Eating disorders are mental health conditions in which attitudes towards food, eating, weight or body shape, and related behaviours, cause significant distress or affect physical health and everyday life. They can affect people of any sex, age or body size. A person's appearance or weight does not necessarily show how medically serious their condition is.
Main types of eating disorder
Anorexia nervosa involves persistent restriction of food intake, an intense fear of weight gain or behaviour that interferes with weight restoration, together with a disturbance in body image or limited recognition of the seriousness of the condition. Anorexia does not simply mean “loss of appetite”: a person may feel hungry but restrict food because of fears, rules or beliefs related to weight and body shape.
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Bulimia nervosa involves repeated episodes of binge eating with a sense of loss of control, followed by attempts to compensate for the food eaten. These may include self-induced vomiting, fasting, excessive exercise, or misuse of laxatives or diuretics.
Binge eating disorder involves repeated episodes of eating a large amount of food with a sense of loss of control and marked distress. Unlike bulimia nervosa, these episodes are not regularly followed by compensatory behaviour.
Other specified feeding or eating disorders also occur. Symptoms may not fully match the descriptions of anorexia, bulimia or binge eating disorder but can still require professional assessment and treatment.
Signs that may need attention
- rigid rules about food, skipped meals or significant restriction of food intake;
- episodes of binge eating with a sense of loss of control;
- self-induced vomiting, misuse of laxatives or diuretics, or excessive exercise;
- persistent preoccupation with food, calories, weight or body shape;
- avoiding meals with other people, hiding eating-related behaviour or becoming socially isolated;
- rapid or substantial weight changes, menstrual changes, dizziness, weakness or difficulty concentrating;
- anxiety, low mood, self-harm or suicidal thoughts.
A single sign does not confirm a diagnosis. However, seeking help should not be delayed because a person's weight appears to be in a “normal” range or because their symptoms do not fit a common stereotype of an eating disorder.
When urgent medical help is needed
Seek urgent medical help for fainting, chest pain, an irregular or very slow heartbeat, marked weakness, confusion, seizures, severe dehydration, inability to drink, vomiting blood, rapid deterioration or suicidal thoughts. Severe malnutrition, electrolyte disturbance, dehydration or signs of organ failure may require hospital treatment. In Ukraine, call 103 or 112.
Why eating disorders develop
Eating disorders do not have a single cause and are not a person's choice. A combination of biological, psychological, family and social factors may contribute. Stress, traumatic experiences, appearance-related criticism, dieting or social pressure may be relevant to an individual, but they do not explain every case and cannot establish a diagnosis on their own.
Assessment
A clinician asks about eating patterns, binge eating and compensatory behaviour, weight changes, physical symptoms, mood, anxiety, self-harm, medication and coexisting conditions. A screening questionnaire can support assessment but should not be used as the sole basis for diagnosis.
Physical assessment may include pulse and blood pressure measurements, blood tests to check electrolytes and other measures, and an electrocardiogram when risk factors are present. A doctor decides which investigations are needed. Assessment for children and young people also considers growth, development and the family's support needs.
Treatment
Treatment depends on the specific disorder, the person's age, physical health, risks and individual needs. Care is often multidisciplinary and may involve a psychiatrist or psychotherapist, a family doctor or paediatrician, and, when needed, other medical professionals and a dietitian working as part of the clinical team.
- For anorexia nervosa, important goals include safely restoring nutrition and physical health, moving towards a healthy weight for the individual, and providing specialist psychological treatment. Family involvement is often recommended for children and young people.
- For bulimia nervosa, treatment may include eating-disorder-focused guided self-help or cognitive behavioural therapy, restoring regular eating and stopping purging behaviour.
- For binge eating disorder, recommended approaches include eating-disorder-focused guided self-help and cognitive behavioural therapy focused on binge eating. Weight loss is not a treatment target of this psychological therapy in itself.
Medication may be used for particular indications or coexisting conditions, but it should not be the sole treatment for anorexia nervosa or bulimia nervosa. Unsupervised restrictive diets, sudden changes in food intake or medication use can be dangerous, particularly after prolonged restriction.
Recovery and support
Recovery often takes time and may not follow a straight path. Regular physical and mental health monitoring, an agreed nutrition plan, psychological treatment, support from trusted people and relapse prevention planning can support lasting change. Seeking help early allows risks to be assessed and appropriate treatment to begin promptly.