Understanding eating disorders
Eating disorders are complex mental health conditions in which a person has an unhealthy relationship with food, eating, and their body. They are not vanity, a diet gone wrong, or a phase. They are serious illnesses with physical and psychological dimensions that require professional treatment.
NICE guidance emphasises that eating disorders should be treated as a priority, that early treatment leads to better outcomes, and that families play a crucial role in recovery.
Types of eating disorder
Anorexia nervosa
Severe restriction of food intake, intense fear of weight gain, and a distorted perception of body weight or shape. Can involve extreme weight loss but not always , people of any body size can have anorexia.
Bulimia nervosa
Cycles of overeating followed by purging (vomiting, laxatives, excessive exercise). Weight may appear normal, making it harder to spot.
Binge eating disorder
Recurrent episodes of eating large amounts of food in a short time, often in secret, with significant distress but without purging.
ARFID (Avoidant/Restrictive Food Intake Disorder)
Severely limited food intake based on sensory characteristics, fear of choking/vomiting, or lack of interest in food. Not related to body image. More common in younger children and those with autism or ADHD.
Other specified feeding or eating disorders (OSFED)
Many people do not fit neatly into one category but are still significantly affected and deserve treatment.
Warning signs to watch for
OCD in children can look very different depending on the child’s age and the content of the obsessions. Common signs include:
Behavioural
- Skipping meals or making excuses to avoid eating
- Going to the bathroom immediately after meals
- Eating in secret or disappearing food
- Wearing baggy clothes to hide their body
- Obsessive interest in food, recipes, or other people eating without eating themselves
- Excessive exercise that feels compulsive and driven by guilt
- Rigid food rules , only certain foods, always the same amount
Physical:
- Noticeable weight loss (though not always present)
- Feeling cold constantly
- Hair loss or fine downy hair on the body
- Swollen cheeks or jaw (from purging)
- Calluses on knuckles (from self-induced vomiting)
- Fainting, dizziness, or low energy
Emotional:
- Intense anxiety or distress around mealtimes
- Negative body image comments: “I’m disgusting”, “I’m so fat”
- Perfectionism and rigidity
- Social withdrawal, particularly around food situations
What causes eating disorders?
Eating disorders do not have a single cause. Contributing factors include:
Bullying, particularly around appearance
Genetics , eating disorders run in families
Trauma or adverse childhood experiences
Perfectionism and anxiety
Social media and diet culture
Neurodevelopmental differences (autism and ADHD are significantly over-represented)
Life transitions , starting secondary school, exam pressure, relationship difficulties
How to start the conversation
Beat recommends approaching with care and concern rather than confrontation about food or weight.
Try:
- “I’ve noticed you seem really stressed around mealtimes. I’m worried about you.”
- “I love you and I want to understand what you’re going through.”
- Focus on your child’s wellbeing, not their weight or eating behaviour
Listen more than you speak. Do not argue about food. This is not about willpower , your child cannot simply eat normally by choosing to.
What not to say
"You just need to eat more" , oversimplifies a complex illness
"You don't look like you have an eating disorder" , eating disorders are not always visible
"I went on a diet at your age and I was fine" , minimises the experience
"You're being so selfish" , adds shame to an already shame-saturated illness
"I'm watching everything you eat from now on" , creates a battleground rather than support
Getting professional help in the UK
GP
CAMHS
Specialist eating disorder teams exist in most areas.
Beat
The UK’s eating disorder charity. Helpline: 0808 801 0677. Youthline (under 18): 0808 801 0711.
First Steps ED
Support for those affected by eating disorders in the UK.
Private treatment
If NHS waiting times are long and your child is deteriorating, speak to your GP about urgent pathways.
How to support your child through treatment
- Involve yourself in treatment if the team recommends it , family-based therapy is effective for younger people
- Avoid discussing food, weight, or diets at home
- Keep mealtimes as calm and connection-focused as possible
- Celebrate non-food wins: mood, energy, engagement with activities
- Look after your own mental health , Beat has support for parents too
FAQs: eating disorders in teenagers
Absolutely. Most people with eating disorders are not underweight. Bulimia, binge eating disorder, and ARFID often present at a normal weight. Never use weight alone as a measure of severity.
No. Research consistently shows that open, caring conversations reduce isolation and improve outcomes. Silence keeps eating disorders in the dark where they thrive.
Recovery is non-linear and varies widely. Many young people do recover fully, particularly with early intervention. Set goals around health and quality of life, not timelines.