What are eating disorders
Eating disorders are serious mental illnesses and can affect people of all ages, genders, ethnicities and backgrounds. Disordered eating behaviour is often a way that people with eating disorders cope with difficult situations or feelings. 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) are some of these behaviours.
Food itself is not the main problem in an eating disorder, but instead more 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 that the behaviour is serving. The person experiencing the eating disorder is never at fault, and anyone who has an eating disorder deserves fast, compassionate support to help them get better.
There are numerous 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 cause serious harm both physically and emotionally, and can be fatal. However, they are treatable even though they are serious illnesses. As with any other illness, the quicker somebody with an eating disorder is treated, the more likely they are to recover. The most important thing is getting yourself or someone you know into treatment as quickly as possible. Visiting a GP is the first step.
Anorexia – trying to be in control of your weight by not eating enough food, over-exercising, or doing both
ARFID (Avoidant/restrictive food intake disorder) – avoiding certain foods, limiting how much they eat or both.
Binge eating disorder – consuming 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.
If you or people around you are worried that you have an unhealthy relationship with food, you may be experiencing 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 not a single cause to an eating disorder and people might not have all symptoms for any one in particular. Many people are diagnosed with “other specified feeding or eating disorder” (OSFED), which means that their symptoms don’t match exactly what doctors look for to diagnose binge eating disorder, anorexia, or bulimia, however this doesn’t mean that it’s not still very serious.
It’s also possible for someone’s symptoms to change over time, and therefore their diagnosis will change too. For example, someone could have anorexia, but their symptoms could later change to fit with a diagnosis of bulimia.
Symptoms of eating disorders include:
- spending a lot of time worrying about your weight and body shape
- avoiding socialising when you think food will be involved
- eating very little food
- taking laxatives or making yourself sick after you eat
- having very strict habits or routines around food
- changes in your mood such as being withdrawn, anxious or depressed
You may also notice physical signs, including:
- feeling cold, tired or dizzy
- pains, tingling or numbness in your arms and legs (poor circulation)
- feeling your heart racing, fainting or feeling faint
- problems with your digestion, such as bloating, constipation or diarrhoea
- your weight being very high or very low for someone of your age and height
- not getting your period or other delayed signs of puberty
It doesn’t mean you can’t have an eating disorder if the circumstances, feelings and symptoms you present are different to what you’ve seen or read about. The way eating disorders are presented can vary a lot from person to person which means they can be difficult to identify. 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 may have an eating disorder or be developing one.
Eating disorders are complex – there is no singular reason as to why someone develops an eating disorder. A whole range of different factors can combine to make it more likely any one person develops the condition. These can include: someone’s genetics, biology, psychology and surroundings.
You may be more likely to get an eating disorder if:
- you or a member of your family has a history of eating disorders, depression, or alcohol or drug misuse
- you’ve been criticised for your eating habits, body shape or weight
- you’re really worried about being slim, particularly if you also feel pressure from society or your job, for example, ballet dancers, models or athletes
- you have anxiety, low self-esteem, an obsessive personality or are a perfectionist
- you’ve been sexually abused
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 (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, 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:
- They might be very sensitive to the taste, texture, smell, or appearance of certain types of food, or only able to eat foods at a certain temperature. This can lead to sensory-based avoidanceor restriction of intake.
- They may have had a distressing experience with food, such as choking or vomiting, or experiencing significant abdominal pain. This can cause the person to develop feelings of fear and anxiety around food or eating, and lead to them to avoiding certain foods or textures. Some people may experience more general worries about the consequences of eating that they find hard to put into words, and restrict their intake to what they regard as ‘safe’ foods. Significant levels of fear or worry can lead to avoidance based on concern about the consequences of eating.
- In some cases, the person may not recognise that they are hungry in the way that others would, or they may generally have a poor appetite. For them, eating might seem a chore and not something that is enjoyed, resulting in them struggling to eat enough. Such people may have restricted intake because of low interest in eating.
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 (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 (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.
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:
- Atypical anorexia– where someone has all the symptoms a doctor looks for to diagnose anorexia, except their weight remains within a “normal” range.
- Bulimia nervosa (of low frequency and/or limited duration)– where someone has all of the symptoms of bulimia, except the binge/purge cycles don’t happen as often or over as long a period of time as doctors would expect.
- Binge eating disorder (of low frequency and/or limited duration)– where someone has all of the symptoms of binge eating disorder, except the binges don’t happen as often or over as long a period of time as doctors would expect.
- Purging disorder– where someone purges, for example by being sick or using laxatives, to affect their weight or shape, but this isn’t as part of binge/purge cycles.
- Night eating syndrome– where someone repeatedly eats at night, either after waking up from sleep, or by eating a lot of food after their evening meal.
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.
Getting help for an eating disorder
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 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.
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.
How can I help someone?
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 to look out for include:
- dramatic weight loss
- lying about how much they’ve eaten, when they’ve eaten, or their weight
- eating a lot of food very fast
- going to the bathroom a lot after eating
- exercising a lot
- avoiding eating with others
- cutting food into small pieces or eating very slowly
- wearing loose or baggy clothes to hide their weight loss
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.
- Listen – let them know you care and are there to listen.
- Support – Accept them as they are, without judging them.
- Talk – Stay in touch with them by messaging, texting or phoning
- Look after yourself – Supporting someone else can sometimes be stressful. Making sure that you look after your own wellbeing can mean that you have the energy, time and distance you need to be able to help.
- It can be difficult to know what to do if you’re worried that someone has an eating disorder.
- They may not realise they have an eating disorder. They may also deny it, or be secretive and defensive about their eating or weight.
- Let them know you’re worried about them and encourage them to see a GP. You could offer to go along with them.
Find local Eating Disorder support around Doncaster
A 24/7 service providing assessments to identify the most appropriate needs and services to support individuals.
Out of hours RDaSH
Doncaster – Freephone: 0800 804 8999
One of the 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? Text phone service
For anyone unable to use the standard telephone line, ie hard of hearing, we also have a text phone service:
Doncaster – 07967 793815
Tel: 01302 566980
Community Eating Disorders Service accepts referrals from professionals, as well as self-referrals. In order to safely triage each referral we need to know as much of the following information as possible. However, please do not delay making referral if some of this is missing or will take a long time to obtain:
- Summary of the current concerns
- Current weight and height
- History of weight and height over time
- Changes in eating behaviour and food preferences
- Exercise levels
- Any other behaviours intended to control weight or body shape
- Distorted self-perception or body-image difficulties
- How the young person and their family are managing
- Any recent blood chemistry results, blood pressure and pulse
- Contact details of the referred young person and their family
- Whether you have consent from the young person and their family to refer to Community Eating Disorders Service
Here 24/7 for young people in Doncaster who need urgent help for mental health crisis. could this please be put underneath the RDASH – Mental Health Single Point of Access service.
We are 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.
We provide support to people affected by eating disorders. This includes a range of eating problems including anorexia, bulimia and binge eating disorders.
We see people whose relationship with food, and maybe their body image, dominates their lives, and we help the people who care about them. Men, women, young and old, all access our services. You don’t have to look a particular way to get support from us.
We provide treatment which may be one to one therapeutic and practical support for people experiencing eating disorders and for families and friends. We are a self-referral service and are suitable for ages 11 and above, please visit our website https://www.syeda.org.uk/doncaster-referral-criteria. for more information.
National support organisations
See what national support is available for Eating Disorders.
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.
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.
The NHS website has contact information for a number of mental health helplines.
HealthUnlocked is the world’s largest social network for health. Find and connect with people with a similar health condition.
The Pzizz app helps you quickly calm your mind, fall asleep fast, stay asleep, and wake up refreshed.
Recovery Record is App with a log for how you feel, but also ideas and suggestions for positive thoughts and coping strategies.