Understanding Eating Disorders

Eating disorders can be deeply isolating — often hidden behind smiles, control, or silence. For many young women, the pressure to “be enough” in a world that equates worth with appearance can fuel a complicated relationship with food and body image. If you’ve ever felt stuck in cycles of restriction, bingeing, or guilt around eating, you’re not alone — and help is available.

When Do Eating Disorders Typically Begin?

Eating disorders frequently emerge during adolescence or early adulthood — a time when your body, identity, and social world are all shifting. Anorexia nervosa often begins in the mid-teen years whereas bulimia nervosa and binge-eating disorder tend to appear slightly later, often in late teens to early 20s. These patterns can also begin earlier in childhood or much later in adulthood

Transitions — like starting high school, university, a new job, or leaving home — often bring stress, change, and uncertainty. These can act as turning points where food, control, or body image become ways to cope.

What Causes Eating Disorders?

Eating disorders aren’t simply about food or weight — they’re about underlying emotions, experiences, and societal messages. A helpful way to understand their development is to look at:

Predisposing Factors

These are long-standing influences that increase vulnerability:

• Cultural ideals of thinness and beauty, often reinforced by social media and advertising

• Weight-related teasing or bullying, especially in childhood or adolescence

• Perfectionism and high self-expectations — often celebrated externally, but exhausting internally

• Low self-esteem and a sense of not being “good enough”

• Family dynamics, such as overemphasis on appearance, emotional invalidation, or intergenerational diet talk

“When the world tells us our value is in how we look, it’s easy to believe that controlling our bodies will bring worth.”

— Reflection from a young woman in recovery

Precipitating Factors

These are triggering life events or stressors:

• Puberty and body changes that create discomfort or distress

• Academic or social pressure

• Comments about weight, food, or appearance, even if well-meaning

• Starting a diet or “clean eating” regime that becomes rigid or obsessive

• Emotional trauma, such as abuse, neglect, or grief

Perpetuating Factors

These are patterns that maintain the eating disorder once it has started:

• Restricting food can dull emotion and feel like control — creating a false sense of safety

• Bingeing can temporarily numb or soothe, especially when emotions feel overwhelming

• Shame and secrecy reinforce isolation and prevent seeking help

• Social comparison, particularly through filtered and curated images, can worsen body dissatisfaction

Common Types of Eating Disorders

Eating disorders don’t always look the same, and they don’t always fit neatly into categories. Below are some of the most commonly recognised types:

Anorexia Nervosa

Characterised by ongoing restriction of food intake, an intense fear of gaining weight, and a distorted perception of one’s body size or shape. This often leads to significant weight loss and health complications.

Bulimia Nervosa

Involves repeated cycles of binge eating (eating large amounts of food with a sense of loss of control), followed by compensatory behaviours such as vomiting, excessive exercise, or fasting.

Binge Eating Disorder

Marked by recurrent episodes of binge eating without the purging or compensatory behaviours seen in bulimia. Often accompanied by intense shame, distress, and loss of control.

ARFID (Avoidant/Restrictive Food Intake Disorder)

Involves limited or restrictive eating patterns due to factors like sensory sensitivities, fear of choking or vomiting, or lack of interest in food—not motivated by concerns about weight or shape.

If your relationship with food, eating, or your body causes distress or affects your wellbeing, it’s worth paying attention — even if it doesn’t fit neatly into a diagnosis.

What Helps? Evidence-Based Treatment Options

Recovery is possible, and the earlier you reach out, the better. Support often includes:

1. Psychological Therapy

• CBT-E (Enhanced Cognitive Behavioural Therapy) helps change unhelpful thoughts and behaviours related to food and body image

• Family-Based Therapy (FBT) involves parents and is especially effective for adolescents

• DBT (Dialectical Behaviour Therapy) supports emotion regulation, often helpful in bulimia or binge-eating

2. Nutritional Support

A dietitian or nutritionist can help normalise eating patterns and rebuild trust with food.

3. Medical Monitoring

Eating disorders can affect heart health, bone density, menstrual cycles, and more — medical oversight ensures safety during recovery.

4. Relational and Trauma-Informed Work

Understanding your story — your emotional world, your sense of self, your history — can be a vital part of healing.

If You’re Struggling

It’s not your fault. You didn’t choose to develop an eating disorder, and you don’t have to face it alone.

You are allowed to:

• Ask for help, even if others don’t know you’re struggling

• Take up space — physically and emotionally

• Heal at your own pace, with compassion and care

Whether you’re feeling out of control with food, caught in perfectionistic pressure, or just unsure if things are “bad enough” to need help — your pain is real, and you matter.

References & Further Reading

Stice, E., & Shaw, H. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings. Journal of Psychosomatic Research, 53(5), 985–993.

Levine, M. P., & Smolak, L. (2018). The Prevention of Eating Problems and Eating Disorders: Theory, Research, and Practice. Routledge.

Fairburn, C. G. (2008). Cognitive Behavior Therapy and Eating Disorders. Guilford Press.

National Eating Disorders Association (NEDA). (2024). www.nationaleatingdisorders.org

Treasure, J., Smith, G., & Crane, A. (2020). Skills-based Caring for a Loved One with an Eating Disorder. Routledge.