Eating Disorders and Mental Health

Eating disorders are serious mental health conditions that affect how a person thinks, feels, and behaves around food, eating, and body image. They can affect anyone, regardless of age, gender, background, or body size.

Understanding eating disorders, their signs, and how to find support can make a real difference, whether you are experiencing one yourself or are concerned about someone you care about.

Eating disorders include anorexia, bulimia, binge eating disorder, avoidant/restrictive food intake disorder (ARFID), and other specified feeding or eating disorder (OSFED).

The signs and symptoms vary depending on the disorder being experienced, and the signs of an eating disorder are not always obvious to friends and loved ones. Eating disorders can have serious effects on an individual's physical health, which is why it is important to seek support via your GP as soon as possible.

What Is an Eating Disorder?

An eating disorder is a mental health condition that affects how a person thinks and feels about food, eating, and their body. Eating disorders are not a lifestyle choice or a phase. They are serious mental health conditions that can affect both physical and emotional wellbeing.

For many people, an eating disorder develops as a way of coping with difficult emotions or situations. They can also develop alongside other mental health conditions, including anxiety, depression, OCD, and PTSD.

Types of Eating Disorders

There are several recognised eating disorders, each with its own characteristics.

Anorexia nervosa

Anorexia involves restricting food intake due to a fear of gaining weight or a distorted perception of body size. Someone with anorexia may see themselves as much larger than they are, even when they are significantly underweight. Anorexia has one of the highest mortality rates of any mental health condition, which is why getting support early is so important.

Bulimia nervosa

Bulimia involves cycles of eating large amounts of food, followed by attempts to compensate, such as making yourself sick, using laxatives, or exercising excessively. People with bulimia often feel shame and may hide their behaviour, which means it can go unnoticed for a long time.

Binge eating disorder (BED)

Binge eating disorder involves regularly eating large amounts of food in a short period of time, often feeling out of control during these episodes. Unlike bulimia, there are no compensatory behaviours. BED is the most common eating disorder in the UK and is often accompanied by feelings of guilt, shame, or distress.

Avoidant/restrictive food intake disorder (ARFID)

ARFID involves limiting the amount or variety of food eaten, but not because of concerns about weight or body image. It may be linked to sensory sensitivities, a fear of choking or being sick, or a general lack of interest in food. ARFID is more common in children and autistic people, though it can affect anyone.

Other specified feeding or eating disorder (OSFED)

OSFED is a diagnosis for people who are significantly struggling with food and eating, but do not meet all the criteria for one of the other diagnoses above. OSFED is just as serious as any other eating disorder and deserves the same level of support and care.

Orthorexia

Orthorexia is not formally recognised as a separate eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and GPs may not be able to give it as a diagnosis. However, it is increasingly recognised by experts, who typically treat it as a form of anorexia nervosa or OCD.

If you recognise the signs in yourself or someone you care about, including an obsessive focus on eating in ways seen as healthy or pure, anxiety around food, social withdrawal, or physical health difficulties, it is worth speaking to your GP. You do not need a formal diagnosis to ask for support.

Who Is Affected by Eating Disorders?

Eating disorders can affect anyone. They are more common than many people realise. In the UK, it is estimated that around 1.25 million people are living with an eating disorder at any given time.

While eating disorders have historically been associated with young women, this is a misconception. Eating disorders affect people of all genders, ages, ethnicities, and body sizes. They are increasingly recognised in men and boys, in older adults, and in people from all cultural backgrounds. Certain factors may increase a person's vulnerability, including:

  • A family history of eating disorders or other mental health conditions
  • Experiencing trauma, abuse, or significant stress
  • Low self-esteem or a history of being bullied, particularly about weight or appearance
  • Being autistic or having ADHD
  • Being involved in sports, industries, or activities that place emphasis on weight or body shape

None of these factors mean that someone will develop an eating disorder. Equally, a person without any of these risk factors can still be affected.

Signs and Symptoms of Eating Disorders

The signs and symptoms of eating disorders vary depending on the type and the individual. They are not always obvious to friends and loved ones, and many people work hard to conceal what they are going through.

Behavioural signs may include:

  • Avoiding meals, eating alone, or making excuses not to eat
  • Eating very small amounts, cutting food into tiny pieces, or moving food around the plate
  • Going to the bathroom immediately after meals
  • Excessive exercising, including exercising despite illness or injury
  • Buying or hoarding food
  • Wearing loose or baggy clothing to conceal weight loss or body shape
  • Withdrawing from social activities, particularly those involving food

Emotional and psychological signs may include:

  • Intense preoccupation with food, calories, weight, or body image
  • Distorted perception of body size or shape
  • Extreme fear of gaining weight
  • Mood changes, including increased anxiety, irritability, or low mood
  • Rigid, inflexible thinking around food or mealtimes
  • Feeling a loss of control around eating
  • Feelings of guilt, shame, or distress after eating

Physical signs may include:

  • Significant weight loss or fluctuating weight
  • Feeling cold all the time
  • Tiredness and low energy
  • Hair thinning or loss
  • Dizziness or fainting
  • Stomach pain, bloating, or digestive problems
  • Dental problems (associated with regular vomiting)
  • Swollen cheeks or jaw pain (associated with regular vomiting)

It is important to note that a person can have a serious eating disorder without appearing underweight. Eating disorders exist across all body sizes and appearances. Weight is not a reliable indicator of whether someone is struggling.

Eating Disorders and Mental Health

Eating disorders are mental health conditions. They are not about vanity or a desire to look a certain way. For many people, an eating disorder develops as a way of managing overwhelming emotions, a need for control, or deeply held beliefs about self-worth.

It is common for eating disorders to occur alongside other mental health conditions, including depression, anxiety disorders, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and body dysmorphic disorder

This is why treatment for eating disorders often involves addressing emotional and psychological difficulties alongside any physical health concerns. An eating disorder team may identify that difficulties with food are connected to another underlying mental health condition, and treatment will be tailored accordingly.

How to Support Someone with an Eating Disorder

If you are worried about someone, it can be difficult to know how to help. Some things that can make a difference include:

  • Choosing a calm, private moment to express your concerns
  • Focusing on how you have noticed they seem to be struggling, rather than commenting on food or weight directly
  • Listening without judgement and without trying to fix things immediately
  • Being patient, as eating disorder recovery takes time and is rarely straightforward
  • Encouraging them to speak to their GP or a mental health professional
  • Taking care of your own wellbeing too, as supporting someone with an eating disorder can be emotionally demanding

Avoid commenting on their weight or appearance, even with good intentions. Avoid framing food choices as 'good' or 'bad'. Encouraging someone to 'just eat' is unlikely to help and can increase feelings of shame.

Support Available

Mental Health Matters does not provide support specifically for eating disorders.

If you are struggling with an eating disorder, seek support from your GP as soon as you can. They can review your overall health and may refer you to an eating disorder specialist or team of specialists.

The eating disorder team may identify that your eating difficulties are related to another mental health condition, for example depression or PTSD, and they may refer you to your local psychological service once your physical health is stable.

Beat is the UK's eating disorder charity and provides a wide range of information resources and a national support helpline. The website also provides information about how to support someone who has an eating disorder.

If you are in crisis or need urgent support, please contact your GP, call NHS 111, or visit your nearest A&E.

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