Anorexia Nervosa is characterised by the National Institute of Mental Illness as “a significant and persistent reduction in food intake leading to extremely low body weight; a relentless pursuit of thinness; a distortion of body image and intense fear of gaining weight; and extremely disturbed eating behaviour.”

Avoidant restrictive food intake disorder, more commonly known as ARFID, is a condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of overall amount eaten, or both.

Someone might be avoiding and/or restricting their intake for a number of different reasons. The most common are the following:

They might be very sensitive to the taste, texture, smell, or appearance of certain types of food, or only able to eat foods at a certain temperature. This can lead to sensory-based avoidance restriction of intake. They may have had a distressing experience with food, such as choking or vomiting, or experiencing significant abdominal pain. This can cause the person to develop feelings of fear and anxiety around food or eating, and lead to them to avoiding certain foods or textures. Some people may experience more general worries about the consequences of eating that they find hard to put into words, and restrict their intake to what they regard as ‘safe’ foods. Significant levels of fear or worry can lead to avoidance based on concern about the consequences of eating. In some cases, the person may not recognise that they are hungry in the way that others would, or they may generally have a poor appetite. For them, eating might seem a chore and not something that is enjoyed, resulting in them struggling to eat enough. Such people may have restricted intake because of low interest in eating.

It is very important to recognise that any one person can have one or more of these reasons behind their avoidance or restriction of food and eating at any one time. In other words, these examples are not mutually exclusive. This means that ARFID might look quite different in one person compared to another.

Other key aspects of ARFID are that it can have a negative impact on the person’s physical health and as well as on their psychological wellbeing. When a person does not take in enough energy (calories), they are likely to lose weight. Children and young people may fail to gain weight as expected and their growth may be affected, with a slowing in height increase. When a person does not have an adequate diet because they are only able to eat a narrow range of foods, they may not get essential nutrients needed for their health, development and ability to function on a day-to-day basis.

The term “bulimia nervosa” refers to an eating disorder characterised by episodes of binge eating that are followed by compensatory behaviours such as purging, fasting, and/or excessive exercise. It is a troubling mental illness and eating disorder that can have severe lifetime consequences. For those that struggle with this disorder, overcoming the complicated behaviors of the disorder as well as the misperceptions and stigmas associated with it can be incredibly difficult.

An episode of binge eating is described as eating an atypically large amount of food in a short period of time while feeling of loss of control during the episode and immense shame and guilt afterward. Whilst one episode of binge eating mean that you have an eating disorder, recurrent episodes paired with mental distress would be cause for concern. There is a lot of stigma associated with binge eating, and a misconception that it is due to a lack of self-control and greediness, when it is as much a mental illness as any other eating disorder.

Orthorexia nervosa, while not an officially designated mental health diagnosis, is an increasingly concerning disorder. Evolving out of diet culture and the societal emphasis on “clean” and “healthy” food, orthorexic tendencies are viewed as socially acceptable due to a lack of understanding of the disorder and the dangers it presents.

Sometimes a person’s symptoms don’t exactly fit the expected symptoms for any of these three specific eating disorders. In that case, they might be diagnosed with an “other specified feeding or eating disorder” (OSFED).

This is very common. OSFED accounts for the highest percentage of eating disorders, and anyone of any age, gender, ethnicity or background can experience it. It is every bit as serious as anorexia, bulimia, or binge eating disorder, and can develop from or into another diagnosis. People suffering from OSFED need and deserve treatment just as much as anyone else with an eating disorder.

As OSFED is an umbrella term, people diagnosed with it may experience very different symptoms. Some specific examples of OSFED include:

Atypical anorexia – where someone has all the symptoms a doctor looks for to diagnose anorexia, except their weight remains within a “normal” range.

Bulimia nervosa (of low frequency and/or limited duration) – where someone has all of the symptoms of bulimia, except the binge/purge cycles don’t happen as often or over as long a period of time as doctors would expect.

Binge eating disorder (of low frequency and/or limited duration) – where someone has all of the symptoms of binge eating disorder, except the binges don’t happen as often or over as long a period of time as doctors would expect.

Purging disorder – where someone purges, for example by being sick or using laxatives, to affect their weight or shape, but this isn’t as part of binge/purge cycles.

Night eating syndrome - where someone repeatedly eats at night, either after waking up from sleep, or by eating a lot of food after their evening meal.

As with other eating disorders, it will probably be changes in the person’s behaviour and feelings that those around them notice first, before any physical signs appear.