Eating disorders
Serious conditions in which eating, weight and body shape become central to self-worth and are controlled or lost control of in ways that harm health. They include restriction, binge eating and compensatory behaviours, and they have among the highest mortality of any psychiatric condition.
What drives it
Control of food and body manages emotions and a sense of worth that feel otherwise uncontrollable: restriction can feel like strength and safety, binge eating can numb or soothe, and the rules give structure to a chaotic inner life.
How it shows
Work
Skipping shared meals, eating alone or at odd times, rigid food routines, excessive exercise around the working day, visible fatigue, feeling cold, poor concentration. Often a high achiever and perfectionist who appears very controlled. Can be any body size; many people with serious eating disorders do not look underweight.
Relationships
Secrecy around food, disappearing after meals, food going missing, preoccupation with cooking for others while not eating, mood changes around meals, withdrawal from social events involving food, defensiveness when eating is mentioned.
Self
Your mood for the day depends on what you ate or how your body looks. Food rules feel non-negotiable and breaking them brings intense guilt. You hide behaviour from people close to you.
What tells it apart
Body dysmorphic disorder: In body dysmorphic disorder the preoccupation is with a specific perceived flaw (nose, skin, hair) and behaviour is checking and concealing; in eating disorders the focus is weight and shape and behaviour centres on eating and compensation.
Perfectionism: Perfectionism alone shows in work and standards; an eating disorder adds secrecy and changes around food, physical effects and a self-worth tied to weight and shape.
Major depression: Depression can change appetite but food carries no moral meaning and there are no rules or compensations; in eating disorders food and body are central to the person's sense of worth.
A test
Watch for secrecy around food, rigid rules, compensation after eating, and mood tied to body or food over weeks, raise it privately and without comment on appearance, and encourage prompt assessment by a GP and an eating disorder service, because early treatment matters and medical risk can be high at any weight.
How strong the research is
strong
Where it comes from
Anorexia described by William Gull and Charles Lasègue, 1873; bulimia nervosa by Gerald Russell, 1979; binge eating disorder in DSM-5, 2013; transdiagnostic model by Christopher Fairburn, 2003