An eating disorder is a mental health condition where someone uses the control of food to cope with feelings and other situations.
Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape.
Anyone can get an eating disorder, but the majority start between ages 12 to 20.
With the right and early treatment, most people do recover from an eating disorder.
Eating disorders are serious mental illnesses and can affect people of all ages, genders, ethnicities and backgrounds. Someone with an eating disorder uses disordered eating behaviour as a way to cope with difficult situations or feelings. This behaviour can include limiting the amount of food eaten, eating very large quantities of food at once, getting rid of food eaten through unhealthy means (e.g. making themselves sick, misusing laxatives, fasting, or excessive exercise), or a combination of these behaviours.
It’s not all about food
Eating disorders are not all about food itself, but about feelings. The way someone treats food may make them feel more able to cope, or may make them feel in control, though they might not be aware of the purpose this behaviour is serving. An eating disorder is never the fault of the person experiencing it, and anyone who has an eating disorder deserves fast, compassionate support to help them get better.
There are a number of different eating disorders that someone can be diagnosed with. It’s possible for someone to move between diagnoses if their symptoms change – there is often a lot of overlap between different eating disorders.
Eating disorders can be fatal, and they cause serious harm both physically and emotionally. But even though they are serious illnesses, eating disorders are treatable. Like any other illness, the sooner someone with an eating disorder is treated, the more likely recovery is. The most important thing is getting yourself or someone you know into treatment as quickly as possible. Visiting a GP is the first step.
Types of eating disorders
Anorexia – trying to control your weight by not eating enough food, exercising too much, or doing both
ARFID (Avoidant/restrictive food intake disorder) – when someone avoids certain foods, limits how much they eat or does both.
Binge eating disorder – eating large portions of food until you feel uncomfortably full
Bulimia – losing control over how much you eat and then taking drastic action to not put on weight
OSFED (Other specified feeding or eating disorder) – the most common eating disorder, where symptoms don’t exactly match the list of symptoms of any specific eating disorders.
Do I have an eating disorder?
If you or people around you are worried that you have an unhealthy relationship with food, you could have an eating disorder.
Eating disorders are complex mental illnesses. Anyone, no matter what their age, gender, ethnicity or background, can develop one. Some examples of eating disorders include avoidant/restrictive food intake disorder (ARFID), bulimia, binge eating disorder, and anorexia.
There’s no single cause and people might not have all symptoms for any one eating disorder. Many people are diagnosed with “other specified feeding or eating disorder” (OSFED), which means that their symptoms don’t exactly match what doctors check for to diagnose binge eating disorder, anorexia, or bulimia, but doesn’t mean that it’s not still very serious.
It’s also possible for someone’s symptoms, and therefore their diagnosis, to change over time. For example, someone could have anorexia, but their symptoms could later change to fit with a diagnosis of bulimia.
Symptoms of eating disorders
Symptoms of eating disorders include:
You may also notice physical signs, including:
Your circumstances, feelings, and symptoms may be very different to what you’ve seen or read about, but that doesn’t mean you can’t have an eating disorder. The way eating disorders present themselves can vary a lot from person to person. This means eating disorders can be difficult to identify, and often those suffering can appear healthy despite being unwell. If you think you might be having problems with your eating or feel that difficult feelings or situations are making you change your eating habits or feel differently about food, you could have an eating disorder or be developing one.
What causes eating disorders?
Eating disorders are complex – there is no single reason why someone develops an eating disorder. A whole range of different factors, including someone’s genetics, biology, psychology and surroundings, can combine to make it more likely any one person develops the condition.
You may be more likely to get an eating disorder if:
Eating disorders are a range of psychological conditions that cause unhealthy eating habits to develop. They might start with an obsession with food, body weight, or body shape.
In severe cases, eating disorders can cause serious health consequences and may even result in death if left untreated.
Anorexia (Anorexia nervosa)
Anorexia (or anorexia nervosa) is a serious mental illness where people are of low weight due to limiting how much they eat and drink. They may develop “rules” around what they feel they can and cannot eat, as well as things like when and where they’ll eat. Anorexia can affect anyone of any age, gender, ethnicity or background.
As well as limiting how much they eat, they may do lots of exercise, make themselves sick, or misuse laxatives to get rid of food eaten. Some people with anorexia may experience cycles of bingeing (eating large amounts of food at once) and then purging.
Weight and shape may be a big factor in someone with anorexia’s sense of self-worth. This can lead to them checking their body regularly, or else trying to avoid scales and mirrors. The way people with anorexia see themselves is often at odds with how others see them – they often have a distorted image of themselves, and think they’re larger than they really are. They experience a deep fear of gaining weight, and will usually challenge the idea that they should.
Sometimes, someone’s symptoms may not exactly match everything a doctor checks for to diagnose anorexia – for example, they may be a weight considered “normal” for their age, sex, and expected development. Depending on the exact symptoms, they might be diagnosed with atypical anorexia or another form of other specified feeding or eating disorder (OFSED). This is just as serious and can develop both into or from anorexia. It’s just as important that people suffering with OSFED get treatment as quickly as possible.
Avoidant / restrictive food intake disorder (ARFID)
Avoidant restrictive food intake disorder, more commonly known as ARFID, is a condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of overall amount eaten, or both.
Someone might be avoiding and/or restricting their intake for a number of different reasons. The most common are the following:
It is very important to recognise that any one person can have one or more of these reasons behind their avoidance or restriction of food and eating at any one time.
Binge eating disorder
Binge eating disorder (BED) is a serious mental illness where people eat very large quantities of food without feeling like they’re in control of what they’re doing. It can affect anyone of any age, gender, ethnicity or background, and evidence suggests it is more common than other eating disorders.
People with binge eating disorder eat large quantities of food over a short period of time (called binge eating). Unlike people with bulimia, they don’t usually follow this by getting rid of the food through, for example, vomiting, though sometimes they might fast between binges. BED is not about choosing to eat large portions, nor are people who suffer from it just “overindulging” – far from being enjoyable, binges are very distressing, often involving a much larger amount of food than someone would want to eat. People may find it difficult to stop during a binge even if they want to. Some people with binge eating disorder have described feeling disconnected from what they’re doing during a binge, or even struggling to remember what they’ve eaten afterwards.
Characteristics of a binge eating episode can include eating much faster than normal, eating until feeling uncomfortably full, eating large amounts of food when not physically hungry, eating alone through embarrassment at the amount being eaten, and feelings of disgust, shame or guilt during or after the binge. Someone who experiences at least one of these distressing binge eating episode a week for at least three months is likely to be diagnosed with binge eating disorder.
Binges may be planned like a ritual and can involve the person buying “special” binge foods, or they may be more spontaneous. People may go to extreme lengths to access food – for example, eating food that has been thrown away or that doesn’t belong to them. Binge eating usually takes place in private, though the person may eat regular meals outside their binges. People with binge eating disorder may also restrict their diet or put in certain rules around food – this can also lead to them binge eating due to hunger and feelings of deprivation. People often have feelings of guilt and disgust at their lack of control during and after binge eating, which can reinforce that cycle of negative emotions, restriction and binge eating again.
There are lots of things that can make someone feel the urge to binge eat. This could include difficult or overwhelming feelings, for example, feeling low, bored, angry, upset, or anxious. People may also binge eat when they are feeling happy or excited too. Sometimes binge eating episodes may also be more habitual or planned, rather than driven by a sudden urge, and this can also be due to a number of reasons, such as to numb emotions, to manage uncomfortable feelings or due to the opportunity arising if someone is alone.
Bulimia (Bulimia nervosa)
Bulimia (or bulimia nervosa) is a serious mental illness. It can affect anyone of any age, gender, ethnicity or background. People with bulimia are caught in a cycle of eating large quantities of food (called bingeing), and then trying to compensate for that overeating by vomiting, taking laxatives or diuretics, fasting, or exercising excessively (called purging). Treatment at the earliest possible opportunity gives the best chance for a fast and sustained recovery from bulimia.
It’s normal for people who aren’t suffering from an eating disorder to choose to eat a bit more or “overindulge” sometimes. This shouldn’t be confused with a binge eating episode. Binge eating is often a way to cope with difficult emotions; someone may feel driven to binge eat if they’re feeling stressed, upset or angry, for example. During a binge, people with bulimia don’t feel in control of how much or how quickly they’re eating. Some people also say that they feel as though they’re disconnected from what they’re doing. The food eaten during a binge may include things the person would usually avoid. Episodes of binge eating are often very distressing, and people may feel trapped in the cycle of bingeing and purging. People with bulimia place strong emphasis on their weight and shape, and may see themselves as much larger than they are.
Other specified feeding or eating disorder (OSFED)
Anorexia, bulimia, and binge eating disorder are diagnosed using a list of expected behavioural, psychological, and physical symptoms. Sometimes a person’s symptoms don’t exactly fit the expected symptoms for any of these three specific eating disorders. In that case, they might be diagnosed with an “other specified feeding or eating disorder” (OSFED).
This is very common. OSFED accounts for the highest percentage of eating disorders, and anyone of any age, gender, ethnicity or background can experience it. It is every bit as serious as anorexia, bulimia, or binge eating disorder, and can develop from or into another diagnosis. People suffering from OSFED need and deserve treatment just as much as anyone else with an eating disorder.
As OSFED is an umbrella term, people diagnosed with it may experience very different symptoms. Some specific examples of OSFED include:
Like any other eating disorder, OSFED is a very serious mental illness that is not only about the way the person treats food but about underlying thoughts and feelings. The eating disorder may be a way of coping with these thoughts, or a way of feeling in control.
People with OSFED may work to hide their illness and someone may have been ill for a long time before physical symptoms appear, if they do at all. Any of the symptoms associated with bulimia, anorexia or binge eating disorder can be part of OSFED, and these would come with the same short-term and long-term risks as in the case of these specific eating disorders. As with other eating disorders, it will probably be changes in the person’s behaviour and feelings that those around them notice first, before any physical signs appear.
Eating disorders are mental health conditions that usually require treatment. They can also be damaging to the body if left untreated.
If you have an eating disorder, get help by contacting your GP.
The first step to getting help
The first port of call when seeking help is through your GP or the GP of the person you care about. It could be helpful to go with someone close to you, or suggest that you go to this appointment together if you are concerned about someone else. It is often helpful to go prepared with notes about your concerns and to explain clearly why you think the difficulties are related to ARFID. If you are taking your child to see the GP, it is always best to explain to them why you are going and what you are concerned about, again taking some prompts or notes to the appointment. For example, think about how long things have been going on and any symptoms or behaviours that you are worried about. If going to the GP is something you are anxious about, you can speak to our Helpline about your worries.
If you think you may have an eating disorder, see a GP as soon as you can.
A GP will ask about your eating habits and how you’re feeling, plus check your overall health and weight.
They may refer you to an eating disorder specialist or team of specialists.
It can be very hard to admit you have a problem and ask for help. It may make things easier if you bring a friend or loved one with you to your appointment.
Treatment for eating disorders
You can recover from an eating disorder, but it may take time and recovery will be different for everyone.
If you’re referred to an eating disorder specialist or team of specialists, they’ll be responsible for your care.
They should talk to you about the support you might need, such as for other conditions you have, and include this in your treatment plan.
Your treatment will depend on the type of eating disorder you have, but usually includes a talking therapy.
You may also need regular health checks if your eating disorder is having an impact on your physical health.
Your treatment may also involve working through a guided self-help programme if you have bulimia or binge eating disorder.
Most people will be offered individual therapy, but those with binge eating disorder may be offered group therapy.
Treatment for other specified feeding or eating disorder (OSFED) will depend on the type of eating disorder your symptoms are most like.
For example, if your symptoms are most like anorexia, your treatment will be similar to the treatment for anorexia.
It can be very difficult to identify that someone you care about has developed an eating disorder.
It can also be very upsetting to see someone you care about suffering with an eating disorder.
Remember, you don’t need to be an expert on mental health to offer support. Often small, everyday actions can make the biggest difference.
Warning signs
Warning signs to look out for include:
How you can help
Sometimes people worry about talking to someone because they feel their eating disorder isn’t serious enough, they don’t want to worry people or waste their time, or because they feel guilty, embarrassed or ashamed.
Getting help for someone else
South Yorkshire Eating Disorders Association
An independent charity, originally established in 1996 by a group of people who were affected by eating disorders and who were concerned that they were not able to find helpful information, guidance and help when they needed it.
Kimberworth Road
Rotherham
S61 1AJ
0114 272 8822
info@syeda.org.uk
Five ways to wellbeing
A great place to start with taking care of your mental health is the five ways to wellbeing which outlines 5 steps that are easy to incorporate into your everyday life and could help you feel more positive and able to get the most out of life.
NHS Talking Therapies
0800 074 5560 (confidential)
Monday to Friday, 9am–5.30pm
Online service
Cognitive behavioural therapy (CBT) is a form of psychological therapy that helps you spot how some of your thoughts affect your actions and feelings and teaches you about ways in which you can improve how you feel day-to-day.
Therapy such as CBT is traditionally delivered face-to-face. With Ieso you will work 1:1 with your therapist online, but the conversation is typed instead of spoken. It’s exactly like chatting via a messenger service with friends. You don’t need to be brilliant at spelling or worry about using the correct grammar. Online CBT has been shown to be just as effective as face-to-face, and many people find it less daunting and easier to be open.
Ieso is working in partnership with the NHS in Rotherham. To be eligible for online CBT on the NHS you must be aged 18 or over and registered with a GP in Rotherham.
03000 215 108
Monday to Friday, 9am–5pm
Local venues (dependent on Coronavirus restrictions)
Interpreting service available
Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH) provides an Improving Access to Psychological Therapies Service. The service, provided by local therapists, is for Rotherham residents who require support with:
The service offers:
Treatments include:
020 3947 2600
SMS/text message: 07966 976749
info@signhealth.org.uk
SignHealth is a charity dedicated to making sure Deaf people get the same sort of access as hearing people to healthcare and health information.
Mind – Rotherham
Tel: 01709 919929
Email: contactus@rbmind.co.uk
Mind is an independent local provider of high quality mental health services in Rotherham, which offer a variety of services including one-to-one counselling, group sessions, support for young people, training and services for employers. Committed to supporting those in need by promoting good mental health and offering high quality support so that no-one feels alone when dealing with mental health problems.
RDaSH Community Eating Disorders Service for Children and Young People Aged 0-19
A multi-disciplinary team made up of dedicated health professionals including specialist nurses, cognitive behavioural therapists, family therapists, dieticians, psychologists and psychiatrists who offer assessment and treatment in a variety of community settings as well as specialist consultation and advice for professionals.
01709 304808
Kimberworth Place
Kimberworth Road
Kimberworth
Rotherham
S61 1HE
RDaSH Crisis Team
0800 652 9571 (calls to this number are Free)
If you or someone you know has concerns about their immediate health RDaSH Crisis Team can help. One of our trained call handlers will signpost you to the most appropriate service depending on your level of need. This may include your out of hours GP, a voluntary organisation or our access/crisis team.
Hard of hearing? Deaf? For anyone unable to use the standard telephone line, i.e. hard of hearing, there is a text phone service available.
Please text 07974 603610
BEAT Eating Disorders
You can talk in confidence to an adviser from eating disorders charity by calling:
Adult Helpline: 0808 801 0677
Youth Helpline: 0808 801 0711
5 steps to mental wellbeing
NHS provides information on 5 steps that you can take to improve your mental health and wellbeing. Trying these things could help you feel more positive and able to get the most out of life.
Young Minds
Young Minds has lots of tips, advice and guidance on where you can get support for your mental health during the coronavirus (COVID-19) pandemic.
Every Mind Matters
Having good mental health helps us relax more, achieve more and enjoy our lives more. We have expert advice and practical tips to help you look after your mental health and wellbeing.
Age UK
Tel: 0800 678 1602
Open 8am to 7pm, every day of the year
Age UK is the country’s largest charity dedicated to helping everyone make the most of later life. We provide companionship, advice and support for older people who need it most.
Shout UK
Text 85258 (24/7 help)
info@giveusashout.org
Shout is the UK’s first 24/7 text service, free on all major mobile networks, for anyone in crisis anytime, anywhere. It’s a place to go if you’re struggling to cope and you need immediate help.
Online NHS Mental Health Help
The NHS website has contact information for a number of mental health helplines.
RR (Recovery Record) is App with a log for how you feel, but also ideas and suggestions for positive thoughts and coping strategies. Set yourself goals and choose coping skills that you think might work for you . There are guided meditations which you can pair with images of your choice. Based on CBT techniques, you can also share logs with others such as a counsellor.
Calm Harm provides tasks to help you resist or manage the urge to self-harm.
distrACT gives you easy, quick and discreet access to information and advice about self-harm and suicidal thoughts.
HealthUnlocked is the world’s largest social network for health. Find and connect with people with a similar health condition. The service has over 700 online communities focused on health and wellbeing topics.
My Possible Self: The Mental Health App. Take control of your thoughts, feelings and behaviour with the My Possible Self mental health app. Use the simple learning modules to manage fear, anxiety and stress and tackle unhelpful thinking. Record your experiences and track symptoms to better understand your mental health.
The Pzizz app helps you quickly calm your mind, fall asleep fast, stay asleep, and wake up refreshed.
It uses “dreamscapes” – a mix of music, voiceovers and sound effects designed using the latest clinical research – to help you sleep better at night or take power naps during the day.
The NHS App gives you a simple and secure way to access a range of NHS services on your smartphone or tablet.
You can use the app if you are aged 13 or over. You must be registered with an NHS GP surgery in England or the Isle of Man. You can also log in through the NHS website on a computer to use NHS App services.
