Eating disorders: signs, types, treatment and getting help

The NHS says that if you or people around you are worried that you have an unhealthy relationship with food, you could have an eating disorder. It lists behavioural and emotional signs, and physical signs you may notice.

• Spending a lot of time worrying about your weight and body shape.

• Avoiding socialising when you think food will be involved, and eating very little food.

• Making yourself sick or taking laxatives after you eat, or exercising too much.

• Having very strict habits or routines around food.

• Changes in your mood, such as being withdrawn, anxious or depressed.

• Physical signs: feeling cold, tired or dizzy; pains, tingling or numbness in the arms and legs; heart racing, fainting or feeling faint; digestive problems such as bloating, constipation or diarrhoea; weight that is very high or very low for your age and height; not getting your period or other delayed signs of puberty.

The NHS says teenagers and young adults are mostly affected by eating disorders. For anorexia, it says puberty and the associated growth spurt may be delayed in children, and young people may gain less weight than expected and be smaller than children of the same age. Its signs for under-18s include weight and height lower than the minimum expected for their age.

For treatment, the NHS says young people with anorexia are usually referred to children and young people's mental health (CYPMH) services, or to a children's health team in hospital. For bulimia, family may be involved in therapy if the person is under 18.

The NHS lists warning signs a parent might notice, and gives advice for parents: stay calm and prepare what you want to say, avoid blaming or judging, avoid talking about appearance or diets, use sentences starting with "I", and keep trying if your child does not open up straight away. For mealtimes it suggests agreeing meal plans with your child, not talking about portion sizes or calories, and keeping things lighthearted. It says to ask a GP or your child's treatment team for advice on how to help at home and to get support for yourself.

The NHS and Beat describe several types. Someone may move between diagnoses if their symptoms change, and Beat says there is often a lot of overlap between different eating disorders.

The NHS says you can recover from an eating disorder, but it may take time. If you are referred to an eating disorder specialist or team, they will be responsible for your care and should discuss other support you might need. Treatment depends on the type of eating disorder but usually includes a talking therapy, and you may also need regular health checks if your eating disorder is affecting your physical health. Most people are offered individual therapy, but people with binge eating disorder may be offered group therapy, and people with bulimia or binge eating disorder may work through a guided self-help programme.

For anorexia, the NHS says treatment usually combines talking therapy with supervised weight gain, and that it is important to start as early as possible to reduce the risk of serious complications. Talking therapies it lists include CBT, usually with weekly sessions for up to 40 weeks, MANTRA (20 sessions) and specialist supportive clinical management. Young people are usually referred to children and young people's mental health services. If you are very unwell, you may need hospital treatment.

For bulimia, the NHS says treatment can last several months or years, and may include talking therapies with a self-help booklet or online programme, medicines such as antidepressants if you have a closely linked condition such as anxiety or depression, and support from a dietitian. You may need to stay in hospital if you have serious health problems or doctors are worried you are at risk of self-harm or suicide.

The NHS says the exact cause is unknown. You may be more likely to get an eating disorder if you or a family member has a history of eating disorders, depression, or alcohol or drug misuse, you have been criticised for your eating habits, body shape or weight, you are really worried about being slim, particularly if you also feel pressure from society or your job, you have anxiety, low self-esteem, an obsessive personality or are a perfectionist, or you have been sexually abused.

Beat says they are understood to be caused by a combination of biological, psychological and social factors, and that the way a person treats food may make them feel more able to cope or in control, even if they are not aware of the purpose this behaviour is serving.

The NHS says that if you are pregnant, you should tell your midwife and GP if you have an eating disorder or have had one in the past. This will help them offer you the right support during and after pregnancy.

The NHS says it can be very difficult to identify that a loved one or friend has an eating disorder. Warning signs include dramatic weight loss, lying about how much they have eaten, when or their weight, eating a lot of food very fast, going to the bathroom a lot after eating, exercising a lot, avoiding eating with others, cutting food into small pieces or eating very slowly, and wearing loose or baggy clothes to hide weight loss.

The NHS says they may not realise they have an eating disorder, or may deny it or be secretive and defensive. Let them know you are worried and encourage them to see a GP; you could offer to go along with them. Beat has information and advice on what to do if you are worried about a friend, family member or colleague.

The NHS says support is available if you or someone you know is having a mental health crisis or emergency, and points to its page on where to get urgent help for mental health. For anorexia, it says if someone needs urgent medical help, go to 111.nhs.uk or call 111 for advice.

The NHS says bulimia can sometimes, without the right support, be life-threatening, and complications can include seizures, heart or kidney problems.

On the NHS, the usual first step is a GP appointment, where a GP will ask about your eating habits and how you are feeling, and check your overall health and weight. They may refer you to an eating disorder specialist or team. The NHS says it can be very hard to admit you have a problem, and bringing a friend or loved one may make things easier. You can tell your GP if you do not want to know how much you weigh.

Some people use private eating disorder services, often for faster assessment. NHS guidance on getting help early applies whichever route you use, and it is sensible to keep your GP informed so that physical health checks continue.