What is an eating disorder?

An eating disorder is a serious mental health condition that involves disturbed eating patterns and an unhealthy relationship with food. It may also involve excessive exercise and distorted body image.

Anyone can get an eating disorder, whatever your cultural background, sex or age. Around 1.1 million Australians were affected by an eating disorder in 2023. Eating disorders are most common in adolescents.

An eating disorder can have an impact on your:

• behaviour
• mental wellbeing
• physical health

What are the common types of eating disorders?

There are many types of eating disorders.

Anorexia nervosa

Of people with eating disorders in Australia, 3% have anorexia nervosa. People with anorexia nervosa can be:

• severely underweight
• preoccupied with food and often severely count and restrict their calorie intake
• concerned about putting on weight

They often have a distorted body image. This can make them feel a need to lose weight, even if they are already underweight.

It can be hard for someone with anorexia nervosa to recognise that they are unwell. They may also struggle to understand the impact of their condition on their physical health.

Binge eating disorder (BED)

Around 1 in 5 people who have an eating disorder in Australia have BED. People with this disorder will often eat large amounts of food over a short time, even when they aren’t hungry. This is known as 'binging'.

Binge-eating can cause people feelings of shame, guilt and distress. They may not feel in control of their binge eating. People with binge eating disorder may fast in response to the way they feel after a binge. However, people with BED don’t regularly purge (vomit) their food.

Bulimia nervosa

People with bulimia have periods of binge-eating. These are followed by periods of ‘purging’. This is getting rid of the food that was eaten by vomiting (being sick) or taking laxatives.

People with bulimia often feel out of control. About 12% of people with eating disorders have bulimia nervosa.

Pica

People with pica consume things that are not edible and do not have nutritional value. If you have pica, you feel cravings for these substances. Pica is an eating disorder that does not usually impact what food is eaten.

If you have pica, the things you consume may include:

• paper
• dirt
• clay
• hair
• faeces (poo)

Other specified feeding or eating disorder (OSFED)

You may have an eating disorder that is similar to another eating disorder. But, your symptoms may not be as severe or meet the full criteria for diagnosis. Disorders like these are classified as OSFED. There are five subtypes of OSFED:

• atypical anorexia nervosa
• subthreshold bulimia nervosa
• subthreshold binge eating disorder
• purging disorder
• night-eating syndrome

Around 1 in 3 people who get treatment for an eating disorder have an OSFED.

Unspecified feeding or eating disorder (UFED)

A person with USFED has an eating disorder that does match criteria for other eating disorders, including OSFED.

Orthorexia

Orthorexia is an obsession with healthy or “clean” eating. A person with orthorexia may excessively avoid processed foods. Orthorexia isn’t an official eating disorder diagnosis.

What are the symptoms of eating disorders?

It’s not always easy to tell if someone has an eating disorder. They may try to hide their symptoms.

If you think you or someone you know has an eating disorder, you may notice behavioural, physical and emotional changes.

Changes in behaviour

If you have an eating disorder, you may engage in unhealthy eating habits, like:

• obsessively counting calories or kilojoules
• fasting or skipping meals
• avoiding certain food groups
• binge eating — eating large amounts of food quickly
• purging — making yourself vomit or using laxatives during or after eating
• eating in private to avoid eating with other people

Many people sometimes use food as a source of comfort. If you often eat in large volumes or in secret to comfort or punish yourself (self-harm), seek help.

You may find yourself being secretive about your eating habits, like telling others that you have eaten when you haven't.

Other behaviours linked with eating disorders include:

• doing too much exercise such as exercising while sick or in bad weather
• sensitivity to comments about your body and appearance
• checking your body size often by weighing or measuring yourself
• changing your clothing style such as wearing baggy clothes

Physical changes

There are also physical signs that you may have an eating disorder, including:

• changes in your weight such as rapid weight loss
• changes in your menstrual cycle (periods) such as loss of periods or irregular periods
• dizziness, feeling light-headed or feeling faint
• constantly feeling tired (fatigue) and having difficulty sleeping
• being cold even in warm weather due to loss of body fat

Emotional changes

Some of the emotional signs of an eating disorder are:

• feeling distressed by or obsessed with weight, body appearance or food
• feeling like you are not in control around food
• feeling like your self-esteem depends on your appearance
• having an unrealistic body image and feeling unhappy with your body
• feeling like you need to lose weight even if you are underweight
• finding that eating makes you feel anxious, upset or guilty

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes eating disorders?

The factors that lead to the development of an eating disorder are complex. They involve a range of biological, psychological and sociocultural factors. These risk factors vary from person to person.

Biological and genetic risk factors may include:

• a family history of eating disorders
• high body weight in childhood
• a history of conditions affecting the digestive system

Psychological and behavioural risk factors may include:

• low self-esteem
• neurodiversity
• previous trauma or abuse
• diet restrictions

Social and cultural risk factors may include:

• problems with friends or family relationships
• high academic expectations
• bullying

When should I see my doctor?

If you have an eating disorder, get help as soon as possible. Eating disorders damage your body and can even be fatal (cause death), but they can be treated.

Visiting your doctor is the first step to getting better. If you don't have a doctor, you can find one near you using the healthdirect Service Finder.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How are eating disorders diagnosed?

Many people who have eating disorders try to keep it a secret or won't admit they have a problem often due to shame. However, it's important to get help as soon as you can (see 'Resources and Support').

Early treatment may limit the progression (getting worse) of eating disorders and improve outcomes.

The first step is to see your doctor. A doctor or mental health professional can diagnose an eating disorder. They can refer you for more support, such as from a mental health professional.

There is no single test to decide whether you have an eating disorder. There are a number of assessments that can lead to a diagnosis.

Physical examination

Disordered eating can take a toll on your body, so your doctor must first check that you are physically OK. Your doctor is likely to check your:

• height
• weight
• vital signs (heart rate, blood pressure and temperature)

Your doctor may recommend blood tests and urine tests to check your physical health.

Psychological evaluations

Your doctor or mental health professional may ask you about your eating habits and body image.

They may assess your mental health through questionnaires or surveys.

Your doctor can also work with you to develop a mental health treatment plan.

How are eating disorders treated?

There is no 'one size fits all' approach to treating eating disorders since everyone is different. Often a team of health professionals is involved in your treatment. This can include a:

• psychologist or psychiatrist
• dietitian
• social worker
• occupational therapist
• doctor

Eating disorders can be treated through person-centred, stepped care. This means that your treatment is tailored for your:

• illness
• situation
• needs

Recovery from an eating disorder may not be linear (go in a straight line). How you respond to treatment may be different to how another person responds. Stepped care makes allowances for different services over the course of your illness and recovery.

With the right professional, social and emotional support, you can get better from an eating disorder. Treatment options include the following.

Psychotherapy

Psychotherapy is a group of therapies designed to help you change your thinking patterns and improve your coping skills. This usually involves regular visits to a psychologist.

A common therapy is 'cognitive behavioural therapy' (CBT). This helps you identify and change your thoughts, feelings and behaviours associated with your eating disorder.

Another therapy is dialectical behaviour therapy (DBT). It helps you manage your emotions and accept yourself.

Support from family and friends

If you think you have an eating disorder, talk to someone you trust. This might be a close friend or family member. They can help support you.

If you have an eating disorder, you can talk to your doctor about the 'family approach'. The aim of the family approach is to:

• treat your eating disorder
• support your family
• teach your family how to care for a person with an eating disorder

A family approach is mostly used when young people are being treated for an eating disorder. It can also help to strengthen family relationships.

Nutrition education

A dietitian can help you learn healthy eating habits and behaviours. They may be able to help you return to a healthy weight. A dietitian can also check that you get the right amount of vitamins and minerals.

Medicines

There is no medicine specifically used to treat people with eating disorders. However, you may be prescribed medicines to treat other illnesses such as depression or anxiety.

Medicines should be used alongside other treatments.

What are the complications of eating disorders?

An eating disorder can have an impact on your physical health. It could lead to starvation and malnutrition. Having an eating disorder can damage your organs, including your brain.

People with eating disorders also have a higher chance of developing a mental health condition. They can have a higher chance of suicide.

Can eating disorders be prevented?

There are some things you can do to lower your chance of getting an eating disorder. These include:

• building your self-esteem
• maintaining a healthy relationship with food and eating
• developing social connections
• practicing mindfulness

Resources and support

If you are in crisis you can call:

• Lifeline — 13 11 14 (24 hours)
• Suicide Call Back Service — 1300 659 467 (24 hours)
• 1800 Respect family violence or sexual assault — 1800 737 732 (24 hours)

For more support and information about eating disorders, there are organisations that can help.

• Butterfly National Helpline — you can call on 1800 33 4673 for confidential counselling or for advice about supporting someone with an eating disorder.
• SANE has information on eating disorders — you can also call their support line on 1800 187 263
• Eating Disorders Victoria has resources and support services — if you live in Victoria, you can make an appointment with a counsellor by calling 1300 550 236
• The Inside Out Institute for Eating Disorders website has resources if you think you or someone you know has an eating disorder
• The National Eating Disorders Collaboration website covers resources and local services, support organisations, peer support groups, and support for carers
• Eating Disorders Families Australia (EDFA) offers carer support, including support groups — you can also call them on 1300 195 626.

Languages other than English

• Embrace Multicultural Mental Health has information about eating disorders in multpile community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• The Butterfly foundation has a campaign 'Every BODY is Deadly' focused on eating disorders and body image among Aboriginal and Torres Strait Islander peoples.
• Visit YARN13 for mental health support. You can also call them on 13 92 76.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.