In the medical sense, and according to the International Classification of Mental Disorders (ICD-10, Chapter V (F)), the term "Eating Disorders" encompasses:
Other eating behaviors, such as a vegan diet, orthorexia, or permanent dieting, are not automatically classified as illnesses. For an eating style to be considered a medical disorder, the following criteria, as defined by the ICD-10 (2015), must be met: abnormal weight, excessive preoccupation with weight, body shape, and appearance, counter-regulatory behaviors to counteract perceived weight gain, distorted self-perception of one's weight or body shape, physical health consequences, deficiencies, or other physical sequelae due to inadequate or imbalanced nutrition, subjective distress or functional impairment in everyday life.
The following questions can help identify potential signs of an eating disorder:
According to the International Classification of Diseases (ICD-10), addictive behavior is diagnosed when three or more of the following criteria are met:
While eating disorders are not officially classified as addictive disorders, some behaviors associated with eating disorders align with these criteria. Unlike addictive substances, food does not directly affect the central nervous system or consciousness, and physical dependence with withdrawal symptoms does not develop. However, recent research highlights similarities between the neurobiological processes in the reward systems of individuals with eating disorders and those with substance addictions.
A study conducted by the University of Zurich on behalf of the BAG analyzed the prevalence of eating disorders within the Swiss population. The lifetime prevalence rates (the likelihood of experiencing the disorder at least once in a lifetime) for women are:
For men, the rates are significantly lower:
Eating disorders predominantly affect individuals under the age of 40. The study also provided annual prevalence rates (12-month prevalence):
While anorexia nervosa and bulimia nervosa are significantly less common in men than in women, binge-eating disorder occurs at nearly the same frequency in both sexes. However, the nature of eating disorders in men often differs. Men are more likely to experience anxiety related to athletic performance and muscle mass than weight or beauty concerns. Both men and women may have distorted body ideals. In men, dissatisfaction often stems from discrepancies between their body fat, weight, or muscularity and societal ideals. Dissatisfaction in men is more likely to lead to excessive physical activity rather than starvation or purging. Binge eating seems more socially accepted in men, making it less frequently identified as a clinical disorder.
The development of eating disorders is typically multifactorial, meaning it results from a combination of genetic, biological, psychological, and environmental influences. These factors vary for each individual. On the one hand certain genetic or biological sensitivities, such as a tendency toward body dysmorphic disorder (distorted perception of one’s own body), can increase the likelihood of developing an eating disorder. On the other hand, life experiences, such as peer or sports-related pressures, societal beauty standards, or family stresses, can shape attitudes toward body image and weight. Striving to meet a specific body ideal may serve as a way to stabilize low self-esteem, manage unpleasant emotions (e.g., "After a binge, I feel relieved for a short time"), freedoms (e.g., "Eating is the only thing I decide alone") or form a sense of emotional connection (e.g., "Bulimia is my friend").
Eating disorders are often described as diseases of modern Western industrialized societies, although historical cases of anorexia and ascetic ideals date back to the 19th century. The constant portrayal of a "perfect," excessively slim body in the media has contributed to a rise in eating disorders, particularly anorexia. Many school-aged children and adolescents are already increasingly dissatisfied with their bodies, even when they are within a normal weight range. A WHO survey (2012) of 16-17-year-olds in 39 countries found that nearly half of adolescents, especially girls, felt they were "too fat," despite most being within a healthy weight range. The Germany’s Next Topmodel Study (GNTP, 2015) found that up to 92% of 16-year-olds watched the show regularly. These viewers were significantly more likely to feel too fat than their peers. This dissatisfaction was reinforced not only by watching the show but also by discussing it with peers or parents.
The media frequently uses digitally altered images of models, promoting an unrealistic standard that equates excessive slimness with beauty. These ideals create pressure across all age groups. At critical stages of identity development, they are especially vulnerable to peer criticism and media influence. Media representation suggests that slimness is achievable at all life stages, increasing pressure on these groups to conform to unattainable standards. During the critical phase of identity development, children and adolescents are particularly receptive to judgmental peer comments.
While media and societal beauty standards play a significant role in the development of eating disorders, other factors such as perfectionism, low self-esteem, and difficulties managing negative emotions often serve as additional triggers. The gap between an individual’s reality and the idealized body image perpetuated by media further exacerbates the risk.
Following diets such as Metabolic Balance does not automatically increase the risk of developing an eating disorder. However, prolonged or compulsive dieting behavior can place significant physical stress on the body and, when combined with other risk factors, may contribute to the development of disordered eating behaviors.
Early treatment of an eating disorder is critical for improving outcomes. Initial points of contact include counseling and specialist centers, general practitioner, or psychotherapists. You can find contact addresses under ADDRESSES. Additionally, you are welcome to reach out to ENES directly via the contact form for further information and support.
Night Eating Syndrome (NES) is characterized by a strong craving for food after dinner or during the night, often accompanied by a feeling of loss of control and the consumption of large amounts of food in a short period. NES is typically defined by consuming more than 25% of daily caloric intake after dinner or at night, at least twice per week for a minimum of three months. In the morning, those affected often feel a lack of hunger and eat restricted during the day due to fear of weight gain. This behavior disrupts circadian rhythms and sleep structure, leading to irregular eating and sleeping patterns, as well as daytime fatigue. Stress can act as both a trigger and a consequence of nocturnal eating, with studies showing elevated stress hormone levels. Eating at night is often used as a calming strategy or a method to fall asleep. NES commonly manifests between the ages of 20 and 30, whereby about 60% of those affected are women.
NES is currently being re-evaluated as a distinct medical diagnosis. While it is categorized as an eating disorder rather than a sleep disorder, ongoing scientific studies are exploring its causes and treatment options. The defining characteristic is the food cravings, which serve as a cardinal symptom of the condition.
Following diets such as Metabolic Balance or similar programs does not inherently increase the risk of developing an eating disorder. However, prolonged or compulsive dieting can place physical stress on the body and, when combined with other risk factors, may lead to disordered eating behaviors.