An eating disorder is an overall term for a number of conditions that involve eating in a disordered way. The most common eating disorders are anorexia, bulimia and binge eating disorder.
Key points
An eating disorder is a condition that involves eating in a disordered way, such as eating very little or very large amounts of food, or purging (getting rid of) food you have eaten.
Women are more likely to develop an eating disorder, but anyone of any age may develop one.
The causes of eating disorders are complex and don't involve just one factor.
Getting support is crucial to recovery, so seek help sooner than later. If eating disorders are not treated, they can result in serious medical problems.
However, with treatment, most people with an eating disorder make a good recovery, although it may take several years.
What is an eating disorder?
An eating disorder is one of a number of conditions that involve disordered eating patterns. The person affected tends to be focused on their weight and body shape.
The most common eating disorders are anorexia, bulimia and binge eating disorder.
A new category of eating difficulties is avoidant restrictive food intake disorder (ARFID). This is different from other eating disorders as it involves a disinterest in food for reasons other than a preoccupation with weight and shape.
What is "disordered" eating?
Disordered eating refers to when you no longer have the usual habits of eating that most people have. This can affect how often you eat, how much you eat, the type of food you eat, how flexible you are around your eating habits and whether you experience pleasure in eating. Depending on the eating disorder, it may involve severe avoidance of eating or purging (getting rid of) food you have eaten.
If you no longer have a sense of what is normal eating, you can read about healthy eating basics.
What causes an eating disorder?
Eating disorders happen because of a combination of factors. These factors can be biological (the way your brain works), genetic (things your inherit), psychological (how you think), social (your relationships with other people) or cultural (the customs and values of the people around you).
Who is at risk of getting an eating disorder?
Eating disorders can affect any age or gender; however, women are more often affected, particularly younger women.
Anorexia and bulimia can develop at any stage in life, but most often occur during adolescence and early adulthood. Binge eating disorder can occur at any time, but can often start in mid-adulthood. Avoidant restrictive food intake disorder is likely to start in childhood. Any of these disorders can have a serious impact on your health.
People at risk of an eating disorder often have experienced the following:
having feelings of low self-esteem or worthlessness
living in a western culture in which being thin is considered the ideal body shape
living in an urban area
taking part in activities in which body image is a concern (eg, professional or competitive dancing, gymnastics or fashion modelling)
having a history of strict dieting and body dissatisfaction
having lived in an environment in which leanness or obesity has been a concern
experiencing depression or loneliness
being a perfectionist or impulsive, or having difficulty managing emotions
migrating from a developing country to a western culture
experiencing stressful life changes (eg, leaving home to go to university, a relationship breakup or the physical bodily changes of puberty)
having experienced physical, emotional or sexual abuse.
What should I do if I have an eating disorder?
Self-care and getting support from others is vital in recovering from an eating disorder and feeling happy again. If eating disorders are not treated, they can result in serious medical problems, so seek help sooner than later.
Start by talking to your GP as they can refer you to an eating disorder specialist who understands what you are going through and knows how to help you. Find out more about eating disorder services in New Zealand.
If your doctor thinks you most likely have an eating disorder, they will refer you to an eating disorder specialist or service. Most services that treat people with eating disorders bring together a team of different healthcare professionals, including psychiatrists and other doctors, psychologists and dietitians. Some treatment is publicly funded.
Treatment for eating disorders involves healthy eating, together with medical care and psychological treatment. You may need to learn how to manage your feelings in a different way. Some people might also be prescribed medications.
Most people with eating disorders have mainly outpatient treatment, but you may need to go to hospital for treatment if you are at risk of serious medical problems. With treatment, most people with an eating disorder make a good recovery, although it may take several years.
Self-care
Learning how to take good care of yourself and manage your emotions is key to recovering from an eating disorder. The following steps can help you on your road to recovery.
Learn about eating disorders to help you make sense of how you feel.
Seek help early. The longer you leave it, the harder it is to get well.
Make a decision to recover: see your doctor and get the treatment you need.
Don’t be so hard on yourself – seek support and learn strategies to help you deal with difficult emotions and thoughts.
Learn about nutrition and develop a healthy relationship with food.
Learn ways to improve your body image – self-acceptance and kindness to yourself are important to help you recover.
Feeling good about yourself is key – make time for pleasurable activities and spend time with people who can boost your mood.
Dr Michelle Meiklejohn is a clinical psychologist with experience working with individuals, families and teams to improve individual functioning, develop resiliency and effectively manage challenges in life and work. She has special interests in eating difficulties, social and emotional skill development and leadership development.
Credits: Health Navigator Editorial Team . Reviewed By: Michelle Meiklejohn, Clinical psychologist
Last reviewed: 18 Feb 2019
Note: Some of these resources are from overseas so some details may be different. In New Zealand, ring 111 for emergencies, or Healthline 0800 611 116.
Note: This resource is from overseas so some details may be different in New Zealand, eg, phone 111 for emergencies or, if it’s not an emergency, freephone Healthline 0800 611 116.
Note: This resource is from overseas so some details may be different in New Zealand, eg, phone 111 for emergencies or, if it’s not an emergency, freephone Healthline 0800 611 116.
Note: This resource is from overseas so some details may be different in New Zealand, eg, phone 111 for emergencies or, if it’s not an emergency, freephone Healthline 0800 611 116.
Resources available in different languages Mental Health in Multicultural Australia
Note: This resource is from overseas so some details may be different in New Zealand, eg, phone 111 for emergencies or, if it’s not an emergency, freephone Healthline 0800 611 116.
Note: This resource is from overseas so some details may be different in New Zealand, eg, phone 111 for emergencies or, if it’s not an emergency, freephone Healthline 0800 611 116.
Are you concerned a friend may have an eating disorder? How can you be sure and what can you do or say?
Eating disorders such as anorexia or bulimia are serious medical conditions, which can be fatal if left untreated.
If you’re approaching a friend about a suspected eating disorder, remember to do so in a caring, non-judgemental way.
Many people with eating disorders say they are fine and just want everyone to leave them alone. However, in reality, they may be feeling scared and isolated and unsure how to stop the eating disorder from controlling their life.
They can put a lot of effort into hiding the condition, so it can be difficult to diagnose. But the earlier a diagnosis is made, the better the chance is of recovery.
Here are our top five tips for supporting a friend with an eating disorder.
1. Know your facts
Before you talk to your friend, it's helpful to have read up on eating disorders and know your facts. For example, there are different types of eating disorders, symptoms and possible causes.
2. Be kind and non-judgemental
The last thing a person with an eating disorder wants is to feel judged. They may already be feeling alone, confused and ashamed. Knowing they have a friend who cares and who will listen is often the first and most important step in helping them on the road to recovery. Try to use language that isn’t critical or judgemental and be compassionate.
3. Be honest
Being honest about your concerns shows your friend you care. While it may be a conversation you are nervous to have, it’s an important one that may be life-saving. It helps to pick a time and location where you can talk face-to-face in private and your friend is feeling comfortable and relaxed.
4. Encourage them to seek professional help
The most important thing you can do, apart from letting your friend know you’re there to help, is to encourage them to seek professional help. The longer an eating disorder is left untreated, the harder it is on their body and mind to recover. Encourage them to see their GP, who can provide a diagnosis and advice on where to get further help.
5. Keep supporting them
Be aware your friend may become defensive or angry and even try to deny they have a problem. You can’t force somebody to seek help, especially if they’re an adult, so just keep letting them know you’re there to support them. And once they do seek professional help, keep supporting them throughout their journey to recovery.
Remember, if your friend’s health or life is at risk, then seek medical advice immediately.
There are lots of myths about eating disorders such as:
Myth # 1: You can tell by looking at someone that they have an eating disorder
Myth # 2: Families are to blame
Myth # 3: Mothers are to blame
Myth # 4: Eating disorders are a choice
Myth # 5: Eating disorders are the province of white upper-middle class teenage girls
Myth # 6: Eating disorders are benign
Myth # 7: Society alone is to blame
Myth # 8: Genes are destiny
Myth #9: Eating disorders are for life
This series of videos taken from a lecture, "Eating Disorders Essentials: Replacing Myths with Realities" is helpful to distinguish between fact and fiction.
To find an eating disorder service within your area, use the location filter under the map (mobile view) or at the bottom of the search results (computer view).
Source: HealthPoint services directory used with permission.
Information for healthcare providers on eating disorders
The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.
Key practice points
Eating disorders can occur in people of any age or gender, but are more likely to occur in young people and females.
Consider investigations for medical consequences.
Referral to an appropriate secondary care or local support service is recommended.
Treatment priorities in primary care are to engage with the patient and ensure they are medically stable. Reversing the effects of the eating disorder and psychological treatment are undertaken in secondary care.Specialist regional treatment centres for eating disorders are located in Auckland, Wellington and Christchurch; patients can be referred from around the country. Managing frequently encountered mental health problems in young people – non-pharmacological strategies BPAC, NZ, 2015
Clinical guidelines
In anorexia nervosa the clinical practice guidelines (CPG) recommend treatment as an outpatient or day patient in most instances (ie, in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm-minimisation approach is recommended in chronic anorexia.
In bulimia nervosa and binge eating disorder the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate or orlistat (the last for people with comorbid obesity).
No specific treatment is recommended for avoidant restrictive food intake disorder as there are no trials to guide practice.
Access to the following regional pathways is localised for each region and access is limited to health providers. If you do not know the login details, contact your DHB or PHO for more information:
