What is an eating disorder?

The term eating disorders is used to describe illnesses that are characterised by irregular eating habits and severe anxiety about body weight and/or shape. There are many diseases, disorders, and problems involving food, eating and weight. Often people may not meet all the criteria for a particular eating disorder, for example anorexia, however they may still be restricting their calorie intake or binging and purging on a regular basis. These are classified as other specified feeding or eating disorders  (OSFED).

Who is affected?

Eating disorders can affect anybody at any age. Common misconceptions are that it is mainly women who are affected by eating disorders. However, men can also be affected by issues such as low self-esteem, body image and an obsessive relationship with food.

Beating Eating Disorders (Beat) has indicated that as many as 1.6 million people in the UK are affected by an eating disorder. For  further information, visit the Beat website.

What causes an eating disorder?

There is no single cause of eating disorders, however medical evidence suggests that there is often a link between a stressful event or trauma and the onset of an eating problem. Control over eating is often the last defence for those who feel powerless in other areas of their lives.  Many eating problems are triggered by trauma such as physical, emotional or sexual abuse. There is also evidence to suggest that certain personality traits can make people more vulnerable to eating problems. Examples include people who are:

• perfectionists
• over-competitive
• lacking in confidence
• suffering from obsessive or compulsive behaviour.

Equally, people who suffer from conditions such as depression, anxiety, bipolar disorder or body dysmorphic disorder are also more likely to suffer from an eating problem. Progression into adulthood is often a significant life altering event and this can trigger an eating disorder. For further information, see the National Centre for Eating Disorders (NCFED) website.

Spotting an eating disorder

In the UK doctors often use the SCOFF questionnaire to ascertain whether or not somebody has an eating disorder. People who answer yes to two or more of the following questions are likely to have an eating disorder:

• Sick – do you ever make yourself sick
• Control – do you worry that you have lost control over how much you eat
• One stone – have you lost more than one stone in a three-month period
• Fat – do you believe that you are fat when others say you are too thin
• Food – does food dominate your life.

Types of eating disorders

Most people are familiar with the terms anorexia, bulimia and binge eating, However, many other disorders, although not yet fully understood, are now being identified and named.

Well known eating disorders

Anorexia nervosa

Anorexia is a life-threatening condition that can lead to severe health problems, and in extreme cases, death. Sufferers have a distorted perception of how they look, and often measure their worth by how thin they are. Symptoms include:

• the relentless pursuit of thinness
• denying the danger of low weight
• fear of gaining weight even when obviously already underweight
• compulsive food rituals including division of food into safe/good and unsafe/bad categories.

The Mental Health Foundation have produced several documents and publications about eating disorders. For further information, see the Mental Health Foundation website.

Bulimia nervosa

Bulimia is a serious condition and sufferers are likely to feel depressed and isolated. They often suffer from deeply buried anger that they are unable to express.  Symptoms include:

• binge eating followed by vomiting, misuse of laxatives or excessive exercise
• cycle of crash diets and binge eating
• a belief that self-worth comes from size
• secretive eating
• no significant weight loss.

The Mental Health Foundation have produced several documents and publications about eating disorders. For further information, see the Mental Health Foundation website.

Obesity and Binge eating disorder (BED)

Obesity can be linked to medical issues such as malfunctioning thyroid or pituitary gland. It can also be connected with a disability that limits or prevents physical activity.

However, for most, the combination of inexpensive food and a more sedentary lifestyle have led to a rapid growth in obesity. Obese people are often likely to suffer from BED. Symptoms include:

• binge eating frequently
• inability to control eating during binges
• a history of failed diets
• propensity to be overweight/obese.

For further information about BED, visit the Beat website.

Less known eating disorders

Anorexia athletica

More commonly known as compulsive exercising. Sufferers feel compelled to pursue a regime of excessive exercise no matter what the emotional/physical cost. Symptoms include:

• fanatical exercising beyond what is considered healthy
• putting exercise above work/school/relationships
• often combined with anorexia nervosa, bulimia or an obsessive compulsive disorder.

Little has been written in the UK about anorexia athletica. For further information about anorexia athletica, see the USA Eating Disorders Online website.

Diabulimia

Diabulimia is used to describe type 1 diabetes sufferers who also have an eating disorder. The combination of two life threatening conditions is extremely dangerous, however, once diabetics realise that they can lose weight by misusing their insulin, they often find it very difficult to stop. Symptoms include:

• the misuse of insulin to control weight
• rising blood sugar levels
• blindness
• kidney disease
• impaired circulation.

For further information about diabulimia, visit the Diabetics with Eating Disorders (DWED) website.

Selective eating disorders (SED)

Selective eating disorders, also known as Avoidant Restrictive Food Intake Disorder (ARFID), should not be confused with the ‘fussy or picky eater’. It is not uncommon for young children to be picky, however, whereas a picky eater chooses to avoid certain foods, those suffering from SED want to eat foods but cannot. The symptoms are not always picked up right away, and it can be many years before the condition is correctly identified. For further information about eating disorders, see the BEAT website.

Orthorexia nervosa

What begins as a desire to follow a healthy diet can sometimes result in Orthorexia. Sufferers become obsessed with the quality and quantity of food they consume. Ultimately, the types of food consumed become restrictive, resulting in health issues. Symptoms include:

• obsession with the purity of food eaten
• feeling of superiority over those who eat junk food
• often combined with obsessive-compulsive disorder.

For further information about Orthorexia, see the National Eating Disorders Association website.

Body dysmorphic disorder (BDD)

BDD should not be confused with eating disorders such as anorexia or bulimia. People with eating disorders are obsessed with food, whereas those with body dysmorphic disorders are obsessed with their appearance. Thus, whereas sufferers of eating disorders perceive themselves as fat, those with BDD believe that they are ugly. Symptoms of BDD include:

• obsession with appearance, examples include face, hair and skin
• may become withdrawn and shy
• willingness/desire to undergo multiple, unnecessary plastic surgeries.

For further information about BDD, see the Body Dysmorphic Disorder Foundation (BDD) website.

Other specified feeding or eating disorder (OSFED)

OSFED is an increasingly common diagnosis, as often people may not meet all the criteria for a particular eating disorder, for example, anorexia, however they may still be restricting their calorie intake or binging and purging on a regular basis. The lack of a specific label does not make the disorder any less serious. All eating problems are difficult to deal with and can impact adversely on the sufferers life and health. For further information about OSFED, see the BEAT website.

Treatment for eating disorders

Treatment for eating disorders is available, although recovery can take a long time. It is important for the person affected to want to get better, and the support of family and friends is invaluable.

If an eating disorder is left untreated it can have a negative impact on work, study and relationships with family and friends. The physical effects of an eating disorder can sometimes be fatal.

People with an eating disorder rarely recover without help. Treatments include cognitive behavioural therapy, dietary counselling and family therapy. For further information on all the current treatments offered by the NHS, see the NHS website.

Some sufferers may prefer residential treatment. Residential treatment ordinarily includes therapy, nutritional counselling, group support and complementary therapies. Funding for residential treatment is sometimes provided by the NHS. For further information, contact your local health trust.

Pharmacist Support Addiction Support 

This service provides access to a fully qualified counsellor who can help people to explore the issues behind their eating disorder. If you have an eating disorder, you can contact Addiction Support directly 0808 168 5132.

Read more about Pharmacist Support’s Addiction Support service

Useful organisations

Anorexia nervosa and related eating disorders (ANRED)

ANRED is an organization that provides information about all the well-known and the lesser known eating disorders. The website also includes self-help tips and information about recovery and prevention. For further information, see the ANRED website.

Beating eating disorders (BEAT) 

Beat is a charity that provides support to anybody who has been affected by eating disorders. Services include helplines, on-line support groups and local support groups. For further information, see the BEAT website.

This page was last reviewed on 23 July 2021.