Tips for feeding or eating disorders in adults

Tip Sheet 1 - What to be aware of

Who is this for?

These tips have been developed for professionals working across health care; from primary care to hospital general services through to mental health teams and specialist adult eating disorder services.



This is the first of four tip sheets to provide you with condensed learning on feeding or eating disorders (FEDs) in adults aged 18 years and over. Tips for working with FEDs in children and young people up to age 18 are available separately here.

FEDs are complex and potentially life-threatening mental health disorders that can affect anyone regardless of age, gender, ethnicity, sex, socioeconomic group or background.  There are many myths and misconceptions surrounding FEDs combined with a lack of knowledge. This can produce negative outcomes such as preventing someone from reaching out for help.

This first set of tips is divided into four sections (A-D), and aims to support you in raising your awareness of FEDs and promoting earlier recognition.

Section A: Be aware

Section B: Know the diagnostic categories

Section C: Be aware of what works in treatment

Section D: Understanding the origins of feeding and eating disorders

Section A - Be aware

Stigma and blame are impediments to early detection and good care

Don't be afraid of starting the conversation about people's relationships with food

Be alert, FEDs are easily missed: early intervention leads to better outcomes

Remember that feeding or eating disorders (FEDs) are mind-body conditions, care must be holistic to be effective

Feeding or eating disorders affect all ages, sex, gender, race and ethnic groups

Earlier intervention matters: detect and refer early

Aim to work with the family / carers

Positive outcomes can be expected with treatment

Be aware that people with feeding or eating disorders (FEDs) may lack insight into their condition or be unwilling to talk about their difficulties

There are many effects of starvation

Good quality psychoeducation is important

Section B - Know the diagnostic categories

There are seven specified types of feeding or eating disorders (ICD-11 and DSM-5): be familiar with them so you don’t miss them

One important distinction between different FEDs is whether body image distortion/dissatisfaction is directly linked to the eating disturbance

Section C - Be aware of what works in treatment

Our “What to do” tip sheet provides much more detail on interventions

Increase food intake to establish steady gradual weight gain: address starvation as the best first step for anorexia nervosa:

Bulimia nervosa also has severe physical consequences: regular eating breaks the cycle of bingeing and starving.

Binge eating disorder, avoidant restrictive food intake disorder, regurgitation disorder and pica can also have severe physical consequences. Just different ones.

The best treatment for avoidant restrictive food intake disorder will depend on the specific issues underlying the eating disturbance in the individual; usually a form of cognitive behavioural treatment (CBT) is used.

Weight matters for health, but is a poor measure of health on its own, and differs between people

The illness drives the thinking, it’s not a simple ‘choice’ for the person

What do people with FED say they want from professionals?

What do carers, relatives and friends of people with FED say they want from professionals ?

Section D - Understand the origins of feeding & eating disorders (FEDS)

Key factors

Risk factors

Further Information




Further elearning from NHS HEE & MindEd

All ages - NHS HEE TEL Resources


These tips have been curated, drawn and adapted from a range of existing learning, including MindEd, NHS England, NICE, MEEDs guidance, NHS HEE elfh/BEAT/RCPsych resources. Extracts from the MEEDs are included with permission courtesy of the MEEDs team.  

The content has been edited by Dr Karina Allen (MindEd adult eating disorder Editor) and Dr Raphael Kelvin ( NHS England MindEd Consortium Clinical Educator Lead) with close support of the inner expert group of Dr Nikola Kern, Dr Paul Robinson, Dr William Rhys Jones, and Prof Ulrike Schmidt.

We also acknowledge the support and input of our wider expert stakeholder group including BEAT, the MindEd Consortium, and NHS England/Health Education England.


This document provides general information and discussions about health and related subjects. The information and other content provided in this document, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment.

If you or any other person has a medical concern, you should consult with your healthcare provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that you have read in this document or in any linked materials. If you think you may have an emergency, call an appropriate source of help and support such as your doctor or emergency services immediately.

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