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February 2025 – Eating Disorder Awareness Week

January has flown by, and so much has happened online that parts of last month’s Hot Topic already feel outdated yet still highly relevant.

This February, our focus shifts to Eating Disorder Awareness Week, which officially starts near the end of the month from the 24th of February to the 2nd of March. This year’s theme is “The Time Is Now”, which aligns perfectly as a brand new lunar year for the snake begins, providing time to shed some myths around or perhaps renew knowledge about eating disorders.

What is an Eating Disorder?

An eating disorder is not a choice, hobby, or even a lifestyle; it is a medical condition.

An eating disorder is a serious mental health condition. As with other mental health conditions, anybody can be diagnosed with an eating disorder regardless of age, gender and weight. Their exact causes are also not fully understood.

Characterised by persistent and harmful behaviours that relate to attitudes around eating, body image and food, eating disorders can affect an individual’s quality of life and well-being. They can also coincide with other mental health disorders, such as anxiety, depression and trauma, which can make them more challenging to identify or diagnose.

There are many different types of eating disorders, including:

Anorexia nervosa

Often shortened to anorexia, this eating disorder has two general category types: Restricting or binge eating. Both types of anorexia can involve:

A restricted calorie intake to the point of avoiding certain types of food outright
A need to eat certain foods based on a rule.
A desire to skip meals or engage in strict dieting or exercise.
A reluctance or fear of gaining weight.
A warped perception of body image.
Methods of purging to try and rid the body of food (such as self-induced vomiting or laxatives/diuretics).

Severe cases of anorexia can lead to heart failure, osteoporosis, kidney damage, and even death.

Bulimia nervosa

Often shortened to bulimia, this eating disorder involves eating a lot of food within a short amount of time. It can involve:

Episodes of binge eating where someone eats until they experience pain or discomfort.
The feelings of guilt and shame before, during, or after an episode of binge eating.
A feeling of being unable to stop or control food intake during a binge eating episode.
Methods of purging that are also associated with anorexia.
Keeping secrets related to eating habits and avoiding social activities involving food due to embarrassment, bloating, or tiredness.
Irregular or stopped periods.

Severe cases of bulimia can lead to an imbalance of electrolytes in the body. This imbalance of vital minerals may result in a stroke or heart attack.

Binge Eating Disorder (BED)

This type of eating disorder involves consuming large amounts of food, similar to bulimia and binge-eating anorexia, but without purging to restore a sense of balance. It can involve:

Constant feelings of hunger or bloat.
Difficulty feeling satisfied by meals, often leading to a preference for heavily processed foods.
Eating because of boredom, stress, or a need for gratification that may happen consciously or unconsciously.
A strong urge to stay close to food at all times.
Withdrawing from hobbies and social activities in favour of eating.

Severe cases of BED can lead to high blood pressure and cholesterol that can block arteries and cause further complications, such as an increased risk of obesity, diabetes, and heart disease.

Rumination Disorder

This type of disorder is about repeated regurgitation of food without nausea or other underlying medical conditions and can involve:

The bringing up of food from the stomach to the mouth to re-chew, re-swallow, or spit out
Zero discomfort or effort after eating
Weight loss or malnutrition if food is not digested correctly
A strong avoidance of eating around others
Strained arching of the back and sucking of the tongue
Burping sensations

While this may seem harmless, severe cases of rumination may lead to oesophagal damage (in the area that connects the mouth to the stomach) due to the regurgitation of stomach acid. If food somehow enters the lungs, this can also lead to infections and breathing problems (called aspirational pneumonia).

Pica

This eating disorder may have one of the silliest names for an eating disorder – but do not let that fool you. Often dismissed as a harmless quirk that involves an intense craving to eat non-food items with little to no nutritional value, individuals with pica may also eat regular food items rather than avoid them outright.

For a diagnosis, this behaviour must persist for at least a month and must not be connected to religious or cultural practices such as:

The Catholic tradition of consuming sacred soil or dust from the tombs of saints.
The consumption of vibhuti (sacred ash) in Hindu rituals or burnt palm ashes on Ash Wednesday in Christianity.
The ingestion of dissolved ink or paper from religious texts, such as the Quran or Bible, or prayers in Afro-Caribbean and African spiritual practices.

With that said, pica can involve:

Eating substances like dirt, chalk, soap, paper or hair.
Secrecy or embarrassment around preferring non-food substances.
Sensual fascinations include the crunch of ice, drywall chalkiness, or rubber’s chewable nature.
A deficiency of certain minerals/vitamins.

While some objects may pass through the body without issue, others have the potential to do critical harm. Unsanitary items picked up from the ground (or the ground itself) can lead to infections or blockages. Solid or sharp objects, like metal, may cause lasting dental damage, while toxic substances, such as soap, can result in fatal organ failure.

Not quite as silly-sounding now, is it?

Avoidant/restrictive food intake disorder (ARFID)

Commonly abbreviated to ARFID, avoidant/restrictive food intake disorder involves eating too little or avoiding certain foods for various reasons. Similar to how people may prefer only to eat certain foods/objects for certain reasons, this involves doing the opposite.

Because of the intricacies involved, this particular eating disorder can be complex and challenging to understand. Still, it is usually unnoticed and wrongly assumed to be because an individual is a “picky eater” or “seeking attention”.

This type of eating disorder can involve:

Eating a range of foods, but less than necessary to be healthy.
Difficulty recognising hunger or feeling full quickly.
Missing meals completely.
Opting for safe alternatives or outright refusing those alternatives if deemed unsafe.
Chewing carefully or taking small bites to be cautious.
Being quick to notice when something is not “right”, such as feeling unable to eat because of noise or rejecting a sandwich due to how it is made up (such as misordered fillings or slightly uneven slices of bread)

Other specified feeding or eating disorder (OSFED)

When an individual’s symptoms do not fit, they may be diagnosed with this type of eating disorder as an umbrella term. It is every bit as serious as other disorders, as it can develop from (or into) other diagnoses. This type of eating disorder can cover most other disorders and even be used in some cases to catch those that are not officially medically defined.

Here are some examples:

Night Eating Syndrome – Recurring episodes of eating at night.
Orthorexia – An obsession with eating healthy foods.
Diabulimia (or TE1D) – Mainly affects those with type 1 diabetes, where insulin is deliberately restricted/avoided to control calories.
Purging Disorder – An obsession with removing food from the body, including extreme exercise or fasting.
Low-Frequency BED – Binge eating disorder with a limited duration.
Atypical anorexia – Anorexia, except in an individual that is not classed as underweight.

This type of disorder was also formerly known as ENDOS (Eating Disorder Not Specified).

Why raise awareness?

Eating disorders are among the most life-threatening mental health conditions, yet they remain widely misunderstood, overlooked, or even glamorised due to cultural norms—just like other mental illnesses. They are not lifestyle choices or hobbies; no one wakes up and decides to have an eating disorder.

At its core, the action of eating is about consuming food to sustain life and fuel the body. However, eating disorders are not just about eating too much or too little to fuel. They involve deeply complex thoughts and behaviours surrounding what food is food and how self-perception may cause disarray that can restrict eating.

According to Beat, a UK-based eating disorder charity, over 1.25 million people in the UK are affected by an eating disorder, many of whom may not even realise help is available before it is too late.

Beat also offer a confidential helpline that is able to provide support or further information about eating disorders on 0808 801 0677 (weekdays 3pm to 8pm)

Not only does it impact individuals, but it also has an impact on a broader scale with the NHS. A report published by the All-Party Parliamentary Group (APPG) in January titled “The Right To Health” highlights the urgent need for action. NHS admissions for eating disorders exceeded 30,000 in 2023/24 – up from 19,000 before the pandemic.

This sharp rise in cases is straining an already overwhelmed healthcare system, emphasising the growing demand for better support and treatment services.

While compassion and understanding can’t replace minerals and vitamins, they are incredibly valuable. To be blunt, people with eating disorders don’t want to hear outdated comments like, “In my day, we ate what we were given or went without.”

Feeding Deceit - The Link to Last Month's Hot Topic

Last month, we discussed some predictions about media, and there was much to say about the digital aspect of control and influence surrounding social media. It’s modern and constantly shifting, and you, the reader, probably have an account on a social media platform.

In retrospect, there was so much more to be said about the control and influence of the traditional types, but that was already stretching on to be one of the most ambitious Hot Topics written to date. However, that might have been unfair to those who prefer turning pages or watching TV!

To ensure fairness to everyone, how about predicting how traditional forms of media may evolve in the coming year, particularly regarding body image, beauty standards, and, of course, eating disorders?

Traditional media once held an uncontested influence over beauty standards and global news. One day, it was once possible to turn on the TV and catch a breaking news segment discussing an “obesity epidemic,” and then the very next day, find “the latest diet craze” taking over the cover of a plentiful row of magazines while doing a bit of grocery shopping. One shames individuals for weight gain without factoring in eating disorders, and the other is carefully curated to be eye-catching at a glance. The person featured on the cover of that magazine might have the opportunity to tell their story. Still, occasionally, these stories are sensationalised and edited to the extent that eating disorders are not addressed or become a shock factor.

Not all shows and books are necessarily harmful in the messages they tell. Some do contain valid advice, but depending on the narrative, some can feature fad diets and encourage extreme restrictions that can promote a diet just for the sake of “being thin” and feature buzzwords such as “biohacking” or “longevity”.

In recent years, there has been a growing pushback against harmful narratives around body image and food driven by various laws, activists, medical professionals, and people with genuine experience rather than perpetuated negativity. This can already be seen in effect as more people open up about weight and mental health, but there is still much more that can be done when it comes to eating disorders specifically.

Is it possible that this year we might witness a resurgence of traditional media as people change their minds about social media being increasingly restrictive? Could advertisements for gyms and fitness trackers become commonplace among the likes of food delivery? Will there be an increase in radio broadcasts of talk shows and interviews about eating disorders? Maybe theatrical plays or scripts could see enough of a standing ovation to take over?

Time shall tell.

Discussion points for Safeguarding, Wellbeing and Freedom Of Speech:

In your own words, how would you describe an eating disorder to someone who does not know about them?
Do you know (or already support) someone with an eating disorder?
What challenges can prevent people from receiving an official diagnosis for their eating disorder?
Can communities do more to create a more inclusive environment for those with eating disorders?
Does media help to start conversations around eating disorders, or does it contribute more towards misconceptions and harmful stereotypes?
Why could nutrition labels do more harm than good?

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