Eating Distress

What is Eating Distress?

Eating distress is a broad term that describes any relationship with food, weight, shape or eating that someone finds distressing. It can affect people of all ages, genders, sexual orientations, races, and ethnicities. People can experience their eating distress in a variety of different forms and intensities.

Gradual changes to appetite and eating habits are a normal part of life, however you might notice some of these signs if you are experiencing Eating Distress:

• Feeling ‘out of control’ of the self, regarding food
• Over exercising
• Having a negative body image
• Deliberately over, or under eating at times
• Avoiding certain foods due to anxiety, fear, sensory issues, or past trauma with that food.
• Avoiding eating in front of or with people
• Being sick on purpose, or using laxatives to excess
• Feeling shame or embarrassment around eating patterns

Working towards recovery

Working towards recovery from eating distress can include:

• Talking Therapy, like counselling with EDNE
• Undertaking a course of practical therapy sessions that help with symptom and emotion management, such as Cognitive Behavioural Therapy, or Dialectical Behavioural Therapy
• Group Therapy
• Regular check-ins with a GP, Psychiatrist, Community Psychiatric Nurse (CPN), Dietician, Nutritionist, and/or other specialist

Eating distress and disorders impact people’s bodies, emotions, behaviour, and relationships. No two people will experience their eating distress the same way, and sometimes it can be hard to tell whether you have a problem. You may recognise some of your experiences described in these pages. If you do, remember you are not alone. If you wish, you can seek help and support here.

Some people who experience eating distress are diagnosed with an eating disorder. A diagnosis is given when eating distress presents itself in a specific way. Having a diagnosis of an eating disorder describes the way someone behaves within their eating distress, it does not define the validity, intensity, or impact of the eating distress.

Types of Feeding and Eating Disorders 

There are several feeding and eating disorders named in the ICD-11 (the book doctors in the UK use to define health and treatment), and some that are a growing problem but not yet recognised in their own right. Click on the options below to learn more:

• Anorexia Nervosa (AN)
• Avoidant and Restrictive Food Intake Disorder (ARFID)
• Binge-Eating Disorder (BED)
• Bulimia Nervosa (BN)
• Other Specified Feeding or Eating Disorder (OSFED)
• Rumination-Regurgitation Disorder
• Type 1 Diabetes and Disordered Eating (T1DE)

Anorexia Nervosa

Anorexia Nervosa (AN) is an eating disorder that revolves around calorie and low-weight management. People with AN will restrict how many calories they eat, and/or use excessive exercise, laxatives, and being sick to get calories “out” of the body. Right now, people are only diagnosed with Anorexia by a doctor if their weight falls below a certain threshold, however anorexia can present in any person of any weight and can be very damaging to the body due to malnutrition. If you experience anorexia and your weight is above the threshold, you might be diagnosed with Atypical Anorexia.

People with AN might:

• Have changes in behaviour around food: not eating certain types, rituals or rules, anxiety around food and eating
• Experience a drop in weight below what is considered ‘healthy’
• Increase attention to, and feel guilt around food, exercise, and being ‘fat’
• Have episodes of eating lots of food in a short space of time, usually after a long period of fasting
• Have an unexplained increase in exercise
• In people who menstruate, their period might stop, or not start if they are pre-teens
• Feel more irritable, tired, prone to outbursts, or struggle to concentrate
• The sufferer feeling ‘fat’ despite others telling them they are underweight

Because of the nature of Anorexia, people can sometimes struggle to see that they are experiencing eating distress, so knowing these signs and symptoms can be helpful for yourself, or someone you know.

Please note- this page is a tool for information and awareness. It is not a diagnostic tool.

Recognise yourself?

if you see yourself in this description and want to access help, see our registration form to take the first step.

Avoidant Restrictive Food Intake Disorder (ARFID)

ARFID is an eating disorder that includes a lack of interest in food or eating, sensory sensitivities to texture, taste, or smell, and/or fears around trauma relating to eating.

ARFID often includes a strong anxiety or aversion to new food experiences, and sufferers rarely say that their weight or shape is a contributor. It normally begins early in childhood.

People with ARFID might:

• Have a very limited diet, often only feeling able to eat one group, brand, texture or type of food
• Have fears of vomiting or choking when eating
• Report feeling sick or having no appetite before meals
• Have strong emotional reactions to having to eat certain foods
• Experience weight loss, or faltered growth

ARFID is more than just ‘picky eating’ and should be approached with the same seriousness and specialist support as any other experience of eating distress. The lack of nutrition in an ARFID sufferers’ diet can lead to a risk of deficiencies, malnutrition and disturbed growth.

Please note – this page is a tool for information and awareness. It is not a diagnostic tool.

Recognise yourself?

if you see yourself in this description and want to access help, see our registration form to take the first step.

Binge Eating Disorder (BED)

Binge Eating Disorder (BED) is an eating disorder where a person regularly binges on food. This means they eat an amount of food much greater than an average meal in two hours or less, often eating very quickly and until uncomfortably full.

For everyone, there are times in life where they might eat more food than is normal for them, such as when out for a meal, or at a celebration that involves food. BED involves binging one or more times a week, where there isn’t another explanation for the food consumed. People with BED generally do not fast for extended periods of time or attempt to purge the body of the food they have eaten.

 People with Binge Eating Disorder might:

• Eat secretly, like at night or alone in a room when no one else will see
• Notice that it doesn’t “feel right”: recognise that they aren’t hungry, don’t want to eat that food, or know that they will feel ill afterwards, but eat the food anyway.
• Feeling as if ‘in a trance’ during binges
• Feeling the pull to binge when stressed, or feeling emotional
• Feeling “out of control” of themselves around certain, or all foods. “I can’t have that in the house, I just eat it all”
• Notice rapid weight gain
• Experience health complications due to weight gain
• Experience pain and discomfort immediately following a binge

BED is the most common eating disorder worldwide, if someone is binging less than once a week, they may be diagnosed with BED (lower frequency and/or limited duration).

Please note- this page is a tool for information and awareness. It is not a diagnostic tool.

Recognise yourself?

If you see yourself in this description and want to access help, see our registration form to take the first step.

Bulimia Nervosa (BN)

Bulimia Nervosa (BN) is an eating disorder where sufferers find themselves stuck in a cycle of binging and purging that feels hard to escape. A binge is where someone eats an amount of food much greater than an average meal in two hours or less, often eating very quickly and until uncomfortably full. Purging is where someone takes steps to rid the body of the calories they have just eaten.

This might be any combination of:

• Being sick
• Over exercising
• Restricting food (fasting)
• Using diuretics to wee
• Using laxatives to poo

BN is damaging to the body as the sufferer can experience digestive and internal organ injuries, electrolyte imbalance, and malnutrition.

Someone suffering with Bulimia Nervosa might:

• Experience extreme mood swings
• Changes in weight or shape: increasing or decreasing noticeably
• Have injuries to the hands where the knuckle meets the fingers
• Having episodes of binging that the sufferer feels to need to hide by eating alone, or hiding evidence
• Have a smell of vomit, or make strong attempts to hide it
• Insist on eating in private
• Eat secretly, like at night when no one else will see

If someone is experiencing symptoms of BN, but are binging and purging at a lower frequency than doctors expect, they might still be diagnosed with Bulimia (lower frequency and/or limited duration)

Please note- this page is a tool for information and awareness. It is not a diagnostic tool.

Recognise yourself?

If you see yourself in this description and want to access help, see our registration form to take the first step.

Other Specified Feeding or Eating Disorder (OSFED)

People diagnosed with Other Specified Feeding and Eating Disorder (OSFED) will have eating distress that presents in a specific way over time, but their symptoms don’t fit in any one diagnosis.

There are also some less commonly known eating disorders that fall under the OSFED umbrella:

• Atypical Anorexia – Where someone fits the criteria for Anorexia Nervosa, but is not currently classed as underweight.

• Bulimia (lower frequency and/or limited duration) – Where a person fits the criteria for Bulimia Nervosa, but their binge and purge cycles aren’t as frequent as doctors expect.

• BED (lower frequency and/or limited duration) – Where someone fits the criteria for Binge Eating Disorder but they binge less than once a week.

• Chew & Spit – Where someone chews their meal or snack but spits it back out instead of swallowing it to prevent calorie intake.

• Diabulimia – Where people with Type 1 diabetes manipulate their blood sugar levels in order to manage their weight.

• Night Eating Syndrome – where someone overeats at night, might wake in the night to eat, and experience sleep problems due to eating.

• Orthorexia – Where someone will only eat food if they consider it healthy. They may over-exercise in the name of health and will often have limited diets in an attempt to avoid consuming “unhealthy” foods. This often results in malnutrition.

• Purging Disorder – where someone regularly makes themselves sick or uses laxatives, but it isn’t accompanied by binging.

OSFED can be just as significant as other forms of eating distress and disorder, and should not be overlooked, as it can impact someone emotionally, physically and mentally just as all other eating disorders can.

Please note- this page is a tool for information and awareness. It is not a diagnostic tool.

Recognise yourself?

if you see yourself in this description and want to access help, see our registration form to take the first step.

Rumination-Regurgitation Disorder

People with Rumination-Regurgitation disorder will bring their food back up (regurgitate) on purpose, rechew it, and swallow it again (rumination). This is different to vomiting or purging, as the person won’t feel sick or retch. They will deliberately use their stomach muscles, tongue, or fingers to bring back small mouthfuls of stomach contents that then won’t leave their mouth. There is generally no discomfort in this process. They might notice that they burp or cough, but the aim is for the contents to stay in the body.

Someone might only do this in certain situations, but it can happen every time they eat. It might be just once, or it could be multiple times in one sitting. To be diagnosed with Rumination-Regurgitation disorder this needs to have been happening over several weeks.

Rumination-Regurgitation disorder can damage the body through malnutrition, and dehydration, as people will generally favour foods that feel OK to bring back up. There is also serious risk of oesophageal ulceration (ulcers on the tube that connects the mouth to the stomach), bad breath, and tooth decay.

While Rumination-Regurgitation Disorder can be about managing weight, it is most often about habit or self-soothing. It is one of the most heavily misunderstood and stigmatised eating disorders, so sufferers might feel a heightened sense of social rejection or shame around their behaviour. Anyone with any form of eating distress can access support from EDNE without shame or judgement.

Please note- this page is a tool for information and awareness. It is not a diagnostic tool.

Recognise yourself?

If you see yourself in this description and want to access help, see our registration form to take the first step.

Type 1 Diabetes and Disordered Eating (T1DE)

People with Type 1 diabetes are at a heightened risk of developing eating distress, or an eating disorder, this is referred to as Type 1 and Disordered Eating, or T1DE.

Living with Type 1 Diabetes presents its own health and social challenges, which, when combined with the necessary attention to food, nutrition, and intake, can mean that people are more likely to develop a challenging relationship with food and their bodies. Weight is more difficult to manage with Type 1 Diabetes, and people can develop eating distress in response to the concerns.

Someone with T1DE may develop any kind, or intensity of eating distress. This is particularly dangerous, as any kind of disordered eating can impact the balance of glucose and insulin in the body.

Diabulimia falls under the umbrella of OSFED, as it is not currently a diagnosis in its own right. It describes the specific version of eating distress, where people with Type 1 Diabetes alter, or skip doses of insulin in order to lose weight.

Using Insulin to alter blood glucose is dangerous as it can cause Hyperglycaemia (High Blood Glucose), and Hypoglycaemia (low blood sugar).

Prolonged Hyperglycaemia can cause:

• Heart damage
• Kidney damage
• Nerve damage
• Eye problems

Prolonged Hypoglycaemia can cause:

• Seizures
• Loss of consciousness

It is important that those suffering from T1DE are supported by a wide-ranging team of professionals that can support their physical health, mental health, and lifestyle in order to help them recover and move forward into a healthy life.

Please note- this page is a tool for information and awareness. It is not a diagnostic tool.

Recognise yourself?

If you see yourself in this description and want to access help, see our registration form to take the first step.