Eating disorders can be very serious mental illnesses with symptoms that can be distressing to those experiencing the disorder and those who care for them. But not all eating disorder symptoms are physical. Some emphasis can be misplaced upon physical symptoms and that might, to those suffering, feel like a negation of the psychological symptoms.
Here we look at the symptoms of 4 eating disorders (although there are others and you can find out about them here) and how you might notice whether you could potentially be experiencing them.
Anorexia: a disorder that may include focus on weight loss
Anorexia (or anorexia nervosa) is a serious mental illness that can cause individuals to limit how much they eat or drink. They might gradually develop strict rules around foods they can or cannot eat or when and where they might eat. Sometimes it might lead to low body weight, but this is not necessarily an indicator of the severity of illness.
Weight and shape can be a strong focus or distressing obsession for someone with anorexia and tied to their sense of self-worth. This might mean they are checking their body through touch or weighing themselves or alternatively avoiding weighing themselves and avoiding their reflection. A distorted body image, or body dysmorphia, might be linked for these people too, meaning they see themselves and experience themselves as bigger than they are. A phobia of weight gain may also develop.
“Having lived with anorexia for over half my life, I know only too well the struggle and toil it takes, but I also know that full recovery is possible.” Hope Virgo
You might need to have a conversation with a medical professional if you experience some of the following symptoms:
- You might experience an intense fear of gaining weight or feel like an obsession with your body weight is intruding on your life.
- You might feel a compulsion to lie about how much you have eaten to others or hide how much you weigh or wear oversized clothing to hide your body from others.
- You might focus on strict calorie counting, obsessive or ritualistic behaviour around food, eating only low-calorie food, missing meals, avoiding eating with others, hiding food, cutting food into tiny pieces, eating slowly, taking slimming pills or diet pills, excessive exercising, purging, thinking about food a lot more than usual.
- You might deny the seriousness of your eating disorder and think others are making a fuss about nothing.
- Due to malnutrition you might experience fatigue, insomnia, dizziness, thinning hair, loss of menstruation, constipation, stomach pains, bloating, dry skin.
- If you are very underweight you might have difficulty tolerating the cold, since you might have low body temperature, low blood pressure, dehydration, poor circulation.
Bulimia: a disorder that may include bingeing and purging
Bulimia (or bulimia nervosa) is a serious mental illness. People with bulimia get caught in a cycle of eating large quantities of food (bingeing), and then trying to counterbalance by purging perhaps by vomiting, taking laxatives or diuretics, fasting, or exercising excessively.
While it’s normal to choose to eat a bit more than usual occasionally, this is not the same as a binge associated with bulimia. Binges can be a way to cope with difficult thoughts or feelings or overwhelm. People who binge and purge may feel powerless over this cycle or they may feel driven to binge due to intense and overwhelming emotions and thoughts. Binges can feel extremely distressing.
If someone is developing bulimia, often changes in behaviour are noticeable before changes to physical appearance.
“My experience of OCD and depression started over 15 years ago, and the constant companions of anorexia and bulimia appeared not long after. I am sad that I can’t remember what it is like to have a relationship with my body that isn’t something like a war, and that I have permanent damage to show for it.” James Downs
You might need to have a conversation with a medical professional if you experience some of the following symptoms:
- After eating you might feel intense anxiety and a strong need to purge by vomiting or immediately exercising or you might feel anger, guilt, shame or sadness. You might want to use laxatives to purge or alcohol or self-harm to ease the difficult feelings associated with eating.
- You might experience difficulty sleeping, tiredness, bloating, constipation, stomach pain, swollen salivary glands or puffy face, mood swings and fainting
- Shopping for food or ordering food on takeaway sites, eating and purging behaviours may have become a focal point of your life, organising other activities around this compulsive need. This could be coupled with secrecy and shame, hoarding food, thinking about food obsessively, feeling anxious around meal times and you might feel upset by a loss of control when eating.
- Frequently you might feel a desire to check your body shape or weight or avoiding looking at your body or checking your weight.
- Worries about weight and shape, fear of gaining weight, distorted perception of body shape or weight
- Feeling of losing control when eating
Binge Eating Disorder: a disorder that may include binging without purging
Binge eating disorder (BED) is a serious mental illness where people eat very large quantities of food without feeling like they’re in control of what they’re doing. Evidence suggests it is more common than other eating disorders.
People with binge eating disorder eat large quantities of food over a short period of time which is also known as binge eating. While people with bulimia then purge, people with binge eating disorder don’t usually purge after binging. People experiencing binge eating disorder do not choose to eat a lot of food, large portions or overindulge. Binge eating is very distressing, can be extremely painful physically and involves a feeling of loss of control. Disconnection and disassociation from the world can happen during a binge, and can lead to a blacking out or lack of memory of what someone has eaten.
“I would pass out from the pain of eating, I was suicidal from the psychological pain I felt due to binge eating disorder. While anorexia had been a way of numbing my thoughts and feelings through starvation, binge eating disorder was also a way of numbing my thoughts and feelings. Yet the stigma I experienced was deeply distressing and isolation. Bulimia then became a hidden secret as my eating disorders shifted their shape in my mind, behaviour and psychological distress.” Juliette Burton
You might need to have a conversation with a medical professional if you experience some of the following symptoms:
- You feel as if you cant stop eating, and might eat unusually large amounts of food in a short period of time, eating past the point of satisfaction and to the point of discomfort.
- You might rapidly and without paying attention to how much or how it feels or eating when not hungry or after recently finishing a meal.
- You might change your eating habits in response to emotional stress.
- You might eat alone or secretly and experience a lack of control when eating.
- You might experience intense feelings of depression, guilt, shame or disgust after binge eating.
- You may have extreme poor self image and disgust at your body, perhaps using alcohol, self-harm, sleeping around to punish yourself and your body.
ARFID (Avoidant Restrictive Food Intake Disorder): a disorder that may include avoiding or restricting certain foods
Avoidant restrictive food intake disorder, more commonly known as ARFID, is a condition where a person avoids certain foods or types of food, restricts their food intake, or both. It it the theme to raise awareness of the condition in Eating Disorders Awareness Week 2024.
ARFID can affect anyone of any age and at any weight. There may be many reasons someone might avoid certain foods or restrict their food intake. This might include sensitivity to taste, texture, smell, temperature or appearance of certain foods. Sensory-based avoidance or restriction of intake may be a result of this extreme sensitivity.
Another reason might be a traumatic experience or distressing experience regarding food in general or a certain type of food which might lead to a development of deep-rooted anxiety or phobia around food. This then can lead to avoidance due to concern of the consequences of eating.
Alternatively a reason may be that a person may not feel as connected to their physical hunger as much as others, they might not enjoy eating as a pleasurable experience which leads to eating being more difficult for them. This would result in restricted intake due to disinterest in eating.
There are many reasons and combinations of reasons someone might develop ARFID and due to this, ARFID is sometimes described as an ‘umbrella’ term. Nevertheless, people who have ARFID all experience avoidance or restriction of food intake either in amount, variety of types of food eaten, or both.
ARFID can be present on its own, or it can co-occur with other conditions; interestingly the most commonly co-occurring conditions include anxiety disorders, autism and ADHD.
“The term eating disorder is quite broad and includes different medical diagnoses. The most commonly known is anorexia nervosa, but others exist, such as bulimia nervosa and binge eating disorder. What it means to have an eating disorder will vastly differ from person to person. Generally speaking, all eating disorders include some disordered eating behaviours and a problematic relationship with one’s own body, which together have a detrimental effect on all aspects of life.” Dr Mortiz Herle, MQ Fellow 2023
You might need to have a conversation with a medical professional if you experience some of the following symptoms:
- You might eat a range of foods but overall consume less food than you need and you might struggle to recognise when you’re hungry.
- You might realise you feel full much faster than others with less food.
- Perhaps you take a long time to eat or finding eating food as an unpleasurable experience, maybe even missing meals, particularly when busy.
- You may experience intense sensitivity to sensory aspects of certain foods, eg the texture, smell, or temperature or you might only feel “safe” eating foods exclusively of one colour.
- Others might call you a “picky eater” or “fussy over food”. You might feel compelled to eat the same meals repeatedly, or eating different foods to others around you
- You might feel intense anxiety at mealtimes, chew food with extreme care, or only having tiny bites or sips.
Recovery from eating disorders is possible with the right diagnosis, treatment and support.
If you’re worried about your own or someone else’s health, you can contact Beat, the UK’s eating disorder charity, on 0808 801 0677 or beateatingdisorders.org.uk
