What Are Eating Disorders?
Eating disorders are serious mental health conditions characterised by persistent disturbances in eating behaviour and related thoughts and emotions. They are not lifestyle choices or phases — they are complex illnesses with significant physical and psychological consequences.
Eating disorders affect people of all genders, ages, ethnicities, and body sizes. They have some of the highest mortality rates of any mental health condition, which makes early recognition and treatment critically important.
Recovery is possible with the right support.
Types of Eating Disorders
Anorexia Nervosa
Anorexia is characterised by a persistent restriction of energy intake, an intense fear of gaining weight, and a distorted body image. People with anorexia often perceive themselves as overweight even when they are dangerously underweight.
Key features:
- Severely restricting food intake
- Intense fear of weight gain or "being fat"
- Distorted view of one's own body
- Excessive exercise
- May involve purging behaviours (vomiting, laxatives) — this is called anorexia binge/purge type
Bulimia Nervosa
Bulimia involves recurrent episodes of binge eating — eating a large amount of food in a short period, often accompanied by a feeling of loss of control — followed by compensatory behaviours to prevent weight gain.
Key features:
- Episodes of binge eating followed by purging (vomiting, laxatives, diuretics, fasting, or excessive exercise)
- Often within a normal weight range, making it less visible
- Intense concern about body shape and weight
- Feelings of shame, disgust, or guilt after binges
Binge Eating Disorder (BED)
BED is the most common eating disorder. It involves recurrent episodes of binge eating without regular compensatory behaviours.
Key features:
- Eating large amounts of food rapidly, beyond the point of fullness
- Feeling out of control during binges
- Eating alone due to embarrassment
- Feelings of guilt, shame, or disgust afterwards
- No regular purging
Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID involves limiting the amount or type of food eaten, but unlike anorexia, it is not driven by concerns about body weight or shape. It may be related to sensory sensitivities, fear of choking, or a lack of interest in food.
Other Specified Feeding and Eating Disorders (OSFED)
Many people have eating difficulties that significantly affect their wellbeing but do not exactly fit the above categories. OSFED is a recognised diagnosis for these presentations.
Warning Signs
Physical signs:
- Significant weight loss or fluctuation
- Feeling cold all the time, hair loss, or brittle nails (in anorexia)
- Swollen cheeks or tooth erosion from frequent vomiting (in bulimia)
- Irregular or absent menstrual periods
- Fainting or dizziness
Behavioural signs:
- Avoiding meals, social eating, or certain foods
- Going to the bathroom immediately after eating
- Wearing baggy or concealing clothing
- Extreme dietary restriction or rigid food rules
- Excessive exercise despite illness or injury
Emotional and cognitive signs:
- Preoccupation with food, dieting, calories, or weight
- Intense fear of gaining weight
- Distorted self-image
- Withdrawal from social activities, especially those involving food
- Denial that a problem exists
Causes
Eating disorders are complex and rarely have a single cause. Contributing factors include:
- Genetics and biology — eating disorders run in families; certain genetic factors increase vulnerability
- Psychological factors — perfectionism, low self-esteem, anxiety, depression, and history of trauma
- Sociocultural pressures — cultural emphasis on thinness, social comparison, and media images
- Life events — bullying, abuse, significant stress, or major transitions
- Dieting — restrictive dieting can trigger disordered eating in vulnerable individuals
Treatment
Eating disorders require specialised treatment — ideally from a team that includes medical, nutritional, and psychological support.
Psychological therapies
- Cognitive Behavioural Therapy (CBT) — especially enhanced CBT (CBT-E), which is widely used for bulimia and binge eating disorder and increasingly for anorexia
- Maudsley Approach (Family-Based Treatment) — particularly effective for younger people with anorexia; involves family as active participants in recovery
- Dialectical Behaviour Therapy (DBT) — helpful when there are difficulties with emotional regulation
- Acceptance and Commitment Therapy (ACT) — building psychological flexibility
Medical care
Eating disorders can have serious physical consequences. Medical monitoring and support — including re-feeding plans for people who are severely underweight — is often essential, sometimes in a hospital setting.
Nutrition support
Working with a dietitian who understands eating disorders is often part of a comprehensive treatment plan.
How to Help Someone
If you are worried about someone:
- Choose a calm, private moment to express your concern
- Focus on behaviours and your worry rather than weight or appearance
- Listen without judgement
- Avoid making comments about food, eating, or bodies
- Encourage them to seek professional help
- Be patient — recovery takes time, and people often push back initially
Take care of your own wellbeing too. Supporting someone with an eating disorder can be emotionally exhausting.
Getting Help
If you or someone you love is struggling with an eating disorder, please reach out for support. Early intervention significantly improves outcomes.
Contact your doctor, speak to a mental health professional, or contact Seeds of New Beginnings to find out how we can help.
In a crisis, call 988 or 911.