Recognising Eating Disorders

You may be concerned that you or a loved one may have an eating disorder but aren’t sure, so we have created this guide to help you to identify some of the signs and symptoms. Please remember that all eating disorders and sufferers are individual and different, so you may not exactly match any of these descriptions. If you are concerned and your relationship with food or your body is difficult for you, then it is important that you seek help as soon as you can.

Eating Disorder Classifications

Anorexia

Anorexia is characterised by the maintenance of a low body weight, an intense fear of gaining weight and often of eating itself. This can be accompanied and fuelled by a distorted body image where the sufferer believes themselves to be overweight when they are not. Sufferers of Anorexia usually restrict their calorific intake and may also engage in over-exercising or purging behaviours such as vomiting, over-using laxatives, or taking 'diet pills'.

Signs and symptoms:

  • Weight loss
  • Difficulty sleeping
  • Dizziness/fainting
  • Constipation
  • Stomach pains
  • Poor concentration
  • Weakness
  • Skin problems
  • Brittle bones
  • Loss of periods
  • Loss of libido
  • Depression
  • Tiredness and lethargy
  • Withdrawal from social functioning
  • Secretiveness around food
  • Pre-occupation with food/cooking for others
  • Fine downy hair on body
Bulimia

Bulimia is characterised by recurrent episodes of binging (eating large quantities of food in a short space of time), followed by compensatory behaviours such as vomiting, fasting, laxative abuse, over-exercise and abuse of other medications. Sufferers of bulimia may maintain a normal weight.

Signs and symptoms:

  • Secretiveness around eating
  • Feelings of guilt and shame
  • Pre-occupation with food/cooking
  • Fluctuating weight
  • Feeling out of control
  • Depression
  • Isolation
  • Tooth damage
  • Cracked lips
  • Swollen salivary glands (puffy face)
  • Sore throat
  • Poor bowel function
  • Swelling of hands and feet
  • Russell's sign (bruising or callousing on the knuckle caused by self-induced vomiting)

Bulimia can lead to serious health complications caused by electrolyte imbalances including cardiomyopathy, muscle weakness, fluid imbalance, damage to bowel, kidney damage, fits.

Binge Eating Disorder

Binge Eating Disorder shares many of the symptoms of Bulimia but without the compensatory behaviours. Sufferers are often but not always overweight, depending on the frequency of episodes and the foods that are consumed. Binges or compulsive eating are often used as a way of managing or distracting the sufferer from emotional distress.

Signs and symptoms:

  • Eating large quantities of food in a short space of time
  • Eating until uncomfortably full
  • Eating despite not being hungry
  • Secretiveness over eating
  • Feelings of disgust, guilt and shame
  • Social avoidance
  • Depression
  • High blood pressure
  • Diabetes
  • Weight gain
Orthorexia

Orthorexia is used to describe sufferers who take their concerns about eating 'healthy' foods to extremes. Sufferers often restrict their intake to foods which they consider to be 'pure', 'natural', or 'clean'. As a term it may fall into the category of OSFED as sufferers may maintain a healthy weight if not a healthy relationship with food or their bodies, whilst for some it is a feature of anorexia. Attempts to follow extreme diets which may cut out whole food groups can lead to malnourishment. Sufferers can be left feeling guilty and at fault when their nutritionally inadequate diets lead to constant hunger and the resultant cravings for 'forbidden' foods. Some sufferers of orthorexia may display obsessive compulsive traits. It may be that these are personality traits, however these may be as a result of starvation rather than a cause of the disorder, this kind of thinking can perpetuate the disordered eating and lead it to become an entrenched behaviour.

Signs and symptoms:

  • Focus on the virtue of food rather than any pleasure derived from eating it
  • Social isolation
  • Pre-occupation with food and menu planning
  • Feelings of being in control/out of control based on food choices
  • Rigid about 'allowed' foods
  • Rules about the way food is prepared and the utensils used to do so
  • Righteousness over their food choices
  • Guilt and self-loathing when straying from their diet
  • Beliefs that they will be harmed or contaminated by disallowed foods
Body Dysmorphia

Body Dysmorphia is characterised by obsessional worrying about real (but inflated) or imagined flaws in a persons appearance. BDD is not an eating disorder but can be a characteristic of an eating disorder where the sufferer believes that their body or certain body parts are much larger than they actually are.

Signs and symptoms:

  • Spending excessive amounts of time comparing themselves with others
  • Looking in mirrors repetitively or avoiding mirrors altogether
  • Going to great lengths to conceal flaws by using make up, having cosmetic procedures
  • Wearing specific clothes to cover the flaw
  • Seeking reassurance from others about their appearance
Muscle Dysmorphia

Muscle dysmorphia (sometimes called ‘Bigorexia’) is a type of Body Dysmorphia where the sufferer conversely believes themselves to be much smaller than they actually are and perceives themselves as looking weak or frail.

Signs and symptoms:

  • Spending excessive amounts of time exercising, particularly lifting weights to build muscle
  • Prioritising exercise and diet schedule over work or social commitments
  • Mirror checking or Mirror avoidance
  • Excessive use of supplements
  • Sometimes use of drugs like steroids to aid muscle growth
  • Extreme anxiety over deviating from exercise schedule
OSFED (Otherwise Specified Eating or Feeding Disorder) - EDNOS (Eating Disorder Not Otherwise Specified)

OSFED, (Previously EDNOS), or atypical eating disorder is a term used for those with problems around eating which do not fit the diagnostic criteria (according to DSMIV) of Anorexia, Bulimia or BED, i.e. a person who restricts their intake but whose weight is not considered underweight at this point.