Summary
Anorexia nervosa, often called anorexia, is an eating disorder that can affect the way someone thinks about food, eating, weight, body shape and themselves. It is a serious mental health condition that can affect people of any age, gender, background or body size. Someone with anorexia may restrict their food intake, experience a strong fear of gaining weight or have thoughts and beliefs about their body that make eating feel very difficult. They may also feel that they need to control their food or eating in order to cope with difficult emotions or situations.
Anorexia is more than simply wanting to eat healthily, lose weight or change your appearance. Eating disorders can involve powerful thoughts, emotions and behaviours that can become difficult to control, even when someone recognises that they are affecting their health or everyday life. A person may spend a lot of time thinking about food, eating, weight or body shape, experience anxiety around meals, avoid particular foods or situations involving food, or develop routines and behaviours that feel necessary in order to manage distress.
Someone with anorexia may not always recognise that they are unwell or may find it frightening to consider changing their eating habits. They may feel that they are eating “too much” even when other people can see that they are not eating enough, or may experience significant distress when encouraged to eat more. This can make it difficult for them to ask for help or understand why other people are concerned.
Anorexia can affect both physical and mental health. Restricting food can leave the body without the energy and nutrients it needs to function properly and can affect concentration, sleep, mood, energy, hormones, bones, the heart and other parts of the body. Someone can become medically unwell even if they do not look visibly unwell, which is why concerns about eating should always be taken seriously.
Anorexia can also affect relationships, education, work and everyday activities. Someone may avoid eating with other people, withdraw from friends, become preoccupied with food or find it difficult to concentrate because so much of their attention is focused on eating or body-related thoughts. These difficulties are not a choice or a sign that someone is being difficult.
Recovery from anorexia is possible, and getting support early can make a significant difference. Treatment usually involves a combination of psychological support, nutritional support and physical health monitoring. The approach will depend on the person’s age, circumstances, physical health, symptoms and individual needs.
How to help myself
If you think you may have anorexia or are struggling with food and eating, tell someone you trust. This could be a parent, carer, friend, teacher, GP, school nurse or another healthcare professional. You do not need to be certain that you have an eating disorder before asking for help. If eating, food, weight or body image is causing you significant distress or affecting your everyday life, this is enough reason to talk to someone.
Try to be honest about what has been happening, even if some of it feels embarrassing or frightening to talk about. You might find it difficult to explain how much you are eating, how you feel around food or the thoughts you have about your body. You can write things down before speaking to someone if talking feels too difficult. You could make notes about changes in your eating, thoughts about food or body image, worries around meals, changes in your mood and how these difficulties are affecting school, work, relationships or everyday life.
Try not to judge yourself for finding eating difficult. Anorexia can create powerful fears and beliefs around food, and changing these thoughts can take time. You may feel frightened about getting help or worry that treatment will take away your control. These feelings are common in eating disorders, and you can talk about them with your healthcare team rather than having to manage them alone.
Follow the eating plan or treatment recommendations provided by your healthcare team as closely as you can. Eating disorder treatment can feel challenging, particularly when increasing food or changing established routines causes anxiety. If something feels overwhelming, tell your treatment team rather than silently struggling or stopping treatment. They can help you work through difficulties and adjust the support where appropriate.
Try to reduce behaviours that keep the eating disorder going, with support from your treatment team. This might include rigid food rules, avoiding eating with other people, repeatedly checking your body or seeking reassurance about your appearance. Changing these behaviours can feel uncomfortable at first, but treatment can help you gradually develop different ways of coping.
Be careful about social media and online content. Accounts focused heavily on dieting, weight loss, appearance or eating disorder behaviours can reinforce unhelpful thoughts and make recovery more difficult. Consider muting, unfollowing or taking a break from content that increases anxiety around food or your body. Following accounts that promote a more balanced and realistic approach to food and wellbeing may feel more supportive.
Try not to compare your body, eating or recovery with other people. Eating disorders can make comparison particularly powerful, but another person’s body, symptoms or treatment does not tell you what is appropriate for you. Recovery also looks different for different people, so comparing your progress with someone else’s can create additional pressure.
Stay connected with people who support you. Anorexia can make you want to withdraw from friends and family, particularly around meals or social situations involving food. Let trusted people know when you are struggling rather than disappearing completely. You can ask them to sit with you, distract you after meals or simply spend time with you without making food the focus of every conversation.
Try to keep other parts of your life going where possible. Eating disorders can gradually take up more and more time and attention, leaving less room for friendships, hobbies, education and things you enjoy. Maintaining meaningful activities can help remind you that you are more than your eating disorder.
Be aware that your physical health needs monitoring. Anorexia can affect the body even when you do not feel particularly unwell. Attend physical health checks and appointments recommended by your healthcare team, and tell them about new or worsening symptoms rather than assuming they are part of the eating disorder and therefore do not matter.
Do not try to manage recovery entirely by yourself. Eating disorders can have serious physical consequences, and professional support is important. If you are worried about your eating, speak to a GP or another healthcare professional as soon as possible rather than waiting until things become severe.
If you become physically very unwell, faint, feel extremely weak or confused, experience significant changes in your heart rate or have another serious physical symptom, seek urgent medical help. Eating disorders can become medical emergencies, and you should not assume that you simply need to push through the symptoms.
How to help a loved one
If you are worried that someone you care about may have anorexia, start by approaching them calmly and privately. Choose a time when you are unlikely to be interrupted and explain that you are concerned because you have noticed changes in their eating, mood or behaviour. Focus on what you have observed rather than making accusations or commenting on their appearance.
Try to avoid conversations that focus on whether the person “looks too thin” or whether they have lost weight. Eating disorders can affect people at different body sizes, and someone does not need to look visibly unwell to need help. Focusing on changes in behaviour, eating, mood or wellbeing can be more helpful.
Listen to what they have to say without immediately trying to argue with their thoughts. Someone with anorexia may genuinely feel frightened about eating or gaining weight, even if those fears seem difficult to understand from the outside. You do not have to agree with the eating disorder, but acknowledging that they are finding things difficult can make it easier for them to accept support.
Avoid commenting on their weight, body shape or appearance, including positive comments about weight loss. Even comments intended as compliments can reinforce the idea that body size is something that should be monitored or changed. Try to focus conversations on the person’s interests, relationships, achievements and wellbeing rather than their appearance.
Try not to make food into a source of conflict. Mealtimes can already be extremely stressful for someone with anorexia, and arguments, threats or criticism may increase their anxiety. This does not mean ignoring the eating disorder or allowing harmful behaviours to continue; instead, work with the person’s treatment team to understand how best to support meals and recovery.
Encourage them to speak to a healthcare professional. You could offer to help them make an appointment, go with them or help them write down what they want to say. If they are a child or young person, involve an appropriate parent, carer or professional rather than expecting them to manage the situation alone.
Remember that someone with anorexia may not want help at first. They may feel that they are not ill enough, worry about treatment or be frightened about changing their eating. Try to remain supportive without turning every interaction into a conversation about food. Let them know that you care about them and will support them in getting help.
Support them with ordinary life as well as recovery. Spend time together, encourage hobbies and maintain friendships where possible. Anorexia can gradually take over someone’s life, so helping them remain connected to things they value can be an important part of recovery.
Be mindful of your own language around food, dieting and bodies. Avoid talking negatively about your own body, commenting on other people’s weight or regularly discussing diets and weight loss around someone who is struggling with an eating disorder. Creating a less appearance-focused environment can reduce additional pressure.
Do not take responsibility for treating the eating disorder yourself. You can provide encouragement and practical support, but anorexia can require specialist psychological and medical treatment. If you are worried about someone’s physical health, encourage them to seek professional help rather than trying to monitor or manage their health yourself.
If the person becomes seriously physically unwell, confused, faints, experiences concerning changes in their heart rate or appears to be in immediate danger, seek urgent medical help. Eating disorders can cause serious medical complications, and someone may need urgent assessment even if they do not believe that they are seriously ill.
Look after yourself as well. Supporting someone with an eating disorder can be emotionally exhausting, particularly when they are struggling to accept help. It is okay to ask professionals for advice about how to support them and to recognise that you cannot be responsible for their recovery on your own.
Myth Buster
Myth: Anorexia is just about wanting to be thin
Truth: Anorexia is a serious eating disorder involving psychological, emotional and behavioural difficulties around food, eating, weight and body image. Appearance concerns may be part of the illness, but anorexia is much more complex than simply wanting to lose weight.
Myth: You can tell if someone has anorexia by looking at them
Truth: You cannot determine whether someone has an eating disorder from their appearance. People with anorexia can have different body types, and someone can be seriously affected by an eating disorder without looking visibly unwell.
Myth: Anorexia only affects teenage girls
Truth: Anorexia can affect people of any age, gender, background or body size. Although it is often associated with teenage girls, people of all genders and ages can experience eating disorders.
Myth: Someone with anorexia just needs to eat
Truth: Anorexia is a serious mental health condition, and eating can become associated with intense fear and distress. Telling someone simply to eat more does not address the psychological difficulties that can make eating feel so difficult.
Myth: Someone with anorexia would recover if they really wanted to
Truth: Recovery can be difficult because eating disorders can involve powerful thoughts, fears and behaviours. Someone can genuinely want to recover while still finding changes around food extremely challenging.
Myth: You should wait until someone looks very unwell before getting help
Truth: Early support can be important, and you do not need to wait for someone to look physically unwell before raising concerns. Eating disorders can affect physical health at different body sizes.
Myth: Talking about anorexia will make someone develop an eating disorder
Truth: Talking appropriately about eating difficulties does not cause someone to develop anorexia. Having open, supportive conversations can make it easier for someone to recognise that they are struggling and access help.
Myth: People with anorexia do not eat anything
Truth: Anorexia does not look exactly the same for everyone. Someone may eat regularly at some times or eat certain foods while still experiencing significant restriction, fear or distress around eating. Eating some food does not mean that someone cannot have anorexia.
Myth: If someone eats a meal, their eating disorder has gone away
Truth: Eating disorders involve more than individual meals. Someone may be able to eat in some situations while still experiencing significant distress, restrictive behaviours or difficult thoughts around food and their body.
Myth: Recovery is simply a matter of gaining weight
Truth: Physical recovery is an important part of treatment where someone has become medically compromised, but recovery also involves addressing the psychological and behavioural aspects of the eating disorder. Treatment aims to support both physical health and longer-term psychological recovery.
Myth: Complimenting someone on losing weight is always helpful
Truth: Comments about weight loss can reinforce the idea that changing body size is desirable and may be particularly difficult for someone with an eating disorder. It is generally more helpful to focus on the person rather than their weight or appearance.
Myth: Eating disorders are a lifestyle choice
Truth: Anorexia is a serious mental health condition, not a lifestyle or diet choice. The behaviours associated with an eating disorder can become difficult to control and can have serious consequences for physical and mental health.
Myth: If someone knows they are ill, they should be able to stop
Truth: Understanding that you have an eating disorder does not automatically make the thoughts and behaviours easy to change. Recovery often requires professional support, and ambivalence about change can be part of the illness.
Myth: You cannot have anorexia if you are not underweight
Truth: Diagnosis and clinical concern should not be based simply on appearance. People can experience serious eating disorder symptoms and physical health problems without fitting stereotypes about what someone with anorexia should look like.
Myth: Once someone is physically healthier, they no longer need support
Truth: Physical recovery and psychological recovery do not always happen at the same pace. Someone may continue to experience difficult thoughts, fears and behaviours even after their physical health has improved, so ongoing support may be needed.
Support
If you are worried about your eating or think you may have anorexia, speaking to your GP is an important first step. You can explain what has been happening with your eating, thoughts about food or your body, and how this is affecting your everyday life. Your GP can assess your physical and mental health and discuss whether you need referral to an eating disorder service or other specialist support.
If you are a child or young person, you can also speak to a parent, carer, teacher, school nurse, pastoral worker or another trusted adult. They can help you tell someone about what is happening and support you to access healthcare. You do not need to manage concerns about an eating disorder alone.
Eating disorder services can provide specialist assessment and treatment. Depending on your age, circumstances and local area, support may involve specialist community eating disorder services, Child and Adolescent Mental Health Services (CAMHS) or adult eating disorder services. Treatment may involve psychologists, psychiatrists, dietitians, nurses, doctors and other professionals working together.
Physical health monitoring is an important part of eating disorder care. A healthcare professional may monitor your physical health and arrange appropriate checks to make sure that any medical complications are identified. This does not mean that your concerns are being reduced to your physical health; monitoring the body is an important part of keeping you safe while psychological treatment addresses the eating disorder itself.
If you are already receiving treatment for anorexia, tell your healthcare team if your symptoms change, if you are finding treatment difficult or if you are worried about your physical or mental health. You do not need to manage setbacks privately. Treatment can be adjusted according to your changing needs.
Schools, colleges and universities may also be able to provide practical support. Depending on your circumstances, this might include support around meals, time away from lessons for appointments, adjustments to workload or attendance, a quiet space or communication between education staff and healthcare professionals where appropriate and with the necessary consent.
Parents and carers can also receive support. Eating disorders can be extremely difficult for families to understand, and it is normal for parents or carers to have questions about how to respond. Specialist services can provide guidance about supporting eating, managing difficult situations and looking after your own wellbeing.
If you are supporting someone with anorexia, you do not have to become responsible for monitoring everything they eat or managing their treatment. Work with the healthcare professionals involved and ask them what practical support would be most appropriate.
If someone is physically very unwell, has fainted, is confused, is experiencing severe weakness, has concerning changes in their heart rate or has another serious or rapidly worsening symptom, seek urgent medical advice. If there is an immediate risk to life, call 999 or go to A&E.
You can also seek urgent mental health support if someone is experiencing suicidal thoughts, serious self-harm or feels unable to keep themselves safe. NHS 111 can provide urgent mental health support, and 999 or A&E should be used when there is an immediate emergency.
Therapy interventions
Therapy can help address the thoughts, feelings and behaviours associated with anorexia while supporting physical recovery. Treatment is usually tailored to the person’s age, circumstances, symptoms and stage of recovery. Different approaches may be used depending on the individual and the eating disorder service providing treatment.
- Cognitive Behavioural Therapy for Eating Disorders (CBT-ED) – CBT-ED helps you understand the links between eating disorder thoughts, emotions and behaviours and can support you in changing patterns that maintain the eating disorder. It may focus on reducing restrictive behaviours, challenging unhelpful beliefs about food and body image, and developing healthier ways of coping.
- Family-Based Treatment (FBT) – FBT is a structured treatment commonly used with children and young people with anorexia. It involves parents or carers taking an active role in supporting recovery, particularly around eating, while gradually helping the young person regain independence as their health improves.
- Enhanced Cognitive Behavioural Therapy (CBT-E) – CBT-E is an adapted form of CBT designed to address eating disorder difficulties. It focuses on understanding the processes that maintain the eating disorder and developing healthier patterns around eating, body image and coping with emotions.
- MANTRA (Maudsley Anorexia Nervosa Treatment for Adults) – MANTRA is a psychological treatment specifically developed for people with anorexia. It explores factors that may maintain the eating disorder, including thinking styles, emotional difficulties, relationships and responses to food and eating.
- Specialist Supportive Clinical Management (SSCM) – SSCM combines supportive psychological care with practical help around eating and physical health. It can provide information, encouragement and support while helping someone work towards recovery.
- Cognitive Behavioural Therapy (CBT) – CBT can help address anxiety, low mood, perfectionism, self-criticism or other psychological difficulties that may occur alongside an eating disorder. It can support someone to recognise unhelpful patterns and develop alternative ways of responding.
- Dialectical Behaviour Therapy (DBT) – DBT teaches skills for managing intense emotions, coping with distress and improving relationships. It may be considered when difficulties with emotional regulation are contributing to eating disorder behaviours or when other significant emotional difficulties are present.
- Family Therapy – Family therapy can help families understand the eating disorder, communicate more effectively and develop ways of supporting recovery. It can be particularly useful when the eating disorder is affecting relationships or when family members need support understanding what is happening.
- Psychoeducation – Psychoeducation helps someone and their family understand anorexia, its physical and psychological effects, treatment and recovery. Understanding the illness can make symptoms less confusing and help people recognise why professional support is important.
- Nutritional support – Nutritional support is often an important part of eating disorder treatment. A dietitian or another appropriately trained professional can help someone work towards regular and adequate nutrition, address nutritional difficulties and support recovery alongside psychological treatment.
Helplines
Beat
Beat is a charity providing information, advice and support for people affected by eating disorders. They support people experiencing eating disorders and provide support for families, friends and carers.
England: 0808 801 0677
Scotland: 0808 801 0432
Wales: 0808 801 0433
Northern Ireland: 0808 801 0434
Opening times: 3pm–8pm, Monday–Friday
Website: http://www.beateatingdisorders.org.uk
Childline
Childline is a free service for young people to talk to a counsellor about anything. The service is available 24 hours a day, 7 days a week. Childline is available to anybody who is 18 years old or younger.
Phone: 0800 1111
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
You can also find helpful resources, speak to a counsellor online or send a message on their site.
Website: www.childline.org.uk
For adults concerned about a child, the NSPCC can be contacted
NSPCC
NSPCC is a children’s charity that works to protect children and prevent abuse and neglect. They provide support and advice for adults about child abuse, neglect, child safety, online safety and children’s mental and emotional wellbeing.
Phone: 0808 800 5000
Opening times: 10 am–4 pm, Monday–Friday
Email: help@nspcc.org.uk
YoungMinds
YoungMinds is a national charity supporting the mental health and wellbeing of children and young people. They provide information, advice and support for parents and carers who are concerned about a young person’s mental health, and help people understand mental health difficulties, find appropriate support and access useful resources. Their Parents Helpline can provide information, advice, emotional support and signposting to other services.
Parent helpline: 0808 802 5544 (9:30 am – 4 pm on Mondays, Thursdays and Fridays, and from 9:30 am – 6 pm on Tuesdays and Wednesdays)
Email: parents@youngminds.org.uk
Webchat: https://www.youngminds.org.uk/parent/parents-helpline/
Shout
Shout is a free, confidential text messaging service that provides support to anyone who is struggling to cope. It can help with a wide range of issues, including stress, anxiety, low mood, loneliness, relationship difficulties, bullying, self-harm, suicidal thoughts, feeling overwhelmed and other mental health challenges.
Text: SHOUT to 85258
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
Website: http://www.giveusashout.org
Mind
Mind is a mental health charity providing information, advice and support for people experiencing mental health difficulties. They cover a wide range of mental health and wellbeing issues, including anxiety, depression, stress, relationships, loneliness, coping with difficult experiences and managing everyday life. Mind provides information to help people understand what they are experiencing, know their rights, find appropriate support and feel less alone.
Phone: 0300 123 3393
Opening times: 9am–6pm, Monday to Friday (excluding bank holidays)
Email: info@mind.org.uk
Website: www.mind.org.uk
Samaritans
Samaritans is a charity providing emotional support to anyone who is struggling to cope or needs someone to talk to. They are there for people experiencing all sorts of difficulties, including stress, anxiety, loneliness, relationship or family problems, bereavement, feeling overwhelmed and concerns about mental health or suicide.
Phone: 116 123
Opening times: 24 hours a day, 7 days a week, 365 days a year
Website: www.samaritans.org
NHS 111 (Option 2)
NHS 111 is an NHS service providing urgent medical and mental health advice and support. It can help with mental health concerns, emotional distress, anxiety, low mood, suicidal thoughts and other urgent health problems.
Phone: For mental health support, call 111 and select the mental health option (option 2)
Opening times: Available 24 hours a day, 7 days a week
