Eating disorders: types, symptoms and treatment

Key points

• An eating disorder is a mental health condition in which eating, or thoughts about food and body shape, cause serious harm.
• Eating disorders occur across every body size, age, gender, ethnicity and background. A person does not need to look unwell to be seriously unwell.
• The diagnoses are anorexia nervosa, bulimia nervosa, binge eating disorder, ARFID and OSFED. OSFED is the most common in practice.
• NICE states that single measures such as body mass index (BMI) or length of illness must not decide whether treatment is offered.
• Talking therapies come first, and medication should not be the only treatment.

What eating disorders are

An eating disorder is a mental health condition in which a person uses food, eating or the control of eating to cope with feelings and situations, in a way that harms their health [3]. They are illnesses, not diets or choices, and NICE says treatment should begin at the earliest opportunity [2][8].

If you need help now. Samaritans: call 116 123, free, 24/7. Shout: text 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger. Beat, the UK eating disorder charity, runs a free helpline: 0808 801 0677 in England, 0808 801 0432 in Scotland, 0808 801 0433 in Wales, 0808 801 0434 in Northern Ireland, open 3pm to 8pm Monday to Friday. No diagnosis is needed to use it [4].

Beat’s 2017 estimate is that around 1.25 million people in the UK have an eating disorder, drawn from studies outside the UK [5]. They affect every body size, age, gender, ethnicity and background, most people with one are not underweight, and around one in four are men [8]. Appearance does not measure how serious an eating disorder is: a person can be very unwell with no visible sign of it [8].

Symptoms

Symptoms fall into three groups. Nobody has all of them.

Thoughts and feelings

• Thinking about food, weight or body shape for much of the day
• Fear or dread linked to eating or to gaining weight
• Judging oneself mainly by weight or shape, and shame after eating

Behaviour

• Rigid rules about what, when or how much may be eaten
• Avoiding meals with others, or secrecy about what is eaten
• Repeated episodes of eating a large amount with a sense of lost control
• Behaviours after eating intended to undo it

Physical

• Tiredness, dizziness, feeling cold, poor sleep, difficulty concentrating
• Digestive problems, dental problems, hair and skin changes, loss of periods

Eating disorders are often mistaken for fussy eating, dieting or IBS [3][8]. Depression, anxiety, obsessive compulsive disorder (OCD), self-harm and substance misuse commonly occur alongside them [2].

Types

The UK recognises five main diagnoses, all serious and all deserving treatment [7].

• Anorexia nervosa. Eating is restricted to control weight. Fear of weight gain and a distorted view of one’s own body are central [3].
• Bulimia nervosa. Episodes of eating a large amount with lost control, followed by compensatory behaviours meant to prevent weight gain [3].
• Binge eating disorder. Repeated episodes of eating large amounts with distress and lost control, without regular compensatory behaviours [3].
• ARFID, avoidant restrictive food intake disorder. Food is avoided or intake limited, but not because of concerns about weight or shape. The reasons are usually sensory sensitivity to taste, texture or smell, fear after a distressing experience, or low interest in eating. It occurs at any age, often alongside autism, ADHD or anxiety [9].
• OSFED, other specified feeding or eating disorder. Used when symptoms are serious but do not match the criteria above, including atypical anorexia, where anorexia symptoms occur at a normal or higher weight. OSFED accounts for the largest share of diagnoses and is seen most often in practice [7].

Causes and risk factors

No single cause is known. The evidence points to a mix of biological, psychological and social factors that differs between people [8].

• Biological. Family history of eating disorders or other mental health conditions, and inherited differences in appetite and anxiety.
• Psychological. Perfectionism, low self-esteem, difficulty tolerating uncertainty, and existing anxiety, depression or OCD.
• Social. Bullying or comments about eating or appearance, bereavement, abuse, and settings where weight is closely watched.

The evidence does not support the ideas that they are caused by the media alone, are attention-seeking, or are a failed diet [8].

How it is diagnosed

Diagnosis is usually made within a specialist eating disorder service, but a GP is normally the first contact and does an initial assessment [3]. Where one is suspected, NICE says the person should be referred immediately to a community-based, age-appropriate service [2]. Children and young people go to CAMHS or a community eating disorder service, adults to an adult service or mental health team.

Assessment covers eating patterns, thoughts about food, weight and shape, mood and physical health, usually with blood tests [2].

NICE is explicit that single measures such as BMI or duration of illness must not decide whether to offer treatment [2]. People are still sometimes turned away for not being ill enough, and naming that recommendation with a GP is reasonable.

Waiting times are published only for children and young people in England. In October 2025, 79 per cent of urgent and 83 per cent of routine referrals met the one-week and four-week standards [6]. Adult figures are not published [10].

Treatment

NICE guideline NG69 recommends a talking therapy as the first treatment for every eating disorder diagnosis, and says medication should not be the sole treatment [1][2].

• Anorexia nervosa, adults. One of three therapies: eating-disorder-focused cognitive behavioural therapy (CBT-ED), Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), or specialist supportive clinical management (SSCM), over several months [2].
• Anorexia nervosa, children and young people. Anorexia-nervosa-focused family therapy (FT-AN) first, involving parents or carers in supporting eating. If it does not help, individual CBT-ED or adolescent-focused psychotherapy [2].
• Binge eating disorder. A guided self-help programme first, then group CBT-ED, with individual CBT-ED as an alternative [2].
• Bulimia nervosa. For adults, bulimia-nervosa-focused guided self-help, then individual CBT-ED. For children and young people, family therapy first, then individual CBT-ED [2].
• ARFID. NG69 sets out no separate pathway. Services use behavioural work to widen the range of foods, anxiety treatment and dietitian input, with family-based work for young people. The evidence is thinner here [9].

Medication is sometimes prescribed for conditions alongside an eating disorder, such as depression or anxiety, and is a matter for a GP or psychiatrist. Physical health monitoring runs alongside therapy [2].

Living with eating disorders

Recovery is possible and rarely a straight line [8]. Progress shows in thoughts, feelings and behaviour, not in appearance.

• Keep treatment appointments even in weeks when nothing feels different.
• Agree with one or two people what support looks like. Comments about eating or appearance rarely help.
• Tell your GP about physical symptoms such as dizziness or dental problems, which are treatable.
• Beat runs free online support groups and a helpline for anyone affected, including carers [4].

At work or university, an eating disorder can count as a disability under the Equality Act 2010, so adjustments can be requested without giving diagnosis details.

When to speak to a professional

Speak to your GP if food, eating, weight or body shape takes up much of your thinking, if it is affecting your health, work, studies or relationships, or if others have raised concerns. Ask for referral to your local eating disorder service [2].

Contact your GP or NHS 111 the same day if you feel faint or dizzy, have chest pain or an irregular heartbeat, or cannot keep fluids down.

Call 999 or go to A&E if you have collapsed, are having a seizure, or if anyone is in immediate danger. If you are having thoughts of suicide or self-harm, call Samaritans on 116 123 or text Shout on 85258.

Common questions

Can you have an eating disorder at a normal weight?

Yes. Most people with an eating disorder are not underweight [8]. Atypical anorexia, part of the OSFED group, involves anorexia symptoms at a normal or higher weight [7], and NICE says BMI must not decide whether treatment is offered [2].

What is the difference between ARFID and fussy eating?

Fussy eating involves preferences that do not usually harm health or daily life. ARFID involves restriction serious enough to affect nutrition, growth or eating with others, driven by sensory sensitivity, fear, or low interest in food [9].

How long is the wait for NHS eating disorder treatment?

For children and young people in England the standard is one week for urgent referrals and four weeks for routine ones, met in about 79 and 83 per cent of cases in October 2025 [6]. Adult waiting times are not published [10].

Clinical review pending

References

1. National Institute for Health and Care Excellence. Eating disorders: recognition and treatment. NICE guideline NG69, published 23 May 2017, last updated 16 December 2020. An exceptional surveillance review in 2024 concluded no update was needed. https://www.nice.org.uk/guidance/ng69
2. National Institute for Health and Care Excellence. Eating disorders: recognition and treatment, guideline recommendations. NICE, published 23 May 2017, last updated 16 December 2020. https://www.nice.org.uk/guidance/ng69/resources/eating-disorders-recognition-and-treatment-pdf-1837582159813
3. NHS. Overview: Eating disorders. NHS, accessed 2026. https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/eating-disorders/overview/
4. Beat. I need support now: Helplines. Beat Eating Disorders, accessed 2026. https://www.beateatingdisorders.org.uk/get-information-and-support/get-help-for-myself/i-need-support-now/helplines/
5. Beat. How many people have an eating disorder in the UK? Beat Eating Disorders, accessed 2026. https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/how-many-people-eating-disorder-uk/
6. Nuffield Trust. Waiting times for children and young people with an eating disorder. Nuffield Trust, 2026. https://www.nuffieldtrust.org.uk/resource/children-and-young-people-with-an-eating-disorder-waiting-times
7. Beat. OSFED. Beat Eating Disorders, accessed 2026. https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/osfed/
8. Beat. Eating disorder myths. Beat Eating Disorders, accessed 2026. https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/eating-disorder-myths/
9. Beat. ARFID. Beat Eating Disorders, accessed 2026. https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/arfid/
10. House of Commons Library. Eating disorders. Research briefing CBP-10497, UK Parliament. https://researchbriefings.files.parliament.uk/documents/CBP-10497/CBP-10497.pdf