Overview
Eating disorders are serious mental health conditions characterised by disturbed eating behaviours and intense preoccupation with food, weight, and body shape. The main types are anorexia nervosa, bulimia nervosa, and binge eating disorder. They are among the most dangerous mental health conditions with the highest mortality of any psychiatric diagnosis.
How common is it?
Eating disorders affect around 1.25 million people in the UK. They most commonly develop in adolescence and young adulthood, though they can occur at any age. Females are more commonly affected but males account for about 25% of cases.
Causes and risk factors
Eating disorders arise from a complex mix of genetic, biological, psychological, and social factors. They are not a lifestyle choice. Cultural pressures around thinness, perfectionism, trauma, and anxiety are significant contributing factors.
Common risk factors
- Family history of eating disorders or mental health conditions
- Perfectionist or anxious personality traits
- Traumatic experiences or adverse childhood events
- Bullying about weight or appearance
- Involvement in activities valuing leanness (gymnastics, ballet, wrestling)
- Dieting, particularly in adolescence
- Social media promoting unrealistic body ideals
Symptoms
- Severely restricted food intake (anorexia)
- Recurrent binge eating followed by purging through vomiting or laxatives (bulimia)
- Binge eating without purging, causing significant distress
- Intense fear of weight gain
- Distorted body image
- Extreme preoccupation with calories, food ingredients, or meal timing
- Physical signs: extreme thinness, tooth enamel erosion, swollen cheeks, hair loss
When to see a doctor
Seek help immediately if someone has a very low body weight, fainting, heart palpitations, or is refusing all food. See a doctor if eating behaviours are controlling daily life, causing distress, or affecting physical health. Early treatment leads to significantly better outcomes.
Diagnosis
Clinical assessment by a specialist includes physical examination, blood tests (electrolytes, blood count, bone density) and psychological evaluation. Weight and BMI are assessed but do not determine severity in all cases.
Treatments
Specialist eating disorder therapy
Cognitive behavioural therapy for eating disorders (CBT-E) and family-based treatment (FBT) for younger patients are the main evidence-based psychological treatments. Delivered by specialist multidisciplinary teams.
Medical monitoring and nutritional rehabilitation
Regular medical monitoring for complications. Careful, gradual refeeding under supervision. Treating electrolyte imbalances which can be life-threatening.
Inpatient or day programme treatment
For those at high medical risk or not responding to outpatient treatment. Provides intensive support for both physical and psychological aspects.
Self-care and lifestyle
- Recovery takes time and is non-linear. Relapses are part of the process and do not mean failure
- Involve family in the recovery process where appropriate
- Remove access to triggering content including diet culture accounts on social media
- Connect with peer support and recovery communities
Prevention
Promoting positive body image and healthy relationships with food in families and schools helps. Early intervention at the first signs of disordered eating is the most effective protective measure.