’s expertise—creates pathways for specialized education, earlier identification, informed referrals, and vital support and advocacy. When organizations work together, more individuals, families, and providers know where to turn.

Prevention, Recovery, and Hope

In a culture saturated with dieting and weight stigma, reconnecting with internal cues for nourishment and movement can be challenging—but it is possible. Increasing awareness, reducing bias, and replacing shame with understanding bring us closer to prevention when possible and effective treatment when necessary.

Eating disorders are mental health conditions. They belong in the mental health conversation—and greater reach through collaboration helps increase impact, ensuring no one has to face this disease alone.

Carolina Resource Center for Eating Disorders (CRC for ED) is the only nonprofit in NC providing education, resources, and support to individuals, families, and professionals concerned with disordered eating and recovery from eating disorders.  Programming includes professional development and community outreach, resource and referral services through a Helpline and treatment directory, weekly virtual support group, and independent clinical assessments for individuals with financial hardship and insurance barriers. Carolina Resource Center for Eating Disorders is a small organization doing the work of much larger nonprofits with local, regional, and national reach. All services are provided at no cost and are made possible through the generosity of private donors. Anyone interested in reaching out to CRC for ED can find their Helpline at 828-337-4685 or info@crcfored.com.