Eating disorders are characterised by an abnormal attitude towards food that causes someone to change their eating habits and behaviour.
A person with an eating disorder may focus excessively on their weight and shape, leading them to make unhealthy choices about food with damaging results to their health.
Types of eating disorders
Eating disorders include a range of conditions that can affect someone physically, psychologically and socially. The most common eating disorders are:
- anorexia nervosa – when a person tries to keep their weight as low as possible; for example, by starving themselves or exercising excessively
- bulimia – when a person goes through periods of binge eating and is then deliberately sick or uses laxatives (medication to help empty the bowels) to try to control their weight
- binge eating disorder (BED) – when a person feels compelled to overeat large amounts of food in a short space of time
Some people, particularly those who are young, may be diagnosed with an eating disorder not otherwise specified (EDNOS). This means you have some, but not all, of the typical signs of eating disorders like anorexia or bulimia.
What causes eating disorders?
Eating disorders are often blamed on the social pressure to be thin, as young people in particular feel they should look a certain way. However, the causes are usually more complex.
An eating disorder may be associated with biological, genetic or environmental factors combined with a particular event that triggers the disorder. There may also be other factors that maintain the illness.
Risk factors that can increase the likelihood of a person having an eating disorder include:
- having a family history of eating disorders, depression or substance misuse
- being criticised for their eating habits, body shape or weight
- being overly concerned with being slim, particularly if combined with pressure to be slim from society or for a job – for example, ballet dancers, models or athletes
- certain underlying characteristics – for example, having an obsessive personality, an anxiety disorder, low self-esteem or being a perfectionist
- particular experiences, such as sexual or emotional abuse or the death of someone special
- difficult relationships with family members or friends
- stressful situations – for example, problems at work, school or university
Do I have an eating disorder?
Doctors sometimes use a questionnaire to help identify people who may have an eating disorder. The questionnaire asks the following five questions:
- Do you make yourself sick because you feel uncomfortably full?
- Do you worry you have lost control over how much you eat?
- Have you recently lost more than one stone (six kilograms) in a three-month period?
- Do you believe yourself to be fat when others say you are too thin?
- Would you say food dominates your life?
If you answer “yes” to two or more of these questions, you may have an eating disorder.
Spotting an eating disorder in others
It can often be very difficult to identify that a loved one or friend has developed an eating disorder.
Warning signs to look out for include:
- missing meals
- complaining of being fat, even though they have a normal weight or are underweight
- repeatedly weighing themselves and looking at themselves in the mirror
- making repeated claims that they’ve already eaten, or they’ll shortly be going out to eat somewhere else and avoiding eating at home
- cooking big or complicated meals for other people, but eating little or none of the food themselves
- only eating certain low-calorie foods in your presence, such as lettuce or celery
- feeling uncomfortable or refusing to eat in public places, such as at a restaurant
- the use of “pro-anorexia” websites
It can be difficult to know what to do if you’re concerned about a friend or family member. It’s not unusual for someone with an eating disorder to be secretive and defensive about their eating and their weight, and they may deny being unwell.
Read more about approaching and talking to your child about eating disorders and supporting someone with an eating disorder.
You can also talk in confidence to an adviser from the eating disorders charity Beat by calling their helpline on 0345 634 1414. They also have a designated youth helpline on 0345 634 7650.
Who’s affected by eating disorders?
A 2015 report commissioned by Beat estimates more than 725,000 people in the UK are affected by an eating disorder. Eating disorders tend to be more common in certain age groups, but they can affect people of any age.
Around 1 in 250 women and 1 in 2,000 men will experience anorexia nervosa at some point. The condition usually develops around the age of 16 or 17.
Bulimia is around two to three times more common than anorexia nervosa, and 90% of people with the condition are female. It usually develops around the age of 18 or 19.
Binge eating affects males and females equally and usually appears later in life, between the ages of 30 and 40. As it’s difficult to precisely define binge eating, it’s not clear how widespread it is, but it’s estimated to affect around 5% of the adult population.
Treating eating disorders
If an eating disorder isn’t treated, it can have a negative impact on someone’s job or schoolwork, and can disrupt relationships with family members and friends. The physical effects of an eating disorder can sometimes be fatal.
Treatment for eating disorders is available, although recovery can take a long time. It’s important that the person affected wants to get better, and the support of family and friends is invaluable.
Treatment usually involves monitoring a person’s physical health while helping them deal with the underlying psychological causes. This may involve:
- using self-help manuals and books, possibly under guidance from a therapist or another healthcare professional
- cognitive behavioural therapy (CBT) – therapy that focuses on changing how a person thinks about a situation, which in turn will affect how they act
- interpersonal psychotherapy – a talking therapy that focuses on relationship-based issues
- dietary counselling – a talking therapy to help a person maintain a healthy diet
- psychodynamic therapy or cognitive analytic therapy (CAT) – therapy that focuses on how a person’s personality and life experiences influence their current thoughts, feelings, relationships and behaviour
- family therapy – therapy involving the family discussing how the eating disorder has affected them and their relationships
- medication – for example, a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs) may be used to treat bulimia nervosa or binge eating
There’s a range of other healthcare services that can help, such as support and self-help groups, and personal and telephone counselling services. See the “Useful links” section on this page for more information.