Eating Disorders and Disordered Eating: Signs and Support
Eating disorders are serious mental health conditions that involve significant disturbances in eating, thoughts about food, weight and body shape, and related behaviours. They affect people of all ages, genders, body sizes and backgrounds, and they can have serious physical as well as psychological effects. Disordered eating sits on the same spectrum but doesn't meet the full criteria for a diagnosis. Both deserve support, and recovery is possible, particularly with early help and a coordinated team.
If you're worried about yourself or someone else, you can call the Butterfly National Helpline on 1800 33 4673 (8am to midnight AEST, seven days).
The eating spectrum
It can help to think of eating and body image on a spectrum:
Relaxed, flexible eating: eating for nourishment and enjoyment without significant guilt or rules
Disordered eating: rigid food rules, chronic dieting, skipping meals, compensating for eating, significant guilt about food, or using food to manage emotions
Eating disorders: diagnosable conditions in which these patterns are persistent and cause significant distress, health effects or impairment
Movement along the spectrum can happen in either direction. Disordered eating is a risk factor for developing an eating disorder, so it's worth addressing early.
Types of eating disorders
Anorexia nervosa: restriction of food intake leading to significantly low body weight, with intense fear of gaining weight and disturbance in how body shape or weight is experienced
Bulimia nervosa: recurrent episodes of binge eating followed by compensatory behaviours, with self-worth strongly tied to body shape and weight
Binge eating disorder: recurrent episodes of eating a large amount of food with a sense of loss of control, followed by distress, without regular compensatory behaviours. It's the most common eating disorder
Avoidant/restrictive food intake disorder (ARFID): restricted eating driven by sensory sensitivity, lack of interest, or fear of consequences such as choking, rather than body image concerns
Other specified feeding or eating disorder (OSFED): significant eating disorder presentations that don't fit neatly into the categories above
People in larger bodies can have serious eating disorders, including restrictive ones. You can't tell whether someone has an eating disorder by looking at them.
Warning signs
Behavioural
dieting, skipping meals or cutting out food groups without a medical reason
rigid rules about what, when or how much to eat
eating in secret, or avoiding eating with others
disappearing to the bathroom after meals
compulsive or excessive exercise, including exercising when injured or unwell
frequent body checking, weighing or avoiding mirrors
Psychological
preoccupation with food, weight or body shape
self-worth strongly tied to appearance or eating
anxiety, guilt or shame around eating
irritability, low mood or withdrawal
perfectionism and rigid thinking
Physical
noticeable weight change, or weight fluctuations
tiredness, dizziness or fainting
feeling cold
changes to menstrual cycles
gut problems
Eating disorders can affect the heart, bones, hormones and other organs. Anyone with a suspected eating disorder should see a GP for a medical assessment, whatever their weight.
Why eating disorders develop
There's no single cause. Contributing factors include genetics and temperament (including perfectionism and anxiety), dieting, weight stigma, trauma, major life transitions, sports or environments that emphasise weight or appearance, and cultural and social media pressures. Eating disorders are not a choice, and they're not about vanity.
When therapy helps, and what integrated care looks like
Effective treatment for an eating disorder usually involves a team:
A GP to monitor physical health and coordinate care
A psychologist or mental health clinician for psychological treatment
An accredited practising dietitian experienced in eating disorders
A psychiatrist in some cases
Specialist or hospital services when medical risk is high
Evidence-based psychological treatments include:
CBT-E (enhanced cognitive behavioural therapy) for adults across eating disorder diagnoses
Family-based treatment for children and adolescents
Specialist supportive clinical management and other approaches for anorexia
DBT skills for emotion regulation, particularly where binge eating or bulimia is linked to managing difficult emotions
ACT and compassion-focused approaches for body image and self-criticism
Therapy for disordered eating that doesn't meet diagnostic criteria can focus on dismantling food rules, improving body image, and developing other ways to cope with emotions.
Medicare: Eating Disorder Treatment and Management Plan
People with a diagnosis of anorexia nervosa, or severe presentations of bulimia nervosa, binge eating disorder or OSFED, may be eligible for an Eating Disorder Treatment and Management Plan from their GP. According to the National Eating Disorders Collaboration, this can provide Medicare rebates for up to 40 psychological treatment sessions and up to 20 dietetic sessions over a 12-month period, with regular medical reviews.
Support at Satya Psychology
Our team supports people with disordered eating and eating-related concerns, often alongside anxiety, perfectionism, trauma and self-esteem work, using CBT, ACT, DBT skills and compassion-focused approaches. We work alongside your GP and dietitian.
Because eating disorders can carry significant medical risk, we'll talk with you early about what level of care you need. If a specialist eating disorder service would serve you better, we'll say so and help you find one.
Sessions are available by telehealth, in person in Nobby Beach, or through Walk and Talk therapy on the Gold Coast. Get in touch to talk about whether we're the right fit.
Where to get help
Butterfly National Helpline: 1800 33 4673
Your GP: for a medical check and referral
Lifeline: 13 11 14 (24/7)
000 if you're experiencing chest pain, fainting or other medical symptoms, or are in crisis
This article is general information and isn't a substitute for medical or psychological assessment.