Tips for feeding or eating disorders in adults

Tip Sheet 2 - What to look out for

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 second 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.

There are markers for FEDs across mind-body-behaviour-relationship domains so look out for them all. Do not make the mistake of only looking in one domain.

This tip sheet aims to help you spot signs and symptoms and look out for problems early.




Purging involves getting rid of food/fluids, for example, by intentionally vomiting or by misusing laxatives or diuretics. Purging is often used to try and eliminate calories and manage weight but can also be used to try and manage difficult emotions or in response to stress. People with type 1 diabetes may purge by misusing or not taking their insulin.

Binge eating:

A binge is where people eat an objectively large amount of food and feel unable to stop or control what they are eating. Binges can occur even when not hungry and to the point of being uncomfortable. Binge eating is a core feature of bulimia nervosa (BN) and binge eating disorder (BED) but can also occur in anorexia nervosa (AN) and some types of other specified feeding or eating disorder (OSFED).

 ‘Subjective binges’ are when someone feels out of control of their eating and eats more than they want to but doesn’t eat an unusually large amount of food.


Compulsion to do excessive exercise in order to lose or control weight. People who struggle with over-exercising may exercise even if sick or injured, or at the expense of time with family or friends. When this is associated with an unhealthy obsession about building up muscle it may represent ‘muscle dysmorphia’, which is more common in men than women. It is currently grouped under obsessive compulsive disorder, but many believe it has a lot in common with FEDs. 

Eating disorders have one of the highest mortality rates amongst all mental health disorders

Who gets feeding or eating disorders (FEDs)?

The mind domain: psychological features of feeding or eating disorders (FEDs) to be alert to

GPs beware: many people with FEDs will first seek help from general practitioners and general physical health care services

Anorexia nervosa (AN): what to look for

Bulimia nervosa (BN): what to look for

Binge eating disorder (BED): what to look for

Table of some distinguishing features of anorexia nervosa, bulimia nervosa and binge eating disorder

Avoidant restrictive food intake disorder (ARFID): what to look for

Other feeding or eating disorders (OSFED): what to look for

Eating difficulties not due to eating disorders

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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