In recent years, the debate surrounding eating disorders has been gaining increasing prominence on social media, raising questions about the limits of the pursuit of the "perfect body" and about eating habits that may indicate a problem.
According to the Ministry of Health, in 2022 it was estimated that around 15 million people in Brazil suffered from some type of eating disorder, including anorexia, bulimia, binge eating disorder, and other related conditions. The agency also emphasizes that, according to experts, eating disorders are among those with the highest mortality rates within mental disorders, highlighting the seriousness and urgency of addressing these cases.
In this article, you will understand what eating disorders are, how they manifest, and what the appropriate treatment guidelines should be. Furthermore, throughout the text, we include clarifications from Dr. Celso Garcia, a psychiatrist and coordinator of the postgraduate course in Psychiatry at São Leopoldo Mandic, providing a clinical and specialized perspective on the subject.
What are eating disorders?
By definition, eating disorders involve a persistent disturbance affecting the act of eating or eating-related behaviors. This leads to alterations in food consumption or absorption and significantly impairs physical health, as well as the patient's psychosocial functioning. Among the most well-known eating disorders, we can mention:
Anorexia nervosa
Anorexia nervosa is an eating disorder characterized by an unrelenting pursuit of thinness. This pursuit is accompanied by a distorted body image, an extreme fear of weight gain, and restricted food intake. Additionally, the condition may or may not involve episodes of self-induced vomiting.
As a consequence, there is a significant reduction in body weight, which can reach dangerous levels and seriously compromise physical and mental health.
Bulimia nervosa
Bulimia nervosa, on the other hand, is characterized by episodes of binge eating followed by inappropriate compensatory behaviors, such as self-induced vomiting, use of laxatives or diuretics, fasting, and excessive physical activity.
Binge eating
Binge eating disorder is characterized by episodes of excessive food consumption accompanied by a feeling of loss of control. Unlike bulimia, these episodes are not followed by compensatory behaviors.
Causes and risk factors for eating disorders
The causes of eating disorders are varied and can involve family factors, social influences, and pressures related to body image. According to the MSD Manuals, genetic factors may also play a role in predisposing individuals to anorexia nervosa.
In this context, the incidence of eating disorders tends to be higher in women, especially during adolescence, since they are more vulnerable to anorexia and bulimia nervosa, for example. Furthermore, the incidence is also high when considering cases of people who do not identify as heterosexual or who identify with a gender different from the one assigned at birth.
Amidst the debate about the incidence and spread of eating disorders, mainly focused on the "glamorization of thinness," the discussion arises about medications whose side effects include weight loss. In recent years, appetite suppressant medications have gained fame on social media for their weight-loss potential. These medications have come to be nicknamed "slimming pens.".
Although doctors agree that these medications do indeed aid in weight loss by reducing appetite, they also warn of the risks of indiscriminate use. According to information released by G1, use without guidance can lead to hair loss, vitamin deficiencies, muscle loss, and, in more severe cases, malnutrition.
According to the G1 news article, USP researcher Thamires Capello points out that 45% of purchases of the famous "slimming pens" occurred without a prescription. And, 73% of these were without any history of medical guidance, and more than half were for the purpose of losing weight.
“One of the very characteristic symptoms of anorexia and bulimia nervosa is the pursuit of weight loss methods in a patient who does not need to lose weight. Previously, amphetamines were used, but today medications traditionally used to treat diabetes and obesity, which result in weight loss, are also being used. We can consider these medications 'maintaining factors' of the eating disorder, although they are not the only ones,” explains Dr. Celso Garcia.
"In binge eating disorder, the vast majority of patients are overweight, obese, or have weight gain. In these cases, the patient may have been advised to use these medications, which requires a more careful analysis of the contraindications," she added.
Another article from G1 points out that, in June 2025, the National Health Surveillance Agency (Anvisa) approved the drug Mounjaro (tirzepatide), known as the "slimming pen," for the treatment of obesity. The approval considers the use of the drug provided that the obesity condition presents at least one comorbidity.
Treatment and prevention of eating disorders
The treatment of eating disorders is interdisciplinary and involves follow-up with a nutritionist, psychologist, psychiatrist, and other professionals specializing in body image distortion. Each one works in a specific dimension of care, ensuring comprehensive patient support.
Furthermore, it is crucial to start treatment early, as soon as the first signs of the disease appear. This prevents the condition from worsening and developing into more severe physical manifestations and associated complications.
"Anorexia nervosa, when treated early and correctly, has a very good outcome, reaching a remission rate of almost 80%. We can say something similar about bulimia as well. Without treatment, the greatest risk is that these patients will enter a chronic state, evolving into serious physical complications that lead to death or, given the chronicity of the disease, lose their autonomy and become dependent on others.".
During the interview, Dr. Celso highlighted that, although the remission rate for the disease is high, relapses are still possible. Therefore, he emphasizes that at the first sign of any symptom, the patient should seek their psychiatrist for a reassessment.
When should you seek help?
In the case of anorexia nervosa, for example, the patient is unable to recognize that they are suffering from an eating disorder. This is because there is a distortion in the perception of their own body image. The patient sees themselves as having a body that does not correspond to reality and does not understand the seriousness of the condition.
According to Dr. Celso Garcia, in the case of anorexia and bulimia nervosa, the most common signs include food restriction, obsession with weight loss, excessive exercise, among others. In these cases, it is common for the family to be able to identify changes in eating habits. These include attempts to eat away from others, repeatedly saying that they will eat later, or claiming that they have already eaten.
Regarding binge eating disorder, the main sign is related to recurrent episodes of excessive food intake. During these episodes, the patient loses control over the act of eating and consumes large quantities of food in a short period. Following this, an intense feeling of guilt for not having been able to control themselves is common. Unlike anorexia and bulimia nervosa, in the vast majority of cases the patient themselves realizes that there is a problem.
It is important that, upon noticing these signs, the family or the patient themselves seek professional help to identify the existence of a disorder and begin treatment as early as possible.
“The diagnosis of mental disorders is made based on a psychiatric history, an interview with the patient and their family. There is no single test that defines a diagnosis of anorexia or bulimia. On the contrary, most of the time, laboratory tests for these patients come back normal. Therefore, it is necessary to follow the evaluation criteria of the International Classification of Diseases (ICD), but the basic information should come from the interview,” explains the doctor.
The role of Psychiatry in the treatment of eating disorders
According to Dr. Celso Garcia, the participation of a psychiatrist is essential when the patient, in addition to the eating disorder, also presents a pre-existing history of other associated psychiatric illnesses such as depression, anxiety, or personality disorders, for example. The involvement of this specialist is also indispensable in more severe cases of eating disorders.
In general, the psychiatrist is responsible for coordinating the treatment, assisting in the integration and alignment of the work of all professionals involved. Furthermore, whenever necessary, they guide pharmacological treatment and work with the interdisciplinary team to ensure the patient and family receive the best possible care.
