What are eating disorders?

An eating disorder is when someone is locked into unhealthy behaviours around food and eating. Eating disorders can affect people of all ages and gender. There is no single reason why a person develops an eating disorder. 

Eating disorders are centred around a problematic relationship with body image and eating, but they are not only about food or weight, and are often linked to underlying struggles with managing emotions and distressing thoughts about the self. Some of the main features of eating disorders can be:

• Unhealthy eating behaviours, such as starving, restricting food intake, over-eating or binge-eating
• Other unhealthy behaviours, such as induced vomiting, abusing laxatives or exercising excessively after eating
• Obsessive or extreme thoughts and beliefs about weight, shape and eating

Types of eating disorders include:

• Anorexia Nervosa - People with this disorder starve or restrict their eating, lose dangerous levels of weight and are terrified of putting on weight
• Bulimia Nervosa - People with this disorder are very concerned about their weight or shape. They will binge-eat but they will then either induce vomiting, abuse laxatives, exercise excessively or starve themselves in order to try and stay within their normal weight range
• Binge-Eating Disorder - People with this disorder binge-eat. Their weight may increase to above their normal range

Eating disorders can lead to serious physical health problems, such as kidney or heart failure and difficulty getting pregnant, and may lead to a loss of periods or sexual interest. Eating disorders can be fatal.

People with eating disorders may also have struggles with mood, lack of self-esteem or depression, as well as anxiety related to food and eating.

What is CBT for eating disorders?

As in all types of CBT, goals for therapy will be set together with the therapist after conversations to understand more about how the eating disorder is presenting and what the person coming for therapy wants to work on. Sessions and work in-between sessions will include thinking about motivation to change and taking a gradual and steady approach to making these changes. Often regular check-ups with a GP or other healthcare practitioner are suggested in combination with talking therapy to ensure that the person is physically safe.

Some of the aims of CBT in treating eating disorders are:

• Understanding all the factors related to the eating disorder
• Agreeing on goals to help change unhealthy eating behaviours and related activities such as over-exercising
• Testing out the accuracy of thoughts and beliefs about eating, weight and shape
• Focus on building behaviours to become more physically healthy and manage weight better
• Identifying and tackling any underlying factors, such as low self-esteem or relationship difficulties
• Learning techniques to help prevent the eating disorder from returning
• Using CBT to treat depression and/or anxiety if they are linked to the eating disorder

Obesity is not classed as an eating disorder, but can also be helped with CBT. 

Other resources

You can download a pdf version of the information contained on this page here.

National Institute for Health and Care Excellence (NICE) guidelines for the recognition and treatment of eating disorders