Eating disorders can be complex and can be difficult to fit into distinct categories. If you have some but not all of the diagnostic symptoms of an eating disorder or combine behavioural characteristics of different eating disorders, you may be described as having an Eating Disorder Not Otherwise Specified - EDNOS. This does not make your condition any less serious and you should still seek to receive help and support.

At SYEDA, we do not "label" you into a particular eating disorder, at assessment we ask questions around how things are for you at the moment, what your eating habits are like and how our services may be of help to you.

Anorexia Nervosa

Sufferers of anorexia stop allowing themselves to satisfy their hunger. You are likely to be restricting how much you eat and drink, controlling the types of food you eat and may exercise in order to burn off what you perceive as excessive calories. A combination of these behaviours will result in weight loss and chemical changes in the body that affect your mood and your ability to make rational decisions about food.

How you might behave

  • Restrict your intake of food and drink.
  • Use of exercise or purging to get rid of what you perceive as excessive calories.
  • Repetitive or obsessive behaviour around food such as cutting food up into small pieces, eating at specific and exact times of day and/or using small plates and cutlery for eating.
  • Restrict your dietary range to foods that you perceived as ’safe’. ‘Safe foods’ will vary from one person to the next. Sufferers of Anorexia often reduce their intake of carbohydrate and fat restricting their diet to mainly fruit and vegetables.
  • Restlessness and hyperactivity.
  • Avoid eating food that you have not prepared yourself and avoid eating in company. This may start to have an affect on your social life and relationships.
  • Become defensive and angry when people talk about food, exercise and weight.
  • Deny you have a problem even when those around you express concern.
  • Obsessive checking of the calorie and/or fat content of food.
  • Find excuses to skip meals.

What you might feel

  • Intense fear of gaining weight.
  • Irritable and anxious, especially around food.
  • Increased or obsessive interest in diet and nutrition.
  • Distracted by thoughts of food and eating.
  • Fat or overweight despite being told the contrary by those around you.
  • Low self-esteem.

How you might be affected physically

  • Weight loss.
  • Constipation and abdominal pains.
  • Dizziness and feeling faint.
  • Bloated stomach, puffy face and ankles.
  • Growth of downy hair on the body.
  • Feeling cold.
  • Discomfort while sitting or lying down.
  • Dry, rough, or discoloured skin.
  • Disrupted menstrual cycle in women.
  • Loss of libido.
  • Reduction in bone mass possibly leading to osteoporosis.

Effects on your mood

The relationship between what you eat and your mood is complex. It is likely that you have developed anorexia as a way of coping with or controlling difficult thoughts and feelings. As time goes by, the eating disorder will start to take control. The chemical changes caused by reduced food intake will start to affect your emotions, distort your thinking and make it more difficult for you to make rational decisions. It is this complex relationship that make anorexia so difficult to recover from; you need to understand and work to overcome the underlying emotional issues in order to improve your eating while, at the same time, needing to improve your eating in order to be in a mental state to confront the underlying problem. It is a daunting task but with the help and support of professionals and loved ones a balance in tasks can be achieved.

Long-term physical effects

Anorexia can, unfortunately, have long-term affects on your physical health. The most common are infertility and osteoporosis. If caught early on in their development, these affects can be reversed with improvements to diet and a gradual increase of food intake.

What can you expect during recovery?

How you might feel

Recovering from Anorexia is a long and difficult journey but it is worth it. While you are recovering you may feel more tired despite eating more and exercising less. You may also experience more extreme mood swings and feel more irritable. This is because recovery is emotionally exhausting. You will be constantly fighting anorexic thoughts and feelings, battling to hear the rational voice that knows recovery is the best option. The rational voice will not always win; you will have good days and bad days. This is ok. The important thing is that you keep reflecting on your behaviour, thoughts and feelings. Keep asking yourself why you acted the way you did and what you were thinking and feeling at the time. This knowledge will not only help you to get better, it will also help you to stay better and to cope with difficult situations in the future without using your anorexia.

Physical changes

When you restrict your food intake your metabolism reduces to match the amount of calories you consume; your body slows down to conserve energy. This is why you feel cold. When you begin on the road to recovery and increase the amount of food you are eating your metabolism will also increase. It can however take a while for your metabolism to respond to your increased food intake. You need to eat regularly for weeks or even months before your body trusts that it is going to get enough food to sustain the energy you are using to live. Because of this delay in response you may find that you initially put on weight relatively fast. You may become bloated and experience an increase in appetite. These experiences can be alarming and frightening. Try to trust that the weight gain and increase in appetite will settle down as your body adjusts. You will not put on weight infinitely. In time you will settle at your natural weight; a weight that allows your body to function affectively and allows you to do the things you want to do without feeling exhausted. 

Bulimia Nervosa

Bulimia is characterised by cycles of binging and purging. You may find yourself eating large quantities of food in a short space of time, often in an attempt to ’swallow down’ unwanted emotions or satisfy a need that cannot be met by food alone. After binge-eating you may feel an uncontrollable urge to compensate for the food consumed by vomiting, using laxatives, exercising or reducing food intake.

How you might behave

  • Uncontrolled binges on large quantities of food in a short space of time.
  • Vomiting after meals.
  • Using laxatives, diuretics or enemas to get rid of food consumed during a binge.
  • Periodically fasting.
  • Exercising to compensate for food consumed during a binge.
  • Being secretive about what and how much you are eating.
  • Hoarding food.
  • Reluctance to socialise, especially when the event involves food.
  • Eating irregularly.

What you might feel

  • Out of control and anxious around food.
  • Distracted by thoughts of food and eating.
  • Feelings of guilt and shame, especially after binging.
  • Feelings of helplessness and isolation.
  • Reduced self-esteem and confidence.
  • Emotionally relieved following purging, restrictive eating or exercise.

How you might be affected physically

  • Frequent weight fluctuations.
  • Sore throat and swollen salivary glands.
  • Tooth decay and bad breath.
  • Disrupted menstrual cycle in women.
  • Loss of libido.
  • Poor skin condition.
  • Reduced energy and feeling of lethargy.
  • Frequent headaches.

Effects on your mood

A binge may be used initially to help you to deal with difficult emotions such as loneliness or anxiety or to ease tension caused by pressure or stress. It may help for a short while, but as you begin to feel full you are likely to experience feelings of guilt or shame. It is likely to be these feelings that lead to an uncontrollable urge to get rid of the food you have consumed by vomiting or using laxatives or to compensate by restricting your food intake or exercising. The action of compensating for the food consumed during a binge may bring you temporary relief but this is unlikely to last. Before long, the feelings that caused the binge in the first place will return and cycle will start again.

Bulimic cycles and the emotions associated with them will vary from person to person. You may suffer from bulimic episodes monthly, weekly or several times a day. You may feel that it is not having a great affect on your life or you may feel fearful of your bulimic cycles and be desperate to stop them. However you feel, bulimia is likely to be having a negative affect on your emotional wellbeing. Discussing you concerns and behaviour with a loved one or professional may be hard at first but it will help you to untangle and escape the cycle.

Long-term physical effects

Bulimia can lead to an imbalance or low level of essential minerals that will have a significant affect on the working of vital organs. Repeated vomiting is likely to cause tooth decay and may lead to pain when swallowing, the drying up of salivary glands and rapture of the stomach. Excessive laxative use can cause serious and long-term bowel problems. In the majority of cases, the physical affects of bulimia can be reduced or reversed once the body is receiving the vitamins and minerals it needs regularly and in moderation.

What can you expect during recovery

How you might feel

Admitting that you have a problem and seeking help can be frightening. You may feel ashamed and confused by your behaviour. Sufferers who have broken through these barriers often report feelings of relief to have everything out in the open. Dealing with Bulimia on your own is far more terrifying than dealing with it with the support and help of loved ones and professionals.

Talking about your behaviour and the emotions related to it will help you to unravel and break the bulimic cycle. The urge to binge and purge will not disappear straight away; you will have good days and bad days. But every time you resist the urge you will learn a little bit more about yourself and the ways in which you might cope with life without bulimia.

Physical changes

With regular and balanced meals you will see a decline in the physical symptoms of bulimia such as headaches, poor skin and feelings of lethargy. It will take your body a while to get used to eating regularly and you may find that weight fluctuates until your metabolism settles and your body learns to expect food in certain quantities at certain times.

It can be difficult to know how much to eat and when to eat at first. A profession eating disorders specialist, dietician or you GP can help you with this. Once you have an outline diet, try to stick to it and be patient in waiting for your weight to settle and the physical symptoms of bulimia to subside.  

 

Binge Eating Disorder

Binge Eating Disorder is characterised by periods of uncontrolled, impulsive or continuous eating that pushes you beyond the point of feeling uncomfortably full. Like Bulimia, binges are likely to result from a desire to ’swallow down’ unwanted emotions or to satisfy a need that cannot be met by food alone. Unlike Bulimia, if you are suffering from Binge Eating Disorder you will not purge after a binge although periods of binge eating may be interrupted by sporadic fasts or dieting.

How you might behave

  • Uncontrolled, impulsive or continuous eating until you are uncomfortably full.
  • Eating when you are not hungry.
  • Eating rapidly.
  • Periodically fasting or dieting.
  • Being secretive about what and how much you are eating, eating alone.
  • Hoarding food.
  • Eating irregularly.

What you might feel

  • Out of control and anxious around food.
  • Distracted by thoughts of food and eating.
  • Feelings of guilt and shame, especially after binging.
  • Feelings of helplessness and isolation.
  • Reduced self-esteem and confidence.
  • Self conscious when eating with others.

How you might be affected physically

  • Increase in weight.
  • Poor skin condition.
  • Reduced energy and feeling of lethargy.
  • Problems with blood pressure, heart disease and lack of fitness.

Effects on your mood

A binge may be used initially to help you to deal with difficult emotions such as loneliness or anxiety or to ease tension caused by pressure or stress. It may help for a short while, but as you begin to feel full you are likely to experience feelings of guilt or shame. These feelings will add to the anxiety and distress that caused the binge pushing you into a vicious cycle. Discussing your concerns and behaviour with a loved one or professional may be hard at first but it will help you to untangle and escape this cycle.

Long-term physical effects

Many people with Binge Eating Disorder will become over weight or obese. This can lead to problems with blood pressure and can cause heart disease and diabetes. In the majority of cases, the physical symptoms of binge eating disorder can be reduced or reversed once you are eating a healthy, balanced diet and taking regular exercise.

What can you expect during recovery

How you might feel

Admitting that you have a problem and seeking help can be frightening. You may feel ashamed and confused by your behaviour. Sufferers who have broken through these barriers often report feeling of relief to have everything out in the open. Dealing with Binge Eating Disorder on your own is far more terrifying than dealing with it with the support and help of loved ones and professionals.

Talking about your behaviour and the emotions related to it will help you to unravel and break the cycle of binge eating and emotional turmoil. The urge to binge will not disappear straight away; you will have good days and bad days. But every time you resist the urge you will learn a little bit more about yourself and the ways in which you might cope with life without your eating disorder.

Some suffers of Binge Eating Disorder have reported feeling more exposed and anxious as they lose weight and the emotional protection that the eating disorder provided. You may find that your mood is more erratic without the option of binging to help you to control your emotions. These feelings will pass over time as you develop your self-esteem and confidence and discover alternative ways of dealing with stressful situations and difficult emotions.

Physical changes

With regular and balanced meals you will see a decline in the physical symptoms of binge eating disorder such as poor skin and feelings of lethargy. It will take your body a while to get used to eating regularly and you may find that weight fluctuates until your metabolism settles and your body learns to expect food in certain quantities at certain times.

It can be difficult to know how much to eat and when to eat at first. A professional eating disorders specialist, dietician or you GP can help you with this. Once you have an outline diet, try to stick to it and be patient in waiting for your weight to settle and the physical symptoms of binge eating disorder to subside.

 

Compulsive Overeating

Sufferers of Compulsive Overeating will eat at times when they are not hungry. The behaviour may occur regularly or it may come in cycles. If you are suffering from Compulsive Overeating you are likely to be overweight and may use this weight and you eating disorder to protect yourself from emotional distress or as an excuse to avoid social situations. You may hide behind a happy, jolly façade that enables you to avoid confronting your problems.

How you might behave

  • Uncontrolled or continuous eating until you are uncomfortably full.
  • Eating when you are not hungry.
  • Being secretive about what and how much you are eating, eating alone.
  • Hoarding food.
  • Hiding your emotions behind a jolly facade.
  • Avoiding social interaction.

What you might feel

  • Out of control and anxious around food.
  • Distracted by thoughts of food and eating.
  • Feelings of guilt and shame.
  • Feelings of helplessness and isolation.
  • Low self-esteem and confidence.

How you might be affected physically

  • Increase in weight.
  • Poor skin condition.
  • Reduced energy and feelings of lethargy.
  • Problems with blood pressure, heart disease and lack of fitness.

Effects on your mood

Eating may be used initially to help you to deal with difficult emotions such as loneliness or anxiety or to ease tension caused by pressure or stress. It may help for a short while, but gradually, feelings of guilt and shame are likely to creep in. These feelings will add to the anxiety and distress that causes you to eat compulsively pushing you into a vicious cycle.

Some sufferers of Compulsive Overeating have described using their weight and appearance to hide how they are really feeling or to protect them from emotional pain caused by specific situation or stresses. Appearance may be use as an excuse to avoid social situations that make you feel uncomfortable or anxious.

You may be confused by yours feelings around food and body image. Discussing your concerns and behaviours with a loved one or professional may be hard at first but it will help you to untangle your relationship with food and gradually build your self-esteem and confidence to live without your eating disorder.

Long- term physical effects

Many people suffering from Compulsive overeating will become over weight or obese. This can lead to problems with blood pressure and can cause heart disease and diabetes. In the majority of cases, the physical symptoms of compulsive overeating can be reduced or reversed once you are eating a healthy, balanced diet and are taking regular exercise.

What can you expect during recovery

How you might feel

Admitting that you have a problem and seeking help can be frightening. You may feel ashamed and confused by your behaviour. Sufferers who have broken through these barriers often report feelings of relief to have everything out in the open. Stopping compulsive overeating on your own is far more terrifying than dealing with it with the support and help of loved ones and professionals.

Talking about your behaviour and the emotions related to it will help you to unravel your emotional relationship with food. The urge to eat will not disappear straight away; you will have good days and bad days. But every time you resist the urge you will learn a little bit more about yourself and the ways in which you might cope with life without your eating disorder.

Some suffers of Compulsive overeating have reported feeling more exposed and anxious as they loose weight and the emotional protection that the eating disorder provided. You may find that your mood is more erratic without the option of eating to control your emotions. These feelings will pass over time as you develop your self-esteem and confidence and discover alternative ways of dealing with stressful situations and difficult emotions.

Physical changes

With regular and balanced meals you will see a decline in the physical symptoms of compulsive overeating such as poor skin and feelings of lethargy. You may lose weight rapidly at first. This will settle as your metabolism reduces to match what you are eating. Weight loss will then become more gradual.

It can be difficult to know how much to eat and when to eat at first. A Dietician or your GP can help you with this. Once you have an outline diet, try to stick to it and be patient in waiting for the symptoms of your eating disorder to subside.

 

Exercise Dependence

We are regularly told that exercise is essential to good health and wellbeing. If exercise started off as a positive part of your lifestyle that has now developed into an addiction or obsession you may be described as suffering from Exercise Dependence. Exercise will not only be something that you enjoy and do to improve your fitness but will be your way of coping with and avoiding difficult emotions such as low self-esteem, anxiety and stress.

How you might behave

  • Exercise regardless of injury and illness.
  • Exercise without a specific fitness or sports related goal.
  • Prioritise exercise over your social life, work or study commitments.
  • Alter your diet to allow you to exercise for longer or to help you to recover more rapidly (this may include the use of supplements and dangerous or illegal substances).
  • Obsessively monitor your progress.

What you might feel

  • Feelings of anger, anxiety or depression if you are unable to complete your exercise regime.
  • Panic and anxiety at the thought of taking a rest day.
  • Exercise is the only way you can relax and cope with daily life.
  • Distracted by thoughts of exercise and fitness.
  • Irritable and restless.
  • Poor levels of concentration.
  • Helpless and lonely.

How you might be affected physically

  • Frequent injury and periods of illness.
  • Disruption of sleep pattern.
  • Exhaustion.
  • Changes in hormone levels (specifically in men).
  • Stiffness and aching limbs.

Effects on your mood

You may find that during exercise your worries and problems seem to disappear, providing a break from the stresses of daily life or from a specific emotional or traumatic event that is occupying your mind. Using exercise to this end is fine to an extent. It becomes a problem if you become dependent on it as your only source of relaxation and if it starts to impact negatively on you social life, work and study.

You may find that you start to get anxious and panicked if you are unable to complete your exercise regime at a specific time and place. Being unable to do exercise may make you feel less in control of your life or like you cannot cope with the day ahead. The more you support these feelings by continuing with a rigid exercise regime, the more engrained the feelings will become. The need to exercise to deal with yours emotions will increase.

Long- term physical effects

Exercising continuously regardless of injury, illness and exhaustion and without rest days can cause long-term injury. You will be at increased risk of stress fractures and osteoporosis.

What can you expect during recovery

How you might feel

The thought of taking rest days is likely to be a great source of anxiety. Try to introduce them gradually and remind yourself that they are part and parcel of a productive exercise regime (see physical changes). Discussing your worries with a loved one or professional will help you to overcome your anxieties. Together you will be able to find alternative ways of coping with the emotions and stresses that have caused you to become dependent on exercise.

Physical changes

Reducing the amount of exercising you do and taking regular rest days will give your body the chance to recover and your muscles chance to repair damage caused by exercise. Muscles do not develop while you are exercising; they develop when you are resting with the help of a balanced and nutritious diet. Taking rest days will therefore allow you to work harder and perform better during exercise and will reduce your risk of developing illness or injury. You will not put on weight or become unfit as you might fear. 

 

Muscle Dysmorphia

Muscle dysmorphia usually arises as a result of feeling vulnerable, having low self-esteem or from an intense dissatisfaction with body image, and more specifically with muscle size. You may view yourself as small and weak despite being told otherwise by those around you. In order to increase strength and muscle size you will be driven to a rigorous exercise regime and strict diet.

How you might behave

  • Exercise regardless of injury and illness.
  • Focus on a high protein diet, sometimes at the expense of variety and nutrition.
  • Increased spending on exercise and food supplements.
  • Prioritise exercise over your social life, work or study commitments.
  • Use supplement and steroids to improve performance and increase muscle mass.
  • Wear bulky clothes or multiple layers, even on warm days.
  • Obsessively monitoring your progress.
  • Reluctance expends energy that could be used to benefit your exercise regime.
  • Withdrawn and uncommunicative.

What you might feel

  • Feelings of anger, anxiety or depression if you are unable to complete your exercise regime.
  • Pre-occupied with thoughts of body image and exercise.
  • Feelings of depression and envy when comparing your body to others.
  • Panic and anxiety at the thought of taking a rest day.
  • Exercise is the only way you can relax and cope with daily life.
  • Distracted by thoughts of exercise and fitness.
  • Irritable and restless.
  • Poor levels of concentration.
  • Vulnerable and lonely.

How you might be affected physically

  • Increased muscle mass.
  • Development of disproportionately large neck and shoulders.
  • High blood pressure.
  • Frequent injury and periods of illness.
  • Disruption of sleep pattern.
  • Exhaustion.
  • Changes in hormone levels (specifically in men).
  • Stiffness and aching limbs.
  • Low body temperature.

Effects on your mood

You may have turned to exercise and, more specifically body building, as a way to combat feelings of vulnerability and low self-esteem. These feelings can make you feel weak and uncertain of your ability to cope with life’s challenges. Increasing physical strength may help to reduce these feeling in the short-term but is unlikely to eliminate low self-esteem and vulnerability all together. Continuation of these feeling despite your vigorous work out is likely to make you feel inadequate and even more vulnerable. Not only are you likely to feel emotionally weak and uncertain but you may now also feel physically weak and inadequate. In response you may increase your exercise regime further putting your body under more and more strain.

Entering this cycle, emotions that have arisen from specific events and those related with low self-esteem can become confused with feelings related to body image and exercise. The only way to untangle these feelings is to discuss them, find the real cause of your feelings and work to develop your inner confidence and self-esteem.

Long- term physical effects

Exercising continuously regardless of injury, illness and exhaustion and without rest days can cause long-term injury. You will be at increased risk of stress fractures and osteoporosis. Other physical symptoms, such as high blood pressure and hormonal changes can be reversed by reducing exercise levels.

What can you expect during recovery

How you might feel

The thought of taking rest days and reducing the length of workouts is likely to be a great source of anxiety. Try to make these changes gradually with the help of a friend or trusted gym instructor. Remind yourself that rest days are part and parcel of a productive exercise regime (see physical changes). Discussing your worries with a loved one or professional will help you to overcome your anxieties. Together you will be able to find alternative ways of coping with the emotions and stresses that have caused you to rely so heavily on a strenuous exercise regime.

Physical changes

Reducing the amount of exercising you do and taking regular rest days will give your body the chance to recover and your muscles chance to repair damage caused by exercise. Muscles do not develop while you are exercising, they develop when you are resting, with the help of a balanced and nutritious diet. Taking rest days will therefore allow you to work harder and perform better during exercise and will reduce your risk of developing illness or injury. Exercising less and taking rest days will not cause a rapid reduction in muscle mass or fitness as you might fear.  

 

Eating Disorders Not Otherwise Specified

Eating disorders are complex illnesses that can be difficult to fit into distinct categories.
 
If you have some, but not all of the diagnostic symptoms of an eating disorder or combine behavioural characteristics of different eating disorders you may be described as having an A-typical eating disorder or an EDNOS.
 
This does not make your condition any less serious and should still seek and receive help and support.