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An eating disorder is a mental health condition, not a lifestyle choice. It involves a troubled relationship with food, eating, weight or body shape, and it can seriously harm physical health. The main types are anorexia nervosa, bulimia nervosa, binge eating disorder, ARFID (avoidant/restrictive food intake disorder) and OSFED (other specified feeding or eating disorder).
Eating disorders usually start in the teenage years, but adults of any age and any sex can develop one. You do not need to be underweight to be unwell or to deserve help. The first step in Ireland and the UK is usually your GP. In the US it is a primary care provider. Specialist talking therapies are the core treatment, and most people can recover.
Both main diagnostic manuals, the American DSM-5 and the WHO's ICD-11, now group feeding and eating disorders together.
OSFED is not "less serious". It includes atypical anorexia: the features of anorexia without low weight. It also covers purging disorder, night eating syndrome, and less frequent forms of bulimia and binge eating disorder. A 2024 meta-analysis found symptom levels in OSFED comparable to the full-threshold disorders.
DSM-5 and ICD-11. ICD-11 added binge eating disorder and ARFID, which DSM-5 already recognised. One difference remains. ICD-11 says the core of a binge is losing control, even if the amount eaten is not objectively large. Its authors note this differs from DSM-5.
Men. NICE notes community studies suggesting as many as 1 in 4 people with an eating disorder are male. Men can be missed because it is still seen as a "women's illness".
In a small UK interview study of 10 young men, many did not recognise their symptoms at first and came for help late. A 2026 review notes that eating disorders in men often centre on muscularity, compulsive exercise or performance-enhancing substances. Questionnaires built around thinness can miss this. UK emergency guidance (MEED) tells clinicians to ask men about excessive training and steroid use.
Midlife and later life. Eating disorders do occur in middle and older age. A 2023 review put the rate of full diagnoses among older women at between 2.1% and 7.7%, and among older men at under 1%. Rates fall with age in women but do not reach zero, even in very old age.
Some older people have been ill since adolescence; others develop an eating disorder for the first time. A 2026 scoping review found most late-onset cases followed stresses such as bereavement, caring or isolation. Severe menopausal symptoms have also been linked with more eating disorder symptoms. This research is observational, so it shows links, not causes.
The HSE and NHS list these signs in yourself:
Physical signs can include feeling cold, tired or dizzy, digestive problems, a racing heart or fainting. Periods, sleep, teeth, hair and nails can also be affected.
Signs in someone else include dramatic weight loss, avoiding eating with others, and lying about what they have eaten. Others are going to the bathroom a lot after meals, or wearing baggy clothes to hide their body.
NICE asks clinicians to check for depression, anxiety, self-harm and obsessive-compulsive disorder. It also asks them to check for alcohol or substance misuse.
Eating disorders can be physically dangerous at any weight. NICE says they carry a high death rate from malnutrition, suicide and physical problems such as electrolyte (body salt) imbalances.
UK emergency guidance makes two key points. People can look well and still be at high risk. Normal blood tests do not by themselves mean someone is safe. People with bulimia can develop severe salt imbalances even at an average or higher weight.
Get urgent medical help the same day if someone with an eating disorder:
NICE says people with severe electrolyte imbalance, severe malnutrition, severe dehydration or signs of organ failure need acute medical care. That can include emergency admission.
Call 112 or 999 in Ireland, 999 in the UK, or 911 in the US if someone's life is at risk. That includes if they have seriously harmed themselves, or you cannot keep them safe.
Suicidal thoughts are common in people with eating disorders. MEED guidance notes that suicide accounts for 1 in 5 deaths among adults with anorexia. The risk of self-harm and suicide is also raised in bulimia and binge eating disorder. If you are having these thoughts, use the crisis numbers at the top of this page.
If you have diabetes, tell your diabetes team about any eating difficulties. NICE asks eating disorder and diabetes teams to work together, because the combination brings specific risks.
NICE guideline NG69 sets the standard in England, and the HSE describes a similar approach. Some principles apply to every type:
NICE says to consider one of three talking therapies, and to explain each so you can choose:
If none of these suits you or works, NICE suggests trying one you have not had, or eating-disorder-focused focal psychodynamic therapy. NICE says reaching a healthy weight is a key goal of treatment. Care should be multidisciplinary, with monitoring of physical and mental health.
NICE suggests starting with bulimia-focused guided self-help: cognitive behavioural materials, with short supportive sessions. If that is unsuitable, or has not helped after 4 weeks, the next step is individual CBT-ED. This is typically up to 20 sessions over 20 weeks.
NICE says to offer binge-eating-focused guided self-help first. If that is not acceptable, or has not helped after 4 weeks, the next step is group CBT-ED, then individual CBT-ED.
NICE asks clinicians to explain that weight loss is not a goal of these therapies. It also advises against dieting during treatment, because dieting is likely to trigger binge eating.
For OSFED, NICE says to use the treatment for the eating disorder it most closely resembles. NG69 does not cover ARFID. A 2024 review describes treatments for adults with ARFID as promising but still at an early stage. Ask your GP or specialist team what is available locally.
Medicines may help with related depression or anxiety. NIMH notes there is no FDA-approved medicine for anorexia or ARFID. For binge eating disorder, lisdexamfetamine's status differs by country:
In the UK and Ireland, talking therapy is the recommended treatment, and any medicine decision belongs with a specialist.
The NHS and HSE give the same advice. Let the person know you are worried about them, and encourage them to see a GP. Offer to go along. They may deny it, or be secretive and defensive, and may not realise they are ill.
Family members, partners and friends can call Bodywhys or Beat for support too.
Yes. NICE says eating disorders can develop at any age, although risk is highest in the teenage years. Research describes first onset in midlife and later life, often after a major life change such as bereavement.
No. People with eating disorders can be underweight, average weight or overweight. NICE tells clinicians not to use weight or BMI alone to decide whether to offer treatment.
No. ARFID is a recognised eating disorder in both DSM-5 and ICD-11, and it affects adults as well as children. It is not driven by worries about weight or shape. It can lead to weight loss, malnutrition and real problems with work and relationships.
Yes. The NHS says most people can recover with treatment, although it may take time and recovery looks different for everyone. Getting help early gives the best chance.
This article is general information, not medical advice. It does not replace an assessment by your GP or a specialist. If you are worried about your health or someone else's, contact your GP or the services listed above.
Reviewed by: Proco Team
Last updated: November 2026