Eating disorders are serious mental illness. They are characterised by disturbances to thoughts, behaviours and attitudes to food and eating. For some, this extends to pre-occupation with exercise, and/or body weight and shape. 

Eating can take many different forms. You cannot tell if someone has an eating disorder by the way they look.  

To learn more about specific eating disorders, including signs and symptoms: 

• Anorexia nervosa
• Bulimia nervosa
• Binge eating disorder
• Avoidant/Restrictive Food Intake Disorder (ARFID)
• Other eating disorders

Eating disorders do not have a single, identifiable cause. There are biological, psychological and socio-cultural risk factors that can increase the chances of developing an eating disorder. 

For many people, there will be intersecting risk factors that contribute to them developing an eating disorder. Eating disorder behaviours are often a way to cope with internal or external difficulties, stressors or changes. Addressing these challenges, and developing more healthy coping mechanisms, is often part of the recovery process.

Biological factors 

Emerging evidence shows eating disorders may have a biological link to a person’s genetics. Studies show eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder have moderate to high heritability.

Ongoing research into this field is analysing hundreds of genes that may influence the chances of developing an eating disorder with the hope of improving treatment and even preventing illness. The Eating Disorders Genetic Initiative (EDGI) is the world’s largest ever genetic investigation of eating disorders.

Genetics are beyond our control. But just like hereditary physical illnesses, there are steps you can take to reduce the risks, and know the signs to act early. This includes addressing psychological, socio-cultural, interpersonal and systemic risks. 

Psychological and behavioural factors 

The number one behavioural factor associated with eating disorders is dieting.

Psychological and behavioural factors associated with the development of an eating disorder may include:

• feelings of inadequacy 
• perfectionism 
• difficulty expressing emotions and feelings, particularly negative emotions such as anger, sadness, anxiety or fear 
• fear or avoidance of conflict 
• low self-esteem 
• competitiveness 
• impulsive or obsessive behaviours 
• high concern with the opinions of others, often with a need to please 
• being prone to extremes, such as ‘black and white’ thinking 
• difficulty coping with stress 
• depression or anxiety 
• traumatic life events
• substance misuse.

Psychological symptoms can also present as the result of an eating disorder and the impact of starvation syndrome. Psychological symptoms may resolve with adequate re-nourishing and subsequent recovery.

Some ways to protect from, or reduce the risks of, these symptoms include:

• building self-esteem
• body acceptance
• emotional wellbeing
• healthy problem-solving and coping mechanisms
• media literacy skills to critically understand the messages we receive about eating, exercise and our bodies – including the skills EDV teaches in the Body Project Australia program.

Socio-cultural factors 

The social and cultural factors associated with developing an eating disorder may include:

• cultural value of ‘thinness’, or small bodies as a moral and health imperative 
• normalisation of intentional dieting and weight loss, in pursuit of the ‘thin ideal’ 
• social groups that value people according to outward appearance 
• media and popular culture’s portrayal of ‘ideal’ shapes and bodies 
• professions with an emphasis on body shape and size – for example, athletes,  dancers, or models 

Some ways to protect from, or reduce the risks of, these factors include:

• belonging to culture/s and social groups that accept a wide range of body shapes and sizes
• positive body image messaging
• seeing diverse body representation
• sports clubs that don’t emphasise thinness or muscularity.

Interpersonal factors

Interpersonal experiences associated with eating disorders include:

• difficulties with personal or family relationships
• teasing or bullying, particularly when based on body weight or shape
• peer pressure
• sexual or physical abuse

Some ways to protect from, or reduce the risks of, these factors include:

• eating regular meals with family or kin
• social support structures
• having your gender affirmed by those around you.

Systemic factors

Systemic factors associated with eating disorders include:

• food insecurity
• weight bias in healthcare
• unsolicited or unrelated body or diet comments in healthcare
• body-related discrimination.

Systemic supports that can protect from, or reduce the risk of, eating disorders include:

• equitable, regular and affordable food access
• weight-neutral dietary advice, within scope of practice
• neutral food language in health messaging.

Other factors 

Other factors and life experiences during which someone might be at an increased risk of developing an eating disorder can include:

• Significant body and social change stages, such as puberty, pregnancy and post-partum and menopause.
• Major life changes, like the loss of a family member or friend, the divorce or separation of parents, or moving schools or jobs.
• Autism, particularly in women.
• Unmet needs – these could be emotional, psychological, social, professional, spiritual, physical or pleasure.

Protective factors can vary, but being supported through these experiences is key.

Full recovery from an eating disorder is possible for everyone, even those who have experienced symptoms for many years.

At EDV, we understand that recovery from an eating disorder is an individual and unique process. How you define and experience recovery often depends on your identity, life stage, life experiences, priorities, responsibilities, support systems, and access to services. 

The first step towards recovery is to talk about what you are experiencing. This may start with a health professional, a helpline, a trusted family member or friend, a teacher, a coach, or a spiritual leader. If you find the person you speak to doesn’t validate your feelings, or doesn’t know much about eating disorders, it’s important not to ignore your symptoms. EDV can help.

Learn more about eating disorder recovery.  

Accessing treatment 

There are a range of evidence-based treatments for eating disorders. Accessing treatment requires navigating different parts of the health care system. Treatment options are available in both the public and private health system.

There are a range of clinical manuals for defining and diagnosing eating disorders. In Australia, the most common is the DSM-5. 

About the DSM-5 

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a publication of the American Psychiatric Association. It is currently in its fifth edition, hence ‘DSM-5’.

The DSM-5 contains sets of ‘diagnostic criteria’ – that is, symptoms someone is experiencing. These are grouped into categories of disorders, to assist clinicians with diagnosis and care.

The DSM-5 mentions the following categories of eating disorders: 

• Anorexia nervosa 
• Bulimia nervosa  
• Binge eating disorder 
• Avoidant/restrictive food intake disorder (ARFID)
• Pica  
• Rumination disorder
• Unspecified feeding and eating disorders (UFED)
• Other specified feeding and eating disorders (OSFED): 
  • Purging disorder  
  • Night eating syndrome  
  • Atypical anorexia nervosa 
  • Subthreshold bulimia nervosa and binge eating disorder 
  • Orthorexia 

Who uses the DSM-5? 

GPs, psychiatrists and mental health professionals can all diagnose eating disorders. They will will usually compare an individual’s symptoms against DSM-5 criteria. This process helps them decide if, and how, to diagnose a mental disorder. A diagnosis can help identify the best treatments, based on evidence, for the best chances of good outcomes. 

Note: the DSM-5 is just one tool to help diagnose and treat eating disorders. It may not represent the broad spectrum of eating disorder experiences. Dialogue and research are ongoing to help refine diagnostic criteria, improve clinical practice, and ensure individuals receive appropriate support and treatment for their experiences with eating disorders. 

Learn more about the DSM-5. 

Find out how EDV can help guide and support your recovery: 

• EDV Hub – helpline for information, finding services and general support. 
• Telehealth Counsellors – up to five free counselling sessions.  
• Telehealth Nurse – free expert guidance with registered nurses, specialised in eating disorders.  
• Peer Mentoring Program – 1:1 recovery support with someone who has ecovered from an eating disorder.
• Carer and Family Support – carer services including Carer Coaching and online courses. 
• LearnED eLearning platform – free, self-paced, online education courses.
• EDV Newsletters – monthly recovery support, straight to your inbox.