Eating problems

Explains eating problems, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

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What are eating disorders?

An eating disorder is a medical diagnosis based on your eating patterns and medical tests on your weight, blood and body mass index (BMI). This page lists common eating disorders and other disordered eating diagnoses.

Food is one of the many mediums through which our emotions and distress can be expressed, so you may have a very difficult relationship with food which impacts on your mental health, but doesn't fit into any of the current categories of diagnosis. It's also possible to experience more than one eating disorder, or to experience some symptoms from each disorder.

If your problems with eating aren't easy for your doctor to categorise, they might not give you a specific diagnosis. But even if you don't have a diagnosis, or prefer to think about your experiences in a non-medical way, you may find it helpful to understand some of the feelings and behaviours that can be associated with specific eating disorders.

Body mass index (BMI) and diagnosis

Your BMI should not be the only factor your doctor takes into account when making an assessment. But unfortunately, getting an eating disorder diagnosis and accessing treatment can sometimes be related to how much you weigh. This can be frustrating, as it's possible to have an eating problem but still not match the criteria for a diagnosis.

If you don't have an official diagnosis it can sometimes be harder to get help, but you should not need a diagnosis to get treatment. You should usually be offered treatment that is recommended for the eating disorder that is most like your eating problems (see our page on treatment and support).

Bulimia nervosa

If you experience bulimia, you may find that you eat large amounts of food in one go because you feel upset or worried (binging). You may then feel guilty or ashamed after binging and want to get rid of the food you have eaten (purging).

How you might feel

ashamed and guilty
that you hate your body or that you are fat
scared of being found out by family and friends
depressed or anxious
lonely, especially if no one knows about your eating problems
very low and upset
like your mood changes quickly or suddenly
like you're stuck in a cycle of feeling out of control and trying to get control back
numb, like feelings are blocked out by bingeing or purging.

What you might do

eat lots of food in one go (binge)
go through cycles of eating, feeling guilty, purging, feeling hungry and eating again throughout the day
eat foods that you think are bad for you when you binge
starve yourself in between binges
eat in secret
crave certain types of food
try to get rid of food you've eaten (purge) by making yourself sick, using laxatives or exercising excessively.

What might happen to your body

you might stay roughly the same weight, or you might go from being overweight to underweight quite often
you may be dehydrated, which can cause bad skin
if you menstruate, your periods might become irregular or stop altogether
if you make yourself sick, your stomach acid can harm your teeth and you can get a sore throat
if you use laxatives, you could develop irritable bowel syndrome (IBS), stretched colon, constipation and heart disease.

A young man coping with bulimia: my experience

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Anorexia nervosa

If you get an anorexia diagnosis, this is because you are not eating enough food to get the energy you need to stay healthy. Sometimes people assume anorexia is just about slimming and dieting, but it is much more than this. At its core it is often connected to very low self-esteem, negative self-image and feelings of intense distress.

How you might feel

like you can't think about anything other than food
like you want to disappear
that you have to be perfect
like you are never good enough
lonely, especially if no one knows about your eating problems
that by eating you lose the control you feel you need
that you are hiding things from your family and friends
that you are fat and your weight loss isn't enough
very frightened of putting on weight
angry if someone challenges you
tired and disinterested in things
depressed or suicidal
anxious
a high or sense of achievement from denying yourself food or over-exercising
panicky around meal times.

What you might do

reduce your food intake or stop eating altogether
count calories of all your food and spend a lot of time thinking about them
hide food or secretly throw it away
avoid foods that feel dangerous, like those with high amounts of calories or fat
read recipe books and cook elaborate meals for people but not eat them yourself
use drugs that say they reduce your appetite or speed up your digestion
think about losing weight all the time
exercise a lot and have strict rules about how much you need to do
make rules about food, like listing 'good' and 'bad' foods or only eating things that are a certain colour
develop very structured eating times
check and weigh your body all the time.

"I started starving myself as a means of control. Everything else had been taken out of my control, but no one could force me to eat. I'd enjoy and crave the feeling of my stomach being... empty."

What might happen to your body

you might weigh less than you should or lose weight very fast
you might become physically underdeveloped (in particular if anorexia starts before puberty)
you may feel weak and move slowly
you may feel very cold all the time
if you menstruate, your periods might become irregular or stop altogether
your hair might thin or fall out
you might develop fine fuzzy hair on your arms and face (called 'lanugo')
you might lose interest in sex or not be able to have or enjoy it
you may find it hard to concentrate
your bones may become fragile and you might develop problems like osteoporosis.

Mark in front of the Eiffel Tower wearing a Mind t-shirt with his arms around two others wearing the same top

Not just a girl's disease...

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Binge eating disorder

If you have binge eating disorder you might feel that you can't stop yourself from eating, even if you want to. It is sometimes described as compulsive eating. If you experience binge eating disorder, you might rely on food to make you feel better or to hide difficult feelings.

How you might feel

out of control and as if you can't stop eating
embarrassed or ashamed
lonely and empty
very low, even worthless
unhappy about your body
stressed and anxious.

"I dread any event with a buffet. Because I know I'll eat and I'll keep eating and I won't even enjoy it but I'll eat because I feel somehow I have to. I'll eat even when I'm feeling full, when I'm feeling bloated, feeling pain in my gut, feeling sick."

What you might do

pick at food all day, eat large amounts all at once (bingeing)
eat without really thinking about it, especially when you are doing other things
regularly eat unhealthy food
eat for comfort when you feel stressed, upset, bored or unhappy
hide how much you are eating
eat until you feel uncomfortably full or sick
try to diet but find it hard.

What might happen to your body

you might put on weight
you might develop health problems associated with being overweight, such as diabetes, high blood pressure or joint
and muscle pain
you might experience breathlessness
you might feel sick a lot
you might experience sugar highs and crashes (having bursts of energy followed by feeling very tired)
you might develop health problems such as acid reflux and irritable bowel syndrome (IBS).

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Other specified feeding and eating disorder (OSFED)

OSFED is a diagnosis that is becoming more common. In the past you may have been given a diagnosis of eating disorder not otherwise specified (EDNOS) – but this isn't usually used any more.

If you are given a diagnosis of OSFED it means that you have an eating disorder but you don't meet all the criteria for a diagnosis of anorexia, bulimia or binge eating disorder. This doesn't mean that your eating disorder is less serious, it just means that it doesn't fit into current diagnostic categories. You might experience any of the behaviours, feelings and body changes associated with other eating disorders.

Getting a diagnosis of OSFED can help you access treatment and support.

"I was assessed by my local [eating disorder] service and was given a diagnosis of EDNOS [now OSFED]. I managed to get my eating back on track. I continue to work on the feelings with the help of my therapist and am very much in recovery."

Other diagnoses related to disordered eating

Rumination disorder. If you have rumination disorder you will regularly regurgitate your food (but you do not have a physical health problem to explain it). You might re-chew, re-swallow or spit out the food you regurgitate.
Pica. If you have pica, you will regularly eat things that are not food and have no nutritional value (for example chalk, metal or paint). This can potentially be very harmful.
Avoidant/restrictive food intake disorder (ARFID). If you have ARFID you will feel a very strong need to avoid food in general or certain foods because of their smell, taste or texture. The idea of eating can fill you with anxiety. ARFID does not tend to be connected to issues with body image – it is an anxiety about the process of eating itself.

"My eating disorder has never been about body image or control, and I've had it for as long as I can remember. When I'm faced with certain foods I feel a reaction in the pit of my stomach like someone has put a plate of the most disgusting things in front of me. I can only equate the sensation to walking past an open sewer."