Eating disorders

Eating disorders are mental health problems that involve disordered eating behaviour - this can include eating too little or too much or becoming fixated with one’s weight or shape. 1

Eating disorders are not simply about food; the behaviours that accompany them may often serve as a coping mechanism or a way to feel in control.2 The eating disorder charity Beat estimates that around 1.25 million people in the UK are affected by an eating disorder.3 In 2007 in England, 6.4% of adults screened positive for a possible eating disorder.4

There are several types of eating disorder, including:1,2

  • Anorexia nervosa - where someone tries to keep their body weight as low as possible (by for example, not eating enough and / or exercising excessively) and has a distorted view of their body, thinking they are larger than they are.
  • Bulimia nervosa - where someone is caught in an unhealthy eating cycle of binge eating then purging to compensate for their overeating, for instance by vomiting or taking laxatives.
  • Binge eating – where someone eats excessively in a short period of time in an out-of-control way and feels compelled to do so on a regular basis.

Between 2000 and 2009, the number of people diagnosed with an eating disorder (including eating disorder not otherwise specified) for ages 10-49 years increased from 32.3 to 37.2 per 100,000 population.5 This figure is likely to be underestimated as many people with eating disorders do not have a formal diagnosis.5 It is estimated that between 10% and 25% of those with eating disorders are male.6

Symptoms

Symptoms of eating disorders will vary between individuals and type of eating disorder. Not matching the symptoms exactly does not mean that someone does not have an eating disorder, however, some common symptoms include:1

  • Eating very little food or eating large amounts of food in a short time in an uncontrolled way
  • Having very strict habits, rituals, or routines around food
  • Spending a lot of time worrying about your body weight and shape
  • Changes in mood
  • Deliberately making yourself ill after eating
  • Avoiding socialising when food may be involved
  • Withdrawing from social groups, hobbies you used to enjoy or from family life
  • Physical signs such as digestive problems or weight being very high or very low for someone of your age and height

Causes

Eating disorders are complex mental health problems that can be caused by a combination of factors. These factors include biological factors (for example genetics7 or neurochemical changes8) and psychological or social factors (lack of confidence or self-esteem9, perfectionism10, problems such as bullying, or difficulties with school or work1.)

Getting support

If you are worried you may have an eating problem, please contact your GP. Your doctor may not be an expert in treating eating disorders, but they will be able to assess any physical symptoms resulting from your eating disorder and can then refer you to specialist eating disorder services.

There are a range of approaches for the treatment and management of eating disorders and the most appropriate method will vary depending on the type and severity of the eating disorder, and the personal circumstances and preferences of the person receiving support. Some common approaches to managing and treating eating disorders include:

Psychological therapies

Psychological therapies involve working through your thoughts, feelings and behaviours with a mental health professional in regular sessions over a set period of time.1

Common psychological therapies for treatment and management of eating disorders include cognitive behavioural therapy (CBT), family therapy or psychotherapy and what is right for you may depend on your age. During your therapy sessions, you may work with the mental health practitioner to agree on an eating plan to ensure you are getting the appropriate vitamins and minerals from your diet.11 Your GP may also conduct an X-ray to check the health of your bones as being underweight for a prolonged period of time can lead to low bone strength.11

Self-Help and Self-Management

People with bulimia may be able to participate in a guided self-help programme, which involves completing exercises in a workbook alongside having short sessions with a practitioner. While this approach can be helpful to some, it is not a suitable treatment approach for everyone.11

Other Approaches

There may be other treatments or approaches available that are not outlined here. If you are considering support for eating disorders, we recommend getting in touch with your GP or primary care provider to discuss which approach may be best for you.

Helping others with an eating disorder

If someone you care about has an eating disorder, or is starting to show some of the symptoms, encourage them to see their GP and perhaps offer to go along with them.12 Letting them know they are valued, that you support them and are willing to listen to them without judgement or criticism can be helpful.12 The charity BEAT provides further guidance on supporting loved ones with eating disorders here.

Further resources and information

  • BEAT is an organisation that provides support and advice lines as well as a range of online resources about eating disorders
  • The National Centre for Eating Disorders provides training for professionals and resources for those struggling with eating disorders.
  • Anorexia & Bulimia Care provides on-going care and support and practical guidance for anyone affected by eating disorders, those struggling personally and parents, families and friends.

Date Last Updated:

This page was last updated on 23/04/2019.

References

  1. NHS Choices (2018) Eating Disorders. [online] Available at: https://www.nhs.uk/conditions/eating-disorders/
  2. BEAT (2017) Types of Eating Disorder. [online] Available at: https://www.beateatingdisorders.org.uk/types
  3. BEAT (n.d.) How many people have an eating disorder in the UK? [online] Available at: https://www.beateatingdisorders.org.uk/how-many-people-eating-disorder-uk
  4. McManus et al. (2009) Adult psychiatric morbidity in England, 2007. [online] Available at: https://webarchive.nationalarchives.gov.uk/20130104162040/https://catalo...
  5. Micali et al. (2013) The incidence of eating disorders in the UK in 2000-2009: Findings from the general practice research database. British Medical Journal, 3(5).
  6. National Centre for Social Research, University of Leicester. (2011). Adult Psychiatric Morbidity Survey, 2007. [data collection]. 3rd Edition. UK Data Service. SN: 6379.
  7. Trace et al. (2013) The Genetics of Eating Disorders. Annual Review of Clinical Psychology, 9.
  8. Avena and Bocarsly (2012) Dysregulation of brain reward systems in eating disorders: Neurochemical information from animal models of binge eating, bulimia nervosa, and anorexia nervosa. Neuropharmacology, 63(1).
  9. Brechan and Kvalem (2015) Relationship between body dissatisfaction and disordered eating: mediating role of self-esteem and depression. Eating Behaviors, 17.
  10. Bardone-Cone et al. (2007) Perfectionism and eating disorders. Clinical Psychology Review, 27.
  11. NICE (2013) Eating disorders: recognition and treatment. [online] Available at: https://www.nice.org.uk/guidance/ng69/ifp/chapter/Getting-help-for-an-ea...
  12. NHS (2017) Supporting someone with an eating disorder. [online] Available at: https://www.nhs.uk/live-well/healthy-weight/supporting-someone-with-an-e...