Anorexia Nervosa is a serious mental illness characterised by a pattern of restrictive eating relative to requirements, a desire for weight loss, intense fear of weight gain, and disturbances in the way the body is experienced with individuals using the body as the primary means to evaluate their self-worth.

Restriction is often paired with other behaviours like compulsive exercise, purging, obsessive-compulsive tendencies, and ridged, detailed focussed thinking. All of these can impair quality of life and physical health. Rituals around food and exercise may involve counting every calorie and gram of food consumed, the need to burn off a specific amount of calories through exercise, or achieving a set number of steps every day. Often these behaviours can help individuals impacted alleviate anxiety and feel safe and “in control”.

It is worth recognising that individuals with anorexia are not always “underweight” (defined by BMI <18.5kg/m2), however, will present with the exact same psychopathology and impairments to wellbeing. This presentation is often known as atypical anorexia (although we find this term unhelpful) and warrants the same level of support as low weight anorexia due to the same level of risks involved. Often individuals presenting with atypical anorexia face increased barriers to accessing treatment which we know can be detrimental to prognosis. Regardless of how many years a person has experienced anorexia, recovery is always possible and we always encourage seeking specialist eating disorder help and support.

Bulimia Nervosa is a serious eating disorder where individuals experience a vicious cycle of binge eating and purging.

Binge eating is consuming a large amount of food in a discrete period of time accompanied by feeling the loss of control followed by compensatory purging.

Purging behaviours include self-induced vomiting, laxatives or diuretic misuse, overexercise, or fasting and are often an attempt to purge food as a means to feel safe or in control.

Usually, the loss of control or binge eating is preceded by restrictive eating. Individuals with bulimia often experience emotions like guilt, shame, and disgust associated with this vicious cycle. Recovery is always possible and we recommend reaching out for specialist help as soon as possible.

Binge Eating Disorder is characterised by recurrent binge-eating episodes (eating a large amount of food in a discrete period of time that is definitely larger than what most people would eat in a similar amount of time and under the same circumstances). Unlike in Bulimia, there are no compensatory purging behaviours.

Individuals with binge eating disorder report loss of control over eating and associated guilt, shame, and disgust after eating. Binge eating episodes may be triggered by physiological and psychological factors which is why we always work in a multidisciplinary way with psychologists and other healthcare professionals when supporting your recovery.

Although binging episodes are not followed by compensatory purging behaviours, many individuals with binge eating disorder report food restriction or dieting prior to the onset of binge eating and an intense drive to restrict following an episode due to the high levels of distress and guilt experienced.

Binge eating is actually the most common eating disorder despite being talked about much less than anorexia and bulimia. Binge eating disorder is absolutely available and we recommend anyone struggling to reach out for support.

Avoidant/Restrictive Food Intake Disorder (ARFID) is characterised by a very limited food intake either in the amount or type of food eaten due to sensitivity to the flavour, smell, taste or appearance of specific foods, lack of interest in eating due to a lack of appetite or avoidance of food for fear of aversive consequences like vomiting or choking.

Restriction can result in weight loss and/or nutritional deficiencies which comprise wellbeing, as well as impede on the quality of life. Unlike other eating disorders, however, the restriction or avoidance of food is not associated with fear of weight gain or body image concerns. We recommend seeking specialist ARFID support to anyone experiencing any of the behaviours associated with this eating disorder.

Other Specified Feeding or Eating Disorder (OSFED) is the term used when an individual presents with symptoms of anorexia, bulimia, or binge eating disorder but does not meet the full diagnostic criteria (specified in the DSM-V).

We don’t find it particularly helpful to rely on an old manual for labels of if someone is or isn’t struggling and acknowledge, we prefer to listen to you and consider anyone worthy and deserving of support regardless of diagnosis. Atypical anorexia usually comes under this heading and refers to someone presenting with anorexia who isn’t by the BMI standards considered “underweight” (defined by BMI <18.5kg/m2). At the Isa Robinson Nutrition clinic, we simply refer to this as anorexia.