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Learning About Severe and Enduring Eating Disorders

What is a severe and enduring eating disorder (SEED)?

A severe and enduring eating disorder (SEED) is an eating disorder that goes on for a long time. This may happen despite multiple attempts (usually three or more) to treat it.

Eating disorders cause some people to have unhealthy thoughts and behaviors about food and body image.

What are the types?

Common eating disorders that can turn into a SEED include:

  • Anorexia. People with anorexia severely restrict calories to the point of starvation. They are preoccupied with being thin and have an unhealthy and distorted body image. They may refuse to eat at all. Or they may eat only tiny amounts of food that have few calories, or they may eat only a certain food. People with anorexia are very thin. But they think of themselves as overweight.
  • Bulimia. People with bulimia binge on large amounts of food. They then may force themselves to vomit. They may also exercise too much. Or they may take laxatives to help rid their body of the calories they've eaten. They continue this cycle of binging and purging. They may also restrict food in between binges. People with bulimia aren't always too thin. In fact, they may often have a healthy weight.
  • Binge-eating disorder. This is also known as compulsive overeating. People who are binge eaters eat large amounts of food without purging. They often eat too much despite feeling full. They may feel guilty or ashamed after a binge. They may then go on an extreme diet. People who eat this way may be at a healthy weight, be overweight, or have obesity.

SEED may affect 20% to 25% of those who have anorexia and 10% of those who have bulimia.

Other eating disorders don't fit into these types. They are often grouped as "eating disorders not otherwise specified."

What are the symptoms?

Symptoms of a SEED depend on the type of eating disorder that a person has. Here are some symptoms that are common by type of eating disorder.

People who have anorexia may:

  • Have a very low body weight for their age, height, and sex.
  • Be very afraid of gaining weight.
  • Have a negative and false belief about how they look.
  • Strictly limit how much they eat.

People who have bulimia may:

  • Eat a large amount of food in a short time (called bingeing), often over a couple of hours or less, on a regular basis.
  • Feel out of control and like they can't stop eating during a binge.
  • Do something to avoid weight gain. They may make themselves vomit or misuse laxatives, enemas, water pills (diuretics), or other medicines to get rid of (purge) food. Or they may exercise very hard or for a long time or go without food (fast).
  • Strongly base how they feel about themselves on how much they weigh.

People with binge-eating disorder may:

  • Eat a large amount of food in a short time, often over a couple of hours or less, on a regular basis.
  • Feel like they can't stop eating and eat so much that they feel painfully full.
  • Eat a large amount of food and gain weight.
  • Feel unhappy, upset, guilty, or depressed after they binge.
  • Eat alone because they are embarrassed about how much they eat.

How are they treated?

There isn't a single treatment that works for all eating disorders. Instead, treatment is tailored to each person. Treatment often includes counseling and sometimes medicines. Some people use both. Treatment may also include working with a doctor.

Cognitive behavioral therapy. This can help a person who has an eating disorder change the way they think about food and the way they view their body. And it can help them manage feelings or situations that may have brought on their eating disorder. Sometimes family members take part in therapy so that they can learn ways to support the person's recovery.

Nutritional counseling. A dietitian can help a person get back to and stay at a weight that is healthy for them. The person also learns healthy eating habits.

Medicines. The most common are antidepressants. They can help reduce episodes of bingeing and purging. They can also help with other conditions, such as anxiety and depression. People with binge-eating disorder may sometimes need appetite suppressants to help manage their condition.

Other medical treatment. Doctors will treat the medical problems that have been caused by an eating disorder, such as heart problems or depression.

An eating disorder can take a long time to overcome. Many people have ups and downs. Try to think of treatment as an ongoing process.

If you think you have an eating disorder, get help. Some eating disorders, such as anorexia, need to be treated at a hospital or an inpatient clinic. If left untreated, eating disorders can cause serious health problems. Treatment can help you feel better and be healthier.

How can you prevent them?

Experts don't completely understand what causes eating disorders. Social pressure to meet a certain ideal body shape and weight may play a role. Other causes may include personal stress and possibly certain personality traits. You can take steps to help prevent eating disorders. This is true before the first symptoms appear or in the early stages.

Programs can teach children and adults about healthy eating habits and a healthy body weight. It's also helpful to understand that society's pressures about body weight are unrealistic. Parents of young children and teens should keep track of their children's use of social media. Also, parents can talk to their children about the messages that websites and apps send about body image. This can help to create a healthier body image and may prevent eating disorders.

© 2000-2026 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.