Eating disorders are serious mental illnesses that involve disordered eating behaviour. This might mean limiting the amount of food eaten, eating very large quantities of food at once, getting rid of food eaten through unhealthy means (e.g. purging, laxative misuse, fasting, or excessive exercise), or a combination of these behaviours. It’s important to remember that eating disorders are not all about food itself, but about feelings. The way the person interacts with food may make them feel more able to cope, or may make them feel in control.
Eating disorders include anorexia, bulimia, and binge eating disorder. It’s also common for people to be diagnosed with “other specified feeding or eating disorder” (OSFED). This is not a less serious type of eating disorder – it just means that the person’s eating disorder doesn’t exactly match the list of symptoms a specialist will check to diagnose them with anorexia, bulimia, or binge eating disorder.
It’s also possible for someone to move between diagnoses if their symptoms change – there is often a lot of overlap between different eating disorders. The aim behind diagnosis is to ensure that the person is getting the most appropriate treatment for their illness.
Eating disorders can cause serious harm and may be fatal – anorexia has the highest mortality rate of all mental illnesses. But even though they are serious illnesses, eating disorders are treatable. We know at Beat from our daily contact with people affected that it is very possible to make a full recovery. Like any other illness, the sooner someone with an eating disorder is treated, the more likely recovery is.
Who gets eating disorders?
There are a lot of stereotypes about who can have an eating disorder. These can be very harmful! It’s important to remember that the possibility that someone could develop an eating disorder can never be ruled out. While young women are most likely to develop an eating disorder, particularly those aged 12 to 20, anyone can develop an eating disorder, regardless of their age, gender, or ethnic or cultural background. It is thought that around a quarter of sufferers are male.
In fact, the number of sufferers among men and boys, older people, and people from ethnic or cultural minorities could be higher than we currently think. This is because these people may be more reluctant to come forward and ask for help with an illness that is already very difficult to talk about.
What causes eating disorders?
Eating disorders are complex – there is no one single reason why someone develops an eating disorder. A whole range of different factors combine, including genetic, psychological, environmental, social and biological influences. A number of risk factors need to combine to increase the likelihood that any one person develops the condition.
We don’t yet know everything about what causes an eating disorder, or what treatments will work for everyone, but we do know there are effective treatments available. There is world class research going on, much of it in the UK and involving work with centres of excellence across the globe. The latest research is showing us that eating disorders are much more biologically based than was previously thought.
Eating disorders are complex, and not everyone will experience the same symptoms. People will respond differently to treatment and can take different amounts of time to recover. Some people can be affected by more than one type of eating disorder or find their symptoms changing type as they recover. Someone with an eating disorder may also experience other mental or physical health issues at the same time as their eating disorder. Sometimes these can play a role in the eating disorder developing, or they may develop alongside or because of the eating disorder. Treatment for eating disorders should take into account other health issues the person may have.
Diagnosis of an eating disorder
The first step towards getting help for an eating disorder is usually to visit the GP. If they think someone has an eating disorder, they should refer them to a specialist for further assessment or treatment.
Doctors and healthcare professionals use agreed criteria to make a diagnosis of an eating disorder. Diagnosis is usually essential to be able to access treatment. Diagnosis is made by “taking a history”, which means talking to the person about their feelings and behaviour. It may also involve some physical tests, such as checking their height and weight, and blood tests. You can read more about what might happen at a doctor’s appointment here, and what treatment involves here.
The two main systems used to diagnose mental health issues are the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). Both cover eating disorders and are very similar in the criteria they use. The DSM is used more often in the USA, and the latest version, the DSM-5, was published in 2013. The main eating disorders listed in the DSM-5 are anorexia, bulimia and binge eating disorder (BED). The next version of the ICD is likely to include binge eating disorder as a separate eating disorder in the same way as the DSM-5 has done. You can read more information about the feeding and eating disorders chapter in DSM-5.