Eating disorders
- Dr Sammad Hashmi, Consultant Psychiatrist
An eating disorder, such as anorexia, bulimia or binge eating, is a mental health condition that affects the way you eat. You might have upsetting thoughts or emotions that lead you to control what you eat or what you weigh as a way to cope. Eating disorders can have a big impact on your life but can be effectively treated with medicines and psychological therapies.
About eating disorders
If you have an eating disorder, you might have strong feelings about how much you weigh or the shape of your body. This affects the types of food you will and won’t eat. An eating disorder can start at any age, and affect people of all genders and cultures, although it’s much more common in girls. Estimates suggest over 1.25 million people in the UK have an eating disorder, but the exact number isn’t known.
The way an eating disorder can affect you is personal to you and varies between people. 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.
An eating disorder can affect both your physical and mental wellbeing, and can significantly affect your quality of life.
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.
www.samaritans.org - 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.
Types of eating disorders
There are different types of eating disorder, which can cause different symptoms. It might not always be obvious that you or somebody you know has an eating disorder. Seven common types of eating disorder are discussed below.
Avoidant and restrictive food intake disorder (ARFID)
Avoidance and restrictive food intake disorder (ARFID) is a condition where you avoid certain foods or restrict the amount of them that you eat. This means you don’t get all the nutrients your body needs, and you lose weight. In children, ARFID can cause them to grow too slowly. This is called faltering growth.
ARFID is different from anorexia, bulimia, and binge eating disorder (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 taste, texture, appearance, colour, smell or temperature
- are scared of what might happen if you eat – for example, you might choke or be sick
ARFID commonly develops in childhood, so it’s sometimes dismissed as fussy or picky eating. But ARFID is different to this and needs specialist treatment. People with autism spectrum disorder or attention deficit hyperactivity disorder (ADHD) are much more likely to develop ARFID.
Anorexia
Anorexia nervosa (usually just called anorexia) is an eating disorder in which 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 that can cause both physical and mental health complications if it’s not treated. If you have anorexia, you may be very underweight. It can sometimes even be life-threatening.
Bulimia
Bulimia nervosa (usually just 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 that 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 eat. 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)
Binge eating disorder (BED) is similar to bulimia but you don’t try to prevent gaining weight after you binge. If you have binge eating disorder, you might find that the binges happen quite often and you lose control. This can be very upsetting. Your binging may also cause you to gain weight.
Pica
Pica is an eating disorder that 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, soap or paper. The exact reason why you develop pica isn’t known. But you might develop this eating disorder for several reasons including:
- stress
- having a deficiency in a nutrient
- if you have another health condition such as epilepsy
- if you have autism associated with learning difficulties
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. Pica can also happen if you’re pregnant.
Rumination syndrome
Rumination syndrome is where you constantly bring up (regurgitate) your food after eating, without feeling sick (nausea) or retching. You’ll then either re-chew and swallow the food or spit it out. Rumination is considered both an eating disorder and a digestive disorder.
The exact cause of rumination syndrome isn’t known. It happens after you have an unintentional contraction of your tummy (abdominal) muscles shortly after you eat. This rapidly increases the pressure in your stomach to such an level that it forces the valve in the lower oesophagus (food pipe) to open. This allows the food to travel back into your mouth.
Rumination syndrome in young children usually gets better by the time they’re a year old. In children and adults, it can cause you to lose weight and not get the nutrients you need.
Other specified feeding and eating disorders (OSFEDs)
You might have symptoms that don’t exactly fit into one of these types of eating disorder. If this happens to you, you might be diagnosed with other specified feeding and eating disorder (OSFED). 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 you might develop an eating disorder. Your relationship with food may be disturbed because of something you might think is unrelated – for example, a physical or mental health condition. It can also be a sign of stress and inner distress. Eating disorders are often a way to cope with difficult emotions.
Some things can increase your chance of developing an eating disorder. These include:
- being overweight as a child
- a family history of eating disorders
- childhood trauma such as physical or sexual abuse
- certain personality traits – for example, perfectionism
- experiencing or being around diets and dieting
- experiencing or being around weight stigma – for example, 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
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:
- a racing heartbeat (palpitations)
- feeling light-headed or dizzy and fainting
- being very sensitive to the cold
- losing a lot of weight very quickly
- changes to your period (menstrual cycle), including it stopping altogether
In children and teenagers, it might also include not weighing enough for your age.
Changes in behaviour might include:
- thinking about food a lot
- a disrupted eating pattern
- hiding food
- eating in secret
- avoiding food or eating occasions such as family dinners and parties
- 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 around mealtimes or when you eat with others
- being very concerned about how much your weigh or the shape of your body
Diagnosis of eating disorders
If you think you might have an eating disorder, speak to your GP. They’ll ask you questions about your physical and mental health.
They might do some physical checks, such as measuring your height, weight, and body mass index (BMI), and they may do some blood tests. Your GP may also ask you to complete some questionnaires about your mental health.
You can take a loved one with you to your appointment if you think it would be helpful. Your GP may refer you to a specialist eating disorder service. While you’re waiting to be seen, your GP may ask to see you regularly so they can check your health.
If you have an eating disorder, you may feel that you don’t want help or treatment. You might not feel that you have a problem with your eating habits or your weight. And you may worry that if you change your eating patterns, it will make you feel anxious and distressed. But it’s important to get professional help because it will give you the best chance of making a full recovery.
Self-help for eating disorders
An eating disorder can be very serious, so don’t try to manage it alone. There’s lots of help available. The best way to recover is to seek professional support and treatment; talk to your GP first. There are some things you can do to help yourself too. You might 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 – talk with other people who’ve had similar experiences because it may help to hear how others have coped with eating disorders
For more information on self-help for eating disorders, see our section on other helpful websites. Some organisations can also help you connect with other people dealing with eating disorders through support groups, either in person or online.
Treatment for eating disorders
The kind of eating disorder treatment you have will depend on your age and the type of eating disorder you have. You can have treatment at home but sometimes you might need to go to hospital for treatment. If you have serious complications or if your weight is very low, hospital is often the best place for treatment. Sometimes you might need emergency hospital treatment if you’re very physically or mentally unwell.
Eating disorder treatment 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 specialist – for example, 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, eating disorder treatment will focus on the mental (psychological) effects of the illness. The aim of psychological treatment, which may include cognitive behavioural therapy (CBT), 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 may have individual therapy or group therapy.
Your doctor might prescribe you medicines to help manage some of your symptoms.
Supporting someone with an eating disorder
If somebody you love has an eating disorder, it’s understandable to feel very worried and upset. Try to think of the eating disorder as being separate from your loved one. This can help you to distance them from the illness, and to challenge any eating disorder behaviours. This approach can also help your loved one feel less criticised or less blamed.
There are 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, don’t assume anything.
- Educate yourself about eating 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
- problems with your teeth – for example, losing the enamel from the surface
- nutritional deficiencies (not getting the vitamins, minerals and other nutrients your body needs)
- problems with your heart – for example, a slow heart rate or abnormal heart rhythm
- feeling constipated or bloated
- kidney problems
- liver problems
- shrinking of the brain (this can happen in anorexia, but may be reversible)
If eating disorders aren’t treated, they can lead to serious problems which can sometimes be life-threatening. But if you get treatment, you can reverse most of these complications.
You can also have complications with your mental health, including:
- anxiety
- withdrawing from spending time with friends and family in social situations
- low mood
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.
No. You can only be diagnosed with one eating disorder at a time. But it’s very common for your diagnosis to change over time. Many signs and symptoms of different eating disorders are also the same as each other.
For more information, see our section on types of eating disorder.
Yes, it’s possible to fully recover from an eating disorder, but it can take a long time. How well you recover can depend on at what age you developed the eating disorder, and if you have experienced any trauma in the past. You may still have issues with food after treatment but feel more in control of the condition and can lead a happier, more fulfilled life.
Avoidant/restrictive food intake disorder (AFRID) can be split into different types:
- example
- avoidance because of fear and anxiety about the consequences of eating
- restricted intake because of low interest in eating
For more information, see our section on types of eating disorder.
Atypical eating disorders are the most common type of eating disorder. These eating disorders resemble anorexia, bulimia, and binge eating but they don’t meet the precise diagnostic criteria. Other specified feeding or eating disorder (OSFED) is a type of atypical eating disorder.
The second most common eating disorder is binge eating disorder (BED).
Anorexia is the least common type of eating disorder.
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- Eating disorders. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2024
- Eating disorders: recognition and treatment. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, last updated 16 December 2020
- Learn about eating disorders. Beat. www.beateatingdisorders.org.uk, accessed 19 August 2024
- How many people have an eating disorder in the UK? Beat. www.beateatingdisorders.org.uk, accessed 19 August 2024
- Eating disorders in males. National Centre for Eating Disorders. eating-disorders.org.uk, accessed 19 August 2024
- Balasundaram P, Santhanam P. Eating disorders. StatPearls Publishing. www.ncbi.nlm.nih.gov/books, last updated 26 June 2023
- Types of eating disorders. Patient. patient.info, last updated 22 February 2023
- Avoidant/restrictive food intake disorder (ARFID). Royal College of Psychiatrists. www.rcpsych.ac.uk, published December 2022
- ARFID. Beat. www.beateatingdisorders.org.uk, issued February 2024
- What is ARFID? ARFID Awareness UK. www.arfidawarenessuk.org, accessed 17 September 2024
- Anorexia nervosa. BMJ Best Practice. bestpractice.bmj.com, last reviewed 20 July 2024
- Bulimia nervosa. BMJ Best Practice. bestpractice.bmj.com, last reviewed 20 July 2024
- Binge eating disorder. Beat. www.beateatingdisorders.org.uk, accessed 20 August 2024
- Al Nasser Y, Muco E, Alsaad AJ. Pica. StatPearls Publishing. www.ncbi.nlm.nih.gov/books, last updated 26 June 2023
- Kusnik A, Vaqar S. Rumination disorder. StatPearls Publishing. www.ncbi.nlm.nih.gov/books, last updated 8 May 2023
- Rumination syndrome. Guts UK. gutscharity.org.uk, published 2021
- Anorexia nervosa. Beat. www.beateatingdisorders.org.uk, accessed 20 August 2024
- Bulimia nervosa. Beat. www.beateatingdisorders.org.uk, accessed 20 August 2024
- Nicewicz HR, Torrico TJ, Boutrouille JF. Body dysmorphic disorder. StatPearls Publishing. www.ncbi.nlm.nih.gov/books, last updated 20 January 2024
- Eating disorders. American Psychiatric Association. www.psychiatry.org, accessed 20 August 2024
- Help and treatment for an eating disorder. Beat. www.beateatingdisorders.org.uk, accessed 20 August 2024
- Curzio O, Calderoni S, Maestro S, et al. Lower gray matter volumes of frontal lobes and insula in adolescents with anorexia nervosa restricting type: Findings from a brain morphometry study. Eur Psychiatry 2020; 63(1):e27. doi: 10.1192/j.eurpsy.2020.19
- Rachael Mayfield-Blake, Freelance Health Editor
