Eating disorders
Your health expert: Dr Adhiraj Joglekar, Consultant Child & Adolescent Psychiatrist
Content review by Harriet Smith, April 2022
Next review due April 2025
An eating disorder is a mental health condition that affects the way you eat. Having an eating disorder can have a big impact on your life. If you have an eating disorder, you might have upsetting thoughts or emotions that lead you to control what you eat or what you weigh as a way of coping. The good news is that they can be treated.
About eating disorders
If you have an eating disorder, you might have strong feelings about your weight or body shape which affects the types of foods you can and can’t eat. Eating disorders can start at any age, and they can affect people of all genders and cultures. Up to 5 in every 100 people have an eating disorder.
The way an eating disorder affects you will be different for everyone. For example, you might become focused on being very muscular, or on being very thin. You can’t tell that somebody has an eating disorder just by looking at them.
Having an eating disorder can affect both your physical and mental wellbeing. They can have a big impact on your health.
If you need help now
This page is designed to provide general health information. If you need help now, please use the following services.
- Samaritans. 116 123 (UK and ROI) - This helpline is free for you to call and talk to someone.
- NHS Services has a list of where to get urgent help for mental health.
- Mind website. Click the ‘Get help now’ button on the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.
If you think you might harm yourself or are worried someone else might come to immediate harm, call the emergency services on 999 or go to your local accident and emergency department.
Signs and symptoms of eating disorders
Eating disorders are often hard to see because they’re mental health conditions. But there are some physical symptoms and changes in behaviour to be aware of. Physical symptoms might include:
- chest pains and chest tightness
- feeling light-headed, dizzy and fainting
- being very sensitive to the cold
- losing a lot of weight very quickly
- changes to your menstrual cycle, including it stopping altogether
In children and teenagers, it might also include growth faltering (not weighing enough for your age).
Changes in behaviour might include:
- a disrupted eating pattern
- hiding food
- eating in secret
- avoiding food or eating occasions
- purging behaviours, such as taking laxatives, doing lots of exercise or making yourself sick
- eating a reduced range and variety of foods
- low mood (for example, being disinterested in your usual hobbies and activities)
- being very anxious or distressed when you’re near certain foods
Types of eating disorders
There are lots of different types of eating disorders and they can cause different symptoms. It might not always be obvious that you, or somebody you know, has an eating disorder. There are seven common types of eating disorder.
Bulimia
Bulimia nervosa (usually called bulimia) causes you to think a lot about your weight and body shape. You might find you switch between dieting, or eating certain foods you feel are safe, and binging on high calorie foods.
Binging is when you eat a lot of food in a short space of time and lose control over what, or how much, you’re eating. You might eat in secret and have feelings of shame and embarrassment. After a binge, you might try and do things to stop you gaining weight such as:
- limiting the amount or type of foods you eat
- doing lots of exercise
- purging (for example making yourself sick or taking laxatives)
If you have bulimia you might not be underweight. But if you are, your doctor might diagnose you with anorexia binge-eating/purging type instead.
Binge-eating disorder (BED)
BED is similar to bulimia. But if you have BED, you might not try to prevent weight gain after binging. If you have BED, you might find that the binges happen quite often and that they can be very upsetting. Your binging may also cause you to gain weight.
Anorexia
Anorexia nervosa (usually called anorexia) is an eating disorder that causes you to want to become, and stay, very thin.
There are two types of anorexia nervosa.
- Restricting type. This is where you lose weight mainly by dieting, fasting or doing lots of exercise.
- Binge-eating/purging type. This is where you also sometimes binge eat and then purge, for example by making yourself sick.
Anorexia is a very serious mental health condition which can cause medical complications if it’s not treated. If you have anorexia, you may be very underweight. This can cause both physical and mental health problems. In some cases, it can even be life-threatening.
Avoidance/restrictive food intake disorder (ARFID)
Avoidance/restrictive food intake disorder (ARFID) is a condition where you avoid certain foods or restrict the amount you eat. This means you don’t get all the nutrients your body needs, and you lose weight. In children it can cause faltering growth (growing too slowly).
ARFID is different from anorexia, bulimia and BED because it doesn’t involve upsetting thoughts about your weight and body shape. Instead, you might avoid certain foods because you:
- have a lack of interest in food and eating
- don’t want to eat certain foods because of their texture, appearance, colour, smell or temperature
- are scared of what might happen if you eat, for example choking or being sick
As ARFID commonly develops in childhood, it is sometimes dismissed as fussy eating. But ARFID is different to fussy eating and needs specialist treatment.
Pica
Pica is an eating disorder which causes you to repeatedly eat things that aren’t considered food and that don’t have any nutritional value. This might include things like coal or paper. You might develop this eating disorder for several reasons including:
- feeling bored
- stress
- curiosity
- enjoying the taste
Pica can develop at any age but it’s more common in childhood. It’s also more common if you have autism spectrum disorder (ASD) or a learning disability.
Rumination syndrome
Rumination syndrome is where you constantly regurgitate (bring up) your food after eating, without nausea (feeling sick) or retching. The food is then either re-chewed and swallowed or spat out. Rumination is considered both an eating disorder and a digestive disorder.
Unlike bulimia, the regurgitation in rumination syndrome is automatic (involuntary), and so you may find it difficult to control. About 4 in every 10 people who develop rumination syndrome lose weight because of it.
Other specified feeding and eating disorders (OSFEDs)
You might have symptoms that don’t exactly fit into one of these types. In this case, you might be diagnosed with OSFED.
If you have OFSED, you might have different symptoms from other eating disorders. For example, you might be given an OSFED diagnosis if you have symptoms of anorexia nervosa, but you haven’t lost a lot of weight.
Causes of eating disorders
There isn’t one single cause or reason why you might develop an eating disorder. But eating disorders are often a way of coping with difficult emotions.
There are some things that can increase your chance of developing an eating disorder. These include:
- a family history of eating disorders
- childhood trauma, such as physical or sexual abuse
- certain personality traits, such as perfectionism
- experiencing, or being around, diets and dieting
- experiencing, or being around, weight stigma (such as being bullied for being under or overweight)
- low self-esteem
- difficulty controlling your emotions
If you have an eating disorder, you may also have other mental health conditions such as:
- mood and anxiety disorders
- alcohol and substance problems
- obsessive compulsive disorder (OCD)
- personality disorders
Complications of eating disorders
Eating disorders can have a big impact on your health, both now and in the future. Complications can sometimes be worse if you develop an eating disorder when you’re a teenager because your organs aren’t fully developed yet.
Short-term physical complications include:
- dry skin, brittle nails and hair loss
- nutritional deficiencies (not getting the vitamins, minerals and other nutrients your body needs)
- problems with your heart, such as a slow heart rate or abnormal heart rhythm
- feeling constipated or bloated
- kidney problems
- liver failure
- shrinking of the brain (this is common in anorexia, but it is reversible)
If eating disorders aren’t treated, they can lead to serious problems. They can sometimes be life-threatening. However, if you get treatment, you can reverse most of these complications.
Longer-term issues can develop if you have an eating disorder for a long time. These might include:
- osteopenia and osteoporosis (the loss of bone mass)
- increased risk of broken bones
- fertility problems
- difficulties forming and maintaining close personal relationships
Having a binge-eating disorder (BED) can also increase your risk of high blood pressure, type 2 diabetes and obesity.
Seeking help
If you’re not sure if you have an eating disorder, here are some questions you could ask yourself:
- are you thinking about food a lot?
- do you worry about gaining weight if you lose control of your eating?
- do you spend a lot of time thinking about your body weight?
- are people telling you you’re thin, even if you think you’re not?
- have you taken laxatives or made yourself sick recently because you’ve felt full, or to make up for something you’ve eaten?
- do you eat food in secret?
- are you embarrassed to let others know what you’re eating?
If you think there’s a chance you might have an eating disorder, the next step is to get a diagnosis.
Diagnosis of eating disorders
If you think you might have an eating disorder, speak to a GP. They might ask you questions about your physical and mental health, including any signs or symptoms that you’re experiencing.
They might do some physical checks, such as height, weight, and body mass index (BMI) as well as blood tests. They may also ask you to complete some questionnaires about your mental health. They’ll use this information to see if they can diagnose you with an eating disorder.
You can take a loved one with you to your appointment if you think that would be helpful.
If you’re worried about having any of these checks, speak to someone you trust about your concerns. You can also speak to an organisation such as Beat through their helpline. This is listed at the bottom of this page.
If you have an eating disorder, you might feel that you don’t want help or treatment. You might not feel like you have a problem with your eating habits or your weight. You might also be worried that changing your eating patterns will make you feel anxious and distressed. But it’s important to know that getting professional help gives you the best chance of making a full recovery.
Treatment for eating disorders
What kind of treatment you have will depend on your age and the type of eating disorder you have. In most cases, you won’t have to stay in hospital to get treatment. But you might have to stay in hospital if you have any serious complications or if your weight is very low.
Treatment for eating disorders will always include:
- learning about your eating disorder
- monitoring your mental and physical health
- risk assessments (how likely you are to harm yourself or other people)
You might see different types of specialists, such as nurses, doctors, dietitians and psychologists. Your loved ones or carers might also be involved.
Treatment for all eating disorders will involve helping you to eat a regular, balanced diet. If you’ve lost a lot of weight, your treatment plan will aim to get your weight to a healthy level.
When you’re physically better, treatment will focus on the mental (psychological) effects of the illness. The aim of psychological treatment is to help you to process your thoughts and feelings.
If you’re a teenager, you’ll usually have family-based treatment. If you’re an adult, you’ll probably have individual therapy.
You might also be prescribed medication to help manage some of your symptoms.
Self-help for eating disorders
An eating disorder can be very serious, and you shouldn’t try to manage it alone. There is lots of help available. The best way to recover is to seek professional support and treatment. But there are some things you can do to help yourself too.
The first step to take if you think you might have an eating disorder is to seek professional help from a GP. You also might also find it helpful to:
- talk to someone you trust – they may be able to support you and make you feel better
- find a support group – you’ll be able to talk with other people who’ve had similar experiences. It can help to hear how others have coped with their eating disorders
You can get more tips and hints on self-help for eating disorders from the organisations listed in our section ‘Other helpful websites’. Some can also help you connect with other people dealing with eating disorders through support groups or online chat rooms.
Supporting someone with an eating disorder
If somebody you love has an eating disorder, it’s understandable you might feel very worried and upset. Try thinking of the eating disorder as being separate from your loved one. This can help you to distance them from the illness and challenge any eating disorder behaviours. This approach can also help your loved one feel less criticised, or less blamed.
There are lots of things you can do to support someone with an eating disorder.
- Recognise that you and your loved one are not to blame.
- Acknowledge how distressing this illness is for your loved one.
- Avoid discussing weight, body shape, food, and diets in front of your loved one.
- Remind yourself that recovery is possible.
- Ask them how they’re feeling and what they’re thinking.
- Educate yourself about eating disorders where you can.
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