Types of eating disorders, warning signs and help available

Eating disorders are serious mental health conditions that can affect anyone, regardless of their age, gender, weight or background. They can change the way someone thinks and feels about food, eating and their body, and can have a significant impact on their physical and mental health.

There are several types of eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder (BED) and avoidant/restrictive food intake disorder (ARFID).

Recognising the warning signs and getting support early can make a real difference to someone’s recovery.

This guide explains the different types of eating disorders, their symptoms, possible causes and the treatment and support available.

What is an eating disorder?

An eating disorder is a mental health condition that affects someone’s relationship with food, eating and, in some cases, their weight or body image.

People with eating disorders may restrict how much they eat, eat large amounts of food while feeling out of control, or experience significant anxiety or distress around eating.

Eating disorders are not simply about food or weight. They can be linked to emotional difficulties, anxiety, trauma and other psychological or biological factors.

Eating disorders can have serious consequences for someone’s physical and mental health, but treatment and support are available.

What are the different types of eating disorders?

There are several recognised types of eating disorders. Each has different symptoms, although some behaviours and experiences can overlap.

The main types are:

1. Binge eating disorder (BED): Repeated episodes of eating unusually large amounts of food while feeling unable to stop or control eating.
2. Anorexia nervosa: Restricting food intake, often because of an intense fear of gaining weight or difficulties with body image.
3. Bulimia nervosa: Episodes of binge eating followed by behaviours intended to compensate for eating, such as vomiting, fasting or excessive exercise.
4. Avoidant/restrictive food intake disorder (ARFID): Avoiding or restricting food because of sensory sensitivities, fear of negative consequences of eating or a lack of interest in food.
5. Other specified feeding or eating disorder (OSFED): Eating disorders that cause significant distress or health problems but do not meet all the diagnostic criteria for another specific eating disorder.

All eating disorders should be taken seriously, even when someone appears to be a healthy weight.

What are the warning signs of an eating disorder?

The signs of an eating disorder vary depending on the condition and the individual.

Someone may try to hide their eating habits or may not recognise that they have a problem.

Common warning signs include:

• Skipping meals, eating very little or following strict food rules
• Eating large amounts of food while feeling unable to stop
• Avoiding meals with family or friends
• Becoming anxious or distressed around food
• Going to the bathroom immediately after eating
• Exercising excessively or feeling compelled to exercise
• Becoming preoccupied with weight, body shape or calories
• Feeling guilty or ashamed after eating
• Changes in mood, increased anxiety or social withdrawal
• Physical symptoms such as dizziness, tiredness, digestive problems or unexplained weight changes

Not everyone will experience these symptoms, and some people may have an eating disorder without any obvious physical signs.

If you’re concerned about your own eating habits or those of someone you care about, speak to a GP.

What is binge eating disorder (BED)?

Binge eating disorder is a mental health condition involving repeated episodes of eating unusually large amounts of food in a relatively short period, accompanied by a feeling of losing control.

Someone with BED may continue eating even when they feel uncomfortably full. Afterwards, they may experience guilt, shame or distress.

Unlike bulimia nervosa, binge eating disorder does not involve regular compensatory behaviours such as self-induced vomiting or excessive exercise.

Signs and symptoms of binge eating disorder

Common symptoms include:

• Eating much more quickly than usual
• Eating until feeling uncomfortably full
• Eating large amounts of food when not physically hungry
• Eating alone because of embarrassment
• Feeling unable to control how much is eaten
• Feeling guilty, ashamed or upset after eating
• Becoming secretive about eating habits
• Experiencing anxiety, low mood or reduced self-esteem

How is binge eating disorder treated?

The NHS recommends guided self-help based on cognitive behavioural therapy (CBT) as an initial treatment for many people with binge eating disorder.

If guided self-help is not effective or suitable, group or individual CBT may be offered.

Treatment focuses on understanding binge eating patterns, developing regular eating habits and finding healthier ways to manage difficult thoughts and emotions.

What is anorexia nervosa?

Anorexia nervosa is a serious eating disorder in which someone restricts their food intake, often because of an intense fear of gaining weight or difficulties with how they perceive their body.

People with anorexia may see themselves as overweight even when they are underweight. Some may also exercise excessively or use other behaviours to try to control their weight.

Anorexia can lead to serious health complications, including malnutrition, heart problems and weakened bones.

Signs and symptoms of anorexia nervosa

Warning signs may include:

• Eating very little or regularly skipping meals
• Having strict rules around food and eating
• An intense fear of gaining weight
• Being highly critical of body shape or weight
• Exercising excessively
• Significant weight loss or difficulty maintaining an appropriate weight
• Feeling cold, tired, dizzy or faint
• Difficulty concentrating
• Changes to or loss of menstrual periods in people who menstruate
• Withdrawing from social situations involving food

Someone with anorexia may not recognise how seriously their health is being affected.

How is anorexia nervosa treated?

Treatment usually involves specialist eating disorder support, nutritional rehabilitation and regular monitoring of physical health.

Depending on someone’s age and circumstances, treatment may include:

• Cognitive behavioural therapy for eating disorders (CBT-ED)
• Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
• Specialist Supportive Clinical Management (SSCM)
• Family-based treatment for children and young people

Some people may need hospital treatment if their physical health is seriously at risk.

What is bulimia nervosa?

Bulimia nervosa is an eating disorder involving repeated episodes of binge eating followed by behaviours intended to prevent weight gain.

These behaviours may include making yourself vomit, misusing laxatives, fasting or exercising excessively.

Someone with bulimia may be a healthy weight, underweight or overweight, so the condition is not always obvious from their appearance.

Signs and symptoms of bulimia nervosa

Common warning signs include:

• Eating large amounts of food in a short period
• Feeling unable to control eating during a binge
• Going to the bathroom frequently after meals
• Vomiting after eating
• Misusing laxatives or other medicines
• Exercising excessively
• Feeling ashamed or guilty after eating
• Being highly concerned about body shape or weight
• Avoiding social situations involving food
• Experiencing mood changes, anxiety or depression

Bulimia can also cause physical problems, including dehydration, damage to teeth and disturbances in the body’s electrolyte levels.

How is bulimia nervosa treated?

Treatment often begins with guided self-help based on CBT. If this is not effective or suitable, specialist CBT for eating disorders may be recommended.

Treatment aims to establish regular eating patterns, reduce binge eating and compensatory behaviours, and address difficult thoughts and feelings about food, weight and body image.

What is avoidant/restrictive food intake disorder (ARFID)?

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder in which someone avoids certain foods or restricts how much they eat.

Unlike anorexia nervosa, ARFID is not typically driven by concerns about body weight or shape.

Someone with ARFID may avoid food because:

• They are sensitive to particular tastes, smells, textures or appearances
• They have had a frightening experience involving food, such as choking or vomiting
• They have little interest in eating or difficulty recognising hunger

ARFID can affect children and adults and may lead to nutritional deficiencies, weight loss or difficulties with everyday life.

Signs and symptoms of ARFID

Symptoms may include:

• Eating a very limited range of foods
• Avoiding foods because of their texture, smell or appearance
• Becoming anxious or distressed at mealtimes
• Eating very slowly or taking small bites
• Feeling full after eating only a small amount
• Having little interest in food
• Avoiding social situations involving meals
• Experiencing weight loss, poor growth or nutritional deficiencies

How is ARFID treated?

Treatment depends on the person’s symptoms and needs.

A GP may refer someone to a specialist eating disorder service or other healthcare professionals, including a dietitian, psychologist or occupational therapist.

Treatment may involve psychological therapy, nutritional support and gradually building confidence around eating.

What is other specified feeding or eating disorder (OSFED)?

Other specified feeding or eating disorder (OSFED) is a diagnosis used when someone has significant eating disorder symptoms but does not meet all the criteria for another specific eating disorder.

Examples include:

• Atypical anorexia nervosa: Someone experiences the psychological and behavioural symptoms of anorexia but their weight is not below the expected range, despite significant weight loss.
• Purging disorder: Someone regularly uses behaviours such as vomiting or misusing laxatives to influence their weight or shape, without binge eating episodes.
• Night eating syndrome: Repeated episodes of eating after waking during the night or excessive eating after the evening meal, causing distress or difficulties with daily life.

OSFED can be just as serious as other eating disorders and may require specialist treatment.

How is OSFED treated?

Treatment is usually based on the eating disorder that the person’s symptoms most closely resemble.

This may include psychological therapy, nutritional support and monitoring of physical health.

What causes eating disorders?

There is no single cause of an eating disorder.

They usually develop through a combination of biological, psychological and social factors.

Factors that may increase someone’s risk include:

• A family history of eating disorders or other mental health conditions
• Anxiety, depression or low self-esteem
• Difficult or traumatic life experiences
• Being criticised or bullied about weight, body shape or eating habits
• Social or cultural pressure relating to appearance
• Perfectionism or a strong need for control
• Stressful life events or significant changes in circumstances

Having one or more risk factors does not mean someone will develop an eating disorder.

Eating disorders are complex mental health conditions and are not a lifestyle choice.

How can you support someone with an eating disorder?

If you think a family member, friend or someone you care for may have an eating disorder, approaching the conversation with kindness and understanding can help.

You could:

1. Choose a quiet time to talk: Find somewhere private where the person feels comfortable and there are no distractions.
2. Explain your concerns gently: Focus on changes you’ve noticed in their wellbeing rather than commenting on their weight or appearance.
3. Listen without judgement: Give them time to explain how they feel without criticising their eating habits.
4. Encourage professional support: Suggest speaking to a GP and offer to accompany them to an appointment.
5. Be patient: Someone may find it difficult to acknowledge their eating disorder or accept help immediately.

Avoid making comments about someone’s weight, appearance or how much they eat, even when intended as reassurance.

You can also contact the eating disorder charity Beat for advice on supporting someone.

Where can you get help for an eating disorder?

If you think you or someone you know has an eating disorder, the first step is to contact a GP.

A GP can assess physical and mental health, arrange appropriate tests and refer someone to a specialist eating disorder service.

You do not need to be underweight or have a formal diagnosis before asking for help.

Eating disorder support from Beat

Beat is a UK charity offering information and support to people affected by eating disorders, including family members and carers.

Its helpline numbers are:

• England: 0808 801 0677
• Scotland: 0808 801 0432
• Wales: 0808 801 0433
• Northern Ireland: 0808 801 0434

Visit Beat for information about eating disorders and support services.

If someone is seriously unwell, collapses, has chest pain or is in immediate danger, call 999. For urgent medical advice that is not life-threatening, use NHS 111 where available or your local urgent care service.

Can you recover from an eating disorder?

Yes. Recovery from an eating disorder is possible, although it can take time.

Everyone’s experience of recovery is different. Some people recover fully, while others may need ongoing support or experience periods when symptoms return.

Treatment can help someone develop a healthier relationship with food, improve their physical health and address the thoughts and feelings contributing to their eating disorder.

Seeking help early can improve the chances of recovery, but it is never too late to ask for support.