Eating Disorders

What is an eating disorder?

An eating disorder is a serious mental health problem characterised by extreme concerns about weight, shape, eating and/or body image. These concerns lead to disordered and unhealthy patterns of behaviour, including restricting food intake, fasting, counting calories, vomiting, misuse of laxative use, and excessive or driven exercise. These behaviours can greatly affect your physical, psychological and social functioning.

Eating disorders affect people of all ages, of all socio-economic backgrounds, and of all shapes and sizes. Eating disorders are not lifestyle choices, or a “diet gone too far”.

With early appropriate treatment, dedication and hard work, recovery is possible. The sooner you get help, the greater the chance of a full recovery. Therefore, if you have concerns that you or someone close to you has an eating disorder, it is important to take the issue seriously, and to seek urgent medical advice.


Bulimia Nervosa (BN)

Bulimia Nervosa is characterised by recurrent episodes of binge eating, followed by compensatory behaviours.

Binge eating involves two key components:

    1. Eating an amount of food that most people would consider very large within a relatively short period of time (e.g., within two hours).
    2. Feeling a sense of loss of control over eating (e.g., you couldn’t stop even if you wanted to, or you couldn’t resist starting).

    Compensatory behaviours are ways of attempting to control weight or shape. They include:

    • vomiting, misusing laxatives or diuretics, fasting, excessive exercise, or misusing over the counter or prescription medications for the purpose of weight control.

    Because of the large amount of food consumed in a binge, and the relative ineffectiveness of most compensatory behaviours, weight may fluctuate, but many people with bulimia nervosa remain within the typical weight range or may even gain weight. People who meet criteria from Bulimia Nervosa often get caught up in an out-of-control cycle of binge eating and attempting to compensate. This can lead to feelings of guilt, shame and embarrassment, as well as preoccupation with eating, body image and fear of weight gain. For this reason, individuals often keep their eating and compensatory behaviours very secretive, and therefore the disorder can go undetected by friends and family.


    Anorexia Nervosa (AN)

    Anorexia Nervosa is characterised by persistent restricted intake leading to significantly low body weight. This is accompanied by an intense fear of weight gain, or, persistent behaviour that interferes with necessary weight gain. For a person with Anorexia Nervosa, self-worth is often very much caught up with weight, shape or control over eating. Individuals also often experience a distorted view of their body, believing that they are overweight when in fact they are dangerously underweight.

    There are two subtypes of Anorexia Nervosa:

    • Restricting type refers to individuals who severely restrict the amount and type of food they eat. They may also engage in other weight control behaviours such as excessive exercise.
    • Binge Eating/Purging type also involves extreme restriction, but this is accompanied by episodes of binge eating and compensatory purging.


    Other Specified Feeding or Eating Disorders (OSFED)

    A person with OSFED presents with some of the symptoms of other eating disorders (Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder), but does not quite meet the full criteria. OSFED is no less serious than other eating disorders and is the most commonly diagnosed eating disorder amongst adolescents and adults.


    Binge Eating Disorder (BED)

    Binge eating disorder is characterised by regular episodes of binge eating. Unlike Bulimia Nervosa, someone suffering from Binge Eating Disorder will not engage in compensatory behaviours (such as vomiting, laxatives, fasting etc.). Individuals with Binge Eating Disorder will often eat alone or in secret because of feelings of shame and guilt about their eating behaviours. Many people with binge eating disorder are at a higher weight.


    Avoidant/Restrictive Food Intake Disorder (ARFID)

    An ARFID diagnosis describes a disorder where an individual struggles to obtain adequate nutrition, in the absence of the fear of weight gain &/or preoccupation with weight and shape that characterises AN, BN or OSFED. Feeding or eating disturbances such as lack of interest in food or lack of appetite, aversion to certain textures, or feared consequences of eating (not weight/shape based) lead to weight loss and difficulty maintained a healthy weight for them.


    Do I have an Eating Disorder?

    If any other the above resonate with you, you may have an eating disorder. It’s advisable to seek help from your GP in the first instance as they will be able to direct you to what type of support is best suited to meet your needs.


    Online therapy and treatment for eating disorders

    There are many effective ways ways to overcome eating disorders, including: CBT-E, CBT, compassion- focused therapy (CFT), and EMDR  – find out more about how CBT-E can help with eating disorders here.

    The type and level of support that will be best suited to you will depend on the nature and severity of the eating disorder. For instance, someone with severe and long standing AN will more likely benefit from staying at a specialist eating disorder service, perhaps as an inpatient where your overall physical health and diet can be closely monitored, whereas someone with mild-moderate BED, BN, ARFID or OSFED may benefit from regular online therapy with someone trained and experienced in these areas.

    Several of our online therapists are trained to help those with mild BN, BED, ARFID, OSFED and those who are recovering from AN. Please do not hesitate to contact us if you would like to arrange an initial assessment session.

    You may also wish to look at our resources page for further ideas of getting help to manage symptoms that may be driving your eating disorder such as low self-esteemanxiety and depression



    Coping with Eating Disorders with Counselling Psychology Online


    Our qualified psychologists, therapists and counsellors here at Counselling Psychology Online provide bespoke therapy online for those experiencing mild – moderate disordered eating.

    For any further information on our counselling, or any of our therapists, or to schedule in a call with us, contact us here. Answers to the most frequently asked questions about our therapies, fees and online therapy can be found on our FAQ page.