Eating disorders

What is an eating disorder?

The page looks at the different types of eating disorders, the signs of an eating disorder, the types of eating disorders and what can help.

If you worry about what you weigh and how you look so much that it changes your life, you might have an eating disorder. You might think you need to lose weight even if you are thin. You might eat too much to help you cope with things that are happening in your life. If you think you do these things, you might have an eating disorder.

Types of eating disorders

There are different types of eating disorders which affect people in different ways:

Anorexia

• Eating very little food.
• Losing lots of weight very quickly.
• Being afraid of getting fat or putting on weight.
• In women, periods might stop after dramatic weight loss.

Bulimia

• Having an urge to eat lots and lots of foods in one go (bingeing), then making yourself sick (purging).
• Taking laxatives to help you lose weight.
• Feeling low in mood, guilty for bingeing, or feeling bad about yourself.

Binge Eating Disorder

• Eating lots of food quickly, when you don’t feel hungry and not stopping when you are full.
• Feeling guilty for having eaten so much.
• Eating in secret, away from other people.
• Putting on weight.

Why do people have eating disorders?

Anyone can have an eating disorder. Sometimes, people have eating disorders because of things happening in their lives, like:

• Wanting to have control over parts of life.
• Having very little self-confidence.
• Worrying about what other people think.
• Striving for ‘perfection’ such as wanting to look like someone on the television or in magazines
• Not knowing how to cope with difficult feelings.
• Bereavement.
• Trauma, such as being bullied or abused.

How eating disorders affect your body

Eating disorders can make both visible and invisible changes to the body, such as:

• Pale, dry skin.
• More hair on the body.
• Dental problems caused by the effect of acid on the teeth when vomiting.
• Thinning hair and brittle nails.
• Swelling of the face.
• Increase in weight.
• Problems with the lining of the stomach such as ulcers.
• Fertility problems.
• Using lots of laxatives can create problems in the bowels.

How eating disorders can affect how a person feels

Eating disorders can also create emotional and psychological issues, such as:

• Anxiety.
• Depression.
• Wanting to withdraw and avoid other people.
• Difficulties with concentration.
• Memory problems.
• Decreased sex drive.
• Anger.
• Guilt.

Supporting someone with an eating disorder

Information for service users, carers and staff around supporting someone with an eating disorder.

• Taking the time to do some further information on eating disorders can help you to understand what eating disorders are, so you feel better prepared in offering support. 
• Have a calm and open discussion with your loved one, giving them plenty of space to talk.
• Try to understand why they have developed an eating disorder and work through any issues together.
• Reassure them that you’re there for them, to offer help and support if and when they need it.
• Encourage your loved one to see their GP as soon as possible and offer to go with them if they would find it helpful.

Some other things you can do which you might find helpful:

• Concentrate on how they are feeling.
• Learn as much as you can about eating disorders.
• Show love, empathy and support.
• Don’t blame or judge them.
• Try to avoid talking about appearances / weight.
• Encourage positive time with family and friends.

Young people and eating disorders

Information for service users, carers and staff looking at eating disorders in young people, covering signs, things that can help and where to access support.

What are eating disorders in young people?

It’s not uncommon for young people, particularly adolescents, to be concerned about their appearance, body shape and image.

Food is an essential part of our lives. We need it to live and grow, and a healthy, balanced diet is essential for our physical and emotional wellbeing. Everyone eats differently, and it’s normal if your child sometimes forgets to eat for a day or has an occasional blow out and eats far too much food in one go, or perhaps sometimes goes on a diet.  We all have different eating habits but sometimes our relationship with food can become a problem.

It’s not uncommon for young people, particularly adolescents, to be concerned about their appearance, body shape and image. However, trying to control exactly what they eat or how much they eat very strictly, or having urges to eat and then make themselves sick and becoming obsessed with their weight and body shape are possible signs that your child may have an eating disorder.

Eating disorders are serious mental health conditions when eating behaviour becomes very much disrupted.  Young people may begin strict dieting, binge on food secretly, obsessively count calories and vomit after eating (known as purging).

Young people with eating disorders use food to deal with difficult and painful emotions and to help them feel more in control.

Main types of eating disorders

Anorexia Nervosa

Not eating enough food and / or exercising too much to keep their weight as low as possible and to an unhealthy level. Other people may comment that they are too thin but they think that they are overweight.

Bulimia

Losing control of how much they eat, eating a lot of food in a very short time, called binge eating, then deliberately making themselves sick or taking laxatives to make themselves go to the toilet, restricting what they eat or doing too much exercise to try to stop putting on weight.

Binge Eating Disorder

When they regularly lose control of their eating, eat large portions of food all at once until they feel uncomfortably full, and then often feel upset or guilty.

Causes, signs and symptoms

It’s not known exactly why young people develop an eating disorder, but it’s thought that there may be a mix of contributing factors.

Eating disorders are common and can affect anyone. It’s not known exactly why people develop an eating disorder, but it’s thought that there may be a mix of contributing factors, including environment, genetics and psychological factors.  Eating disorders often happen when another area of the young person’s life maybe doesn’t feel right or is out of control, or if they are experiencing a lot of worry or stress. They might feel that being able to control how much or what they eat gives them back a feeling of control and order in their life.

Some possible causes might be:

• Having a family history of eating disorders.
• Being criticised and / or bullied for their body shape and / or weight.
• Pressure to be slim i.e. dancers and athletes.
• Obsessive personality, being a perfectionist.
• Anxiety or low mood.
• Experiences such as trauma or abuse.
• Loss of someone close.
• Difficult relationships with family / friends.
• Stressful situations.
• Problems at school.

Here are some signs and symptoms to look out for:

• Your child may worry excessively about their body shape, how they look and how much they weigh, thinking they are too fat and have a fear of gaining weight.
• They start strict dieting, counting calories obsessively, avoiding food they think is fattening and eating only low calorie foods.
• They may try and avoid social situations that involve eating food around others, such as meal times at home or eating out with their friends or family.
• They may be secretive or start lying about what they have eaten.
• They are doing a lot more exercise than they normally would and may get upset if something stops them from exercising.
• They may disappear to the toilet soon after eating.
• They may eat large amounts of food quickly when they are not really hungry and then feel uncomfortably full afterwards.
• Their mood may change and they appear to be more anxious or irritable than normal.

What can I do?

Information for parents, carers and staff on how to support a young person with an eating disorder.

If you think any one or more of the above sounds familiar, it doesn’t mean that your child definitely has an eating disorder, but if it is affecting their everyday life and stopping them enjoying the things they normally would, and other members of your family or their friends have noticed things, then it’s important to talk to someone and get some support and advice.

Talking to your child about your concerns is the first step to getting the right help and support in place. It can be difficult to have a conversation with a young person about their eating, especially if they don’t accept that there might be a problem.

Try to choose a time when you are both calm and relaxed. It’s not uncommon to receive a negative response from your child so be prepared for this; it can be very difficult for young people to accept that there might be a problem, but be patient and be prepared to try to approach them again.

If your child does have an eating disorder, then it’s usually very difficult for them to get better on their own, so it’s important to find professional help and support.

Remember, it is not the fault of you or your child.

Here are some suggestions on what you can do to help your child:

• Before you talk to you child, think about what you want to say.  You may want to read some further information on eating disorders before you talk to your child.  You might find this booklet from Beating Eating Disorders, a leading UK charity, helpful “Eating disorders: a guide for friends and family’.
• Choose a safe place and time when you will not be disturbed, and when neither of you are feeling angry nor upset. Mealtimes are often not the best time to raise your concerns as the young person may already be feeling very stressed and anxious if they are having difficulties around eating.
• Try not to focus the conversation too much around food or weight
• Explain why you are worried and mention things that have concerned you, but try not to list too many things as your child may be feeling over sensitive and that they are being watched.
• Try to get your child to communicate and listen to them without interrupting, avoiding being confrontational or getting into an argument.
• Try not to use accusatory language or back them into a corner.  A more helpful and sensitive approach could be, for example, ‘I wondered if you’d like to talk about how you’re feeling’, rather than ‘You need to get help’.
• Your child may be angry or defensive, but don’t react or become angry yourself.  Try and remain calm and don’t become disheartened or frustrated.
• Reassure them that you’re there for them.
• If your child acknowledges that they need help, encourage them to see their GP as soon as possible and offer to go with them if they would find it helpful.
• If your child tells you nothing is wrong, reassure them that you are there for them, and keep a close eye on them. Remember that your child may be ill even if they do not realise it themselves. Denial that there is a problem is common, particularly in the case of anorexia.  Trust your instincts.
• If your child doesn’t open up straight away don’t feel hurt or upset.  Try to talk to your child another time.

Some other things you can do which you might find helpful:

• Learn as much as you can about eating difficulties.
• Show love, empathy and support.
• Don’t blame or judge them.
• Try to avoid talking about appearances / weight.
• Encourage positive time with family and friends.
• Concentrate on how they are feeling.
• Be a good role model.
• Have resources that you can refer to and give to them.

Personal Experience: 1

‘My 15 year old daughter decided to go on a ‘diet’. Little did I know this was the beginning of an 18 month living nightmare!

As she lost weight her friends all complimented her on how fabulous she looked. I thought it was just a fad and she would soon get bored of dieting. As the weeks went by, the diet became an obsession and she started to restrict more foods.

I made an appointment with our GP who referred her to a Specialist Eating Disorder Unit. My daughter was diagnosed with anorexia. Once the anorexia was no longer a secret, her illness spiralled out of control.

Anorexia is a beast of an illness! Anorexia overtook my daughter’s body, mind and life. I watched my once happy, vivacious, beautiful daughter become depressed, angry and extremely lonely. The more anorexia controlled her, the more starved she became. The more starved she became, the stronger the anorexia became. I feared for her life, as her mental health was terrible and her body was starting to shut down. I was convinced one day I would find her dead. I would sleep with my daughter every night and basically became a full-time carer. Every meal-time was a battle; things we would normally do as a family stopped – visiting family, going out for meals. Nobody really understood the illness and I would pull away from friends and family because I felt such a failure as a mother; why could I not make her better? What have I done wrong? Why didn’t I see the signs? And many other tormenting questions I would ask myself.

Eventually my daughter’s mental and physical health became so bad she was admitted into a Specialist Eating Disorder Unit. This was the most heart-breaking thing I have ever done. I had two choices – watch her die or have her admitted to the unit.

Our family was torn apart, my eldest son started suffering from insomnia. My other daughter was convinced she would die and would suffer with panic attacks.  My husband buried his head in the sand, but I caught him one day sobbing. He was trying to be strong for us all. Anorexia had its clutches into the whole family.

I decided that during her stay in the unit I had to get strong, as I was a mess. I began walking for 1 hour every morning. I would walk through the forest and cry. I began to get faster and cry less. I could feel myself getting stronger and my daughter drew from my strength. I would say to her you are going to beat this illness, you are so strong you can do this. I started to believe she could too.

My daughter spent 6 weeks in the unit; when she came home she had gained weight, and physically her body was working better, but mentally anorexia was stronger than ever. Things then got really bad. I decided my fight was with the anorexia, not my daughter and splitting the illness from her was a great step forward. I would very calmly say, ‘Anorexia obviously does not want you to have a great life, it wants you obsessing about weight. Look at your friends having a great life, Anorexia wants you to have a rubbish life’. I can’t print her response, but I was sowing the seeds.

I got so much support from the eating disorder out-patients unit. My daughter’s nurse, Jenny, who I am eternally grateful to, would visit us and talk things through for hours. She was not only supportive to my daughter but would reassure me that I was doing a great job supporting my daughter. I needed to hear this.

Unfortunately, there is no quick-fix with mental illness. But I knew this now, I knew all the hard work had to be done by my daughter and I knew I had to be strong to support her.

I carried on running / walking and she carried on battling anorexia. Anorexia started to become quieter. She had more good days than bad; slowly her life started to get better.  It’s such a slow process but she was getting there. Getting strong was the most difficult but most effective thing I did to help my daughter.

18 months on, my amazing girl is back! She is currently studying for her A level’s, getting drunk at parties and kissing boys! That feels so good to write. She says the illness has made her a stronger, more empathetic person. She also says if she can fight anorexia, she can fight anything.

Personal Experience: 2

‘Once we were being seen by CAMHS, they were really great. We found family therapy particularly helpful as it was great to know that other people were experiencing the same thing.

It was hard at first and my daughter was reluctant to be seen, but we got a lot out of it at the end.
At the moment, the main sign that my daughter is getting better is when she gains weight. However, that doesn’t necessarily mean that she has recovered psychologically. This is something that needs more time.

I think, if I was going to give any advice to a parent in our situation, it would be to remember that, when you are being firm with your child, you are actually being firm with the illness. When the illness appears to be taking over, it is not your child.’

Personal Experience: 3

‘Our daughter was hospitalised due to her eating disorder; this came totally out of the blue and she was then referred straight to the CAMHS Team from the general hospital. We were advised that therapy could not start until her weight was stable; this surprised us both as parents, but now further down our recovery journey we understand.

The key was nutrition and getting her to eat. We were in shock at this time and it took us time to understand what we were facing, we struggled to take in all the information.

We have now been in services for a year and have found the service very good; we are still being offered support, she is so much better, fully engaged in school with friends and activities.

Our advice to others going through a similar situation is educate yourself and get as much information as you can, this really helped with our self-confidence and gave us strength; knowledge is power!

As ‘mum’, I decided to be very open and talked about our situation. I would advise you to talk to family and friends and get support. I focused on the positive support and distanced myself from any negativity. It is really important to maintain hope and confidence, surround yourself with positive people.’