• It's estimated that 1.25 million people in the UK suffer with an eating disorder

  • Eating disorder specialist Harriet Frew explores 5 more subtle signs of disordered eating

  • If you need support with an eating disorder, find a therapist here

You don’t believe that you have an eating disorder. Surely eating disorders are the extreme; when you stop eating anything at all. You’ve seen in the newspaper many times; emaciated bodies and hospital admissions; this doesn’t resonate with you. You do like to monitor your food intake and avoid sugar, carbohydrates and anything high in calories, but then isn’t that what everyone is doing nowadays? That it is a lifestyle choice and surely an improved one too? Changing your eating was simply positive action for health. You and a few friends decided to shape up for summer; eat well and get active. It started out quite happily and harmlessly. Yet, you have noticed though that your friends remain fairly carefree and relaxed in their approach to the self-improvement regime, whereas for you, it has started to take on a whole new meaning.

1) Preoccupied with food

Firstly, you are slightly baffled and bemused by how preoccupied you have become with food. You can recall every single morsel that passed your lips yesterday and you find yourself daydreaming about future meals 24/7. You are sure that you never used to be like this. Food used to be just food. It is as though another magical door has been opened to a world that you never knew existed. You wish you could just close it shut and silence the food chatter in your head.

2) Rules abound

Suddenly, rules abound around food. On a march around the supermarket, you could instantly label foods which are ‘good’ or ‘bad’. You try to avoid the ‘bad’ foods and they make you feel uneasy. The judge is forever present in your head, passing a verdict on whether a food can be eaten and in what quantity. You aim to have iron rod control and order around your food. Unfortunately, this creates pressure and expectations which cannot always be adhered to.

3) Food socialising

You spend increasing amounts of time worrying about how you are going to manage situations involving food. Social events involving unpredictable, uncontrollable, unplanned foods suddenly bring on bouts of anxiety for you; whereas in the past you would have looked forward to them with anticipation. Now you yearn for days where you can keep order and control to your eating, as a prerequisite to feeling that you are managing okay.

4) Body image

You may likely have become increasingly conscious of your body shape and there might be a burning desire to lose weight or change it. You may even have lost some weight already, but to your surprise, you feel dissatisfied or unhappy with this. If only you could lose a bit more, then you would feel okay. You might check your body in the mirror or weigh yourself frequently and you feel compelled to keep monitoring this. Suddenly, improving your body seems a vital priority compared to others parts of life. Friendships, work, family, hobbies, they may still be present, but feel more on the fringes of your concerns right now.

5) Bingeing and purging

Possibly, you might have binged or over-eaten on foods that you have eliminated from your ‘allowed choices’. You may (or may not) have tried to compensate for this through restricting or avoiding food the next day, making yourself sick, using laxatives or exercising excessively. You might feel very ashamed and upset by your behaviour and want to keep this secret. You might also feel quite ambivalent about letting go of using food to cope; it may feel safe; give you a sense of weight control and additionally provides a means of handling daily stresses.

An eating disorder is a coping strategy in response to stress. There is no one defined cause and we know that it is a complex interplay of genetics, the environment, life events and our Western culture. Certainly, some people seem more susceptible to developing eating disorders than others. If you have low-self esteem and are prone to perfectionism, you may be vulnerable. 

Life events such as bereavement, bullying and friendship problems can all be factors that have an influence. Over-eating or under-eating can become ways of soothing distress, blocking emotions and escaping from life’s problems, albeit often unconsciously. Eating disorders do seem more prevalent in some families and it hard to clearly separate the nature versus nurture interplay. Early exposure to dieting, disordered eating or addiction can certainly play a part, but not always.

If you recognise that you might have an eating disorder, then early intervention can make a significant difference on the duration and impact that the eating disorder has on your life. Counselling can be really helpful in supporting you to manage current symptoms and also to help you in understanding where the disorder may be rooted. Counselling can offer new strategies and ways of coping rather than turning to food or your body. It is about learning self-acceptance and starting to evaluate yourself more wholly rather than placing such strong emphasis on your weight and shape as indicators of self-worth.

If you recognise that your symptoms have become more severe. Maybe, you have experienced significant weight loss or gain recently, you are purging recurrently with vomiting or laxatives, or have lost your menstrual periods. You may be feeling dizzy, fatigued or unwell, then it is important to seek out more specialised help and this can be initially accessed via your Doctor.

Harriet Frew is a verified welldoing.org therapist 

Further reading

Reclaiming your life from anorexia

Shame, guilt and your relationship with food

How to have a healthy relationship with food when the world is obsessed with diets

Helping your child develop a healthy relationship with food

7 thinking traps about food