Eating problems

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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.

• Bulimia nervosa
• Anorexia nervosa
• Binge eating disorder
• Other specified feeding or eating disorder (OSFED)
• Other diagnoses related to disordered eating

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.

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.

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.

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).

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."

This information was published in June 2017. We will revise it in 2020.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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