Here are some common signs and symptoms of a possible eating disorder. If you experience any of these, you may benefit from speaking to a qualified mental health professional about your experience.

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• Preoccupation with eating, food, body shape and weight

• Inflexibility around exercise routines, which are prioritised above health, relationships and other important life areas

• Repeated food restriction

• Constant thinking about food and future meals

• Continual and unrelenting calorie counting 

• Feeling anxious around meal times

• Feeling “out of control” around food

• Rigid thoughts about food being “good” or “bad”

• Regularly using food as a source of comfort

• Using food/restriction as self-punishment

• Repeated dieting behaviour

• Eating in private or avoiding meals with others

• Binge eating (eating large amounts of food in a small space of time)

• Rapid weight loss or frequent changes in weight

• Ceased menstrual cycle 

• Fainting or dizziness

• Always feeling tired or difficulty sleeping

• Feeling cold most of the time, even in warm weather

At Drummoyne Psychology, our psychologists work from both Enhanced Cognitive Behavioural Therapy (CBT-E) and Schema Therapy approaches in the treatment of eating disorders. CBT-E is highly effective in addressing the current symptoms and maintaining factors of eating disorders, while Schema Therapy helps identify and change the deeper underlying beliefs, emotional patterns, and coping styles that often contribute to the development and persistence of eating difficulties.

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We understand that every person’s experience with an eating disorder is unique. Treatment therefore begins with a thorough assessment to develop a comprehensive understanding of the individual’s symptoms, history, emotional wellbeing, relationships, coping patterns, and any contributing factors. From this, we create an individualised treatment plan tailored to the person’s specific needs, goals, and stage of recovery.

 

Our approach emphasises compassionate, collaborative, and personalised care. We work closely with individuals (and families if appropriate) to help them develop a healthier relationship with food, body image, emotions, and themselves, while also supporting broader wellbeing, functioning, and quality of life.

 

Where appropriate, we also collaborate with other treating professionals as part of a multidisciplinary team to ensure coordinated and holistic care.

There are several different types of eating disorders, and each has its own characteristics and patterns. Some people experience a clearly defined eating disorder such as anorexia nervosa, bulimia nervosa or binge eating disorder, while others may experience symptoms that fall within diagnoses such as Avoidant/Restrictive Food Intake Disorder (ARFID) or Other Specified Feeding or Eating Disorder (OSFED).

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Importantly, eating disorders do not always look the way people expect. A person does not need to be underweight to have an eating disorder, and eating disorders cannot be identified by appearance alone. Someone may have a significant eating disorder while maintaining a weight that appears to be within the expected range.

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Here, we provide an overview of the different types of eating disorders, including their common features, how they may affect a person's life and treatment options. Understanding the differences between eating disorders can be helpful in recognising when professional support may be needed.

What is Bulimia Nervosa?

Bulimia nervosa is characterised by recurrent cycles of binge eating followed by compensatory behaviours aimed at preventing weight gain. These may include self-induced vomiting, laxative misuse, fasting, or excessive exercise. During a binge episode, a person may feel out of control and consume large amounts of food in a short period. Afterwards, they often experience shame, guilt, or fear, which drives the compensatory behaviour. Bulimia nervosa involves persistent concern with body shape and weight, and is maintained by a cycle of dietary restriction, loss of control during eating, and subsequent purging. Bulimia nervosa is a complex mental health condition, not a lack of discipline and it is often linked to emotional distress, body image concerns, trauma histories, and difficulties with regulating feelings.

 

Common signs and symptoms

• Recurrent binge-purge cycles (typically ≥1 per week)

• Secretive eating and compensatory behaviour following meals

• Preoccupation with food, calories, and body image

• Rigid dietary rules and frequent dieting attempts

• Physical signs: dental erosion, calluses on knuckles, parotid gland enlargement

• Electrolyte imbalances (fatigue, dizziness, cardiac arrhythmias)

• Mood disturbance, anxiety, or perfectionism

• Social withdrawal and shame

 

Impact on daily life

Bulimia nervosa can significantly affect emotional wellbeing, relationships, and daily functioning. Many people describe feeling trapped in a cycle of bingeing and purging that interferes with concentration, social activities, and self‑esteem. Physical consequences may include fatigue, electrolyte imbalances, digestive issues, and dental erosion. The secrecy and distress surrounding symptoms often intensify isolation and anxiety.

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Evidence-based treatment

Enhanced Cognitive Behavioural Therapy (CBT-E) is the leading evidence‑based approach, helping clients establish regular eating patterns, reduce compensatory behaviours, and challenge unhelpful beliefs about food and body image.

Dialectical Behaviour Therapy (DBT) is effective for those with significant emotional dysregulation.

What is Anorexia Nervosa?

Anorexia nervosa is characterised by severe dietary restriction leading to significantly low body weight, intense fear of weight gain, and disturbance in the way one's body weight or shape is experienced. The disorder involves a fundamental disconnect between objective body status and subjective body image, with individuals often perceiving themselves as overweight despite being significantly underweight. It has the highest mortality rate of any psychiatric disorder. The condition is not a lifestyle choice, it is a complex mental health disorder influenced by biological, psychological, and social factors, including perfectionism, anxiety, trauma histories, and difficulties with emotional regulation.

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Common signs and symptoms

• Severe caloric restriction and rigid dietary rules

• Significant weight loss and low Body Mass Index (BMI)

• Intense fear of weight gain despite low weight

• Distorted body image and denial of illness severity

• Excessive exercise or ritualistic behaviours

• Social withdrawal and preoccupation with food/calories

• Physical symptoms such as fatigue, dizziness, cold intolerance, hair loss, or digestive issues

• Perfectionism, rigidity, and obsessive thinking patterns

• Comorbid depression, anxiety, or obsessive-compulsive features

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Impact on daily life

Anorexia nervosa can affect concentration, mood, relationships, and overall functioning. Many people describe feeling consumed by thoughts about food and weight, making it difficult to engage fully in work, study, or social activities. The physical consequences can be severe, impacting heart health, hormones, bone density, and cognitive clarity. Emotionally, individuals may experience anxiety, irritability, shame, or a sense of isolation.

 

Evidence-based treatment

Treatment focuses on restoring physical health and addressing the psychological factors that maintain the disorder. Evidence‑based approaches include Cognitive Behavioural Therapy for Eating Disorders (CBT‑E) for adults and Family‑Based Treatment (FBT) for adolescents. Treatment often involves nutritional rehabilitation, medical monitoring, and building flexible thinking around food, body image, and identity. Specialist inpatient care may be necessary for medical instability or severe malnutrition. Multidisciplinary care (psychology, psychiatry, medicine, nutrition) is essential.

What is OSFED?

Other Specified Feeding or Eating Disorder (OSFED) encompasses presentations that do not meet full diagnostic criteria for anorexia nervosa, bulimia nervosa, binge eating disorder, or ARFID, yet cause clinically significant distress or impairment. Common presentations include atypical anorexia nervosa (normal weight despite significant restriction), purging disorder (purging without binge eating), and night eating syndrome. OSFED is the most common eating disorder diagnosis in clinical settings and warrants the same clinical attention as other eating disorders.

 

Common Signs and Symptoms

Presentations vary but can include:

• Restrictive eating with weight loss but BMI in normal range

• Purging behaviours without binge eating episodes

• Recurrent night eating with loss of control

• Binge eating without marked distress

• Compensatory behaviours without full binge-purge cycles

• Preoccupation with food, weight, and body image

• Emotional triggers and mood disturbance

• Social withdrawal and shame

• Physical signs variable depending on specific presentation

 

Impact on Daily Life

OSFED can affect mood, concentration, relationships, and overall wellbeing. Many people describe feeling stuck in cycles of restriction, bingeing, or compensatory behaviours that interfere with work, study, and social activities. Shame, anxiety, and preoccupation with food or body image often contribute to isolation and emotional distress.
 

Evidence-based treatment

Treatment focuses on understanding the patterns maintaining the eating disorder and restoring flexible, balanced eating. Cognitive Behavioural Therapy for Eating Disorders (CBT‑E) is the leading evidence‑based approach, helping clients build regular eating routines, reduce unhelpful behaviours, and challenge body‑related beliefs. Depending on the presentation, treatment may also include DBT skills for emotion regulation, trauma‑informed therapy, nutritional support, and medical monitoring. Multidisciplinary care ensures comprehensive assessment and management of medical and nutritional needs.

What is Body Dysmorphic Disorder?

Body Dysmorphic Disorder (BDD) is characterised by a preoccupation with perceived defects in physical appearance that are not observable or appear slight to others. Individuals experience significant distress and engage in repetitive behaviours (mirror checking, grooming, reassurance seeking) or mental acts (comparing appearance to others, rumination) in response to appearance concerns. BDD typically emerges in adolescence, affects appearance perception and self-worth profoundly, and is associated with high rates of suicidality. It is distinct from normative body image concerns by its intensity, functional impairment, and delusional quality in some cases.

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Common Signs and Symptoms

• Preoccupation with perceived appearance defects (often facial features)

• Repetitive body checking or mirror avoidance

• Excessive grooming, skin picking, or mirror use

• Reassurance seeking from others

• Camouflaging appearance (excessive clothing, makeup)

• Social avoidance and isolation

• Significant distress disproportionate to observable defect

• Occupational or academic impairment

• Comorbid depression, anxiety, or obsessive-compulsive features

• Suicidal ideation or self-harm

• Possible insight impairment (overvalued ideas or delusional beliefs)

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Impact on Daily Life

BDD can significantly affect emotional wellbeing, relationships, work, and social participation. Many people describe feeling consumed by appearance‑related thoughts, making it hard to concentrate, relax, or engage in daily activities. Social withdrawal, heightened anxiety, and reduced quality of life are common. Some individuals pursue unnecessary cosmetic procedures, which rarely alleviate distress.

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Evidence-based treatment

Cognitive Behavioural Therapy (CBT) is the leading evidence‑based treatment for BDD, focusing on reducing appearance‑checking behaviours, challenging distorted beliefs, and building healthier coping strategies. Exposure and response prevention (ERP) is often included to help clients face avoided situations safely. Acceptance and Commitment Therapy (ACT) promotes values-based living despite appearance concerns.

Recovery from an eating disorder is possible but does require appropriate treatment and a high level of personal commitment on the part of the individual.

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Evidence suggests that the earlier you seek treatment for an Eating Disorder, the better the outcome. However, it is never too late to ask for help.

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Effective treatment for eating disorders is often most successful when supported by a multidisciplinary team. Depending on a person’s needs, treatment may involve a psychologist, GP, psychiatrist and dietitian, all working together to support both physical and psychological recovery.

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This collaborative approach helps ensure that medical health, nutritional needs, emotional wellbeing, and underlying psychological factors are addressed together, providing the best opportunity for sustainable recovery.

If you have an Eating Disorder you may be eligible for an Eating Disorder Treatment and Management Plan (EDP).

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The EDP was introduced by the Australian Government to facilitate increased support for people who have an eating disorder through Medicare. To be eligible for an EDP, you will need to get a EDP referral from your doctor.

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The following 4 diagnoses are eligible for an EDP referral:

• Anorexia Nervosa

• Bulimia Nervosa

• Binge Eating Disorder

• Otherwise Specified Eating Disorder ​

 

Under the EDP plan you are eligible to receive up to a maximum of 40 Medicare rebates within 12 months.

 

After the first 10 sessions you will need a treatment review from your doctor.

 

Following the completion of 20 sessions you may be eligible for another 20 Medicare rebated appointments. To release the allocation of these further appointments you will need to have a specialist psychiatrist review appointment.

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In addition, under the EDP, you are also eligible to receive up to 20 Medicare rebated appointments with a dietitian within 12 months. We can give you recommendations for dietitians who specialise in the treatment of eating disorders.

What is Binge Eating Disorder?

Binge eating disorder (BED) is the most common eating disorder. BED is characterised by recurrent episodes of consuming large quantities of food whilst experiencing a subjective sense of loss of control. Unlike other Eating Disorders, BED does not involve regular compensatory behaviours such as purging or excessive exercise. It is associated with significant psychological and physical health impacts. BED is a recognised mental health condition, not a lack of willpower, and often develops in the context of emotional distress, trauma histories, chronic dieting, or difficulties with regulating feelings.

 

Common signs and symptoms

• Recurrent binge episodes (typically ≥1 per week for ≥3 months)

• Eating more rapidly and to the point of discomfort

• Eating when not physically hungry

• Eating alone due to embarrassment

• Marked distress, guilt, or shame following episodes

• Preoccupation with food, weight, and body image

• Emotional triggers (stress, anxiety, low mood, boredom)

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Impact on daily life

BED can affect mood, self‑esteem, relationships, and overall wellbeing. Many people describe feeling “stuck” in a cycle of bingeing, shame, and attempts to restrict food. This pattern can contribute to anxiety, depression, fatigue, and difficulties concentrating. It may also interfere with social activities, work performance, and a person’s sense of confidence around food and body image.

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Evidence-based treatment

Enhanced Cognitive Behavioural Therapy (CBT-E) is effectively addresses eating patterns, emotional and behavioural drivers, and maladaptive cognitions.

Dialectical Behaviour Therapy (DBT) is effective for people with significant emotion dysregulation.

What is Bulimia Nervosa?

Bulimia nervosa is characterised by recurrent cycles of binge eating followed by compensatory behaviours aimed at preventing weight gain. These may include self-induced vomiting, laxative misuse, fasting, or excessive exercise. During a binge episode, a person may feel out of control and consume large amounts of food in a short period. Afterwards, they often experience shame, guilt, or fear, which drives the compensatory behaviour. Bulimia nervosa involves persistent concern with body shape and weight, and is maintained by a cycle of dietary restriction, loss of control during eating, and subsequent purging. Bulimia nervosa is a complex mental health condition, not a lack of discipline and it is often linked to emotional distress, body image concerns, trauma histories, and difficulties with regulating feelings.

 

Common signs and symptoms

• Recurrent binge-purge cycles (typically ≥1 per week)

• Secretive eating and compensatory behaviour following meals

• Preoccupation with food, calories, and body image

• Rigid dietary rules and frequent dieting attempts

• Physical signs: dental erosion, calluses on knuckles, parotid gland enlargement

• Electrolyte imbalances (fatigue, dizziness, cardiac arrhythmias)

• Mood disturbance, anxiety, or perfectionism

• Social withdrawal and shame

 

Impact on daily life

Bulimia nervosa can significantly affect emotional wellbeing, relationships, and daily functioning. Many people describe feeling trapped in a cycle of bingeing and purging that interferes with concentration, social activities, and self‑esteem. Physical consequences may include fatigue, electrolyte imbalances, digestive issues, and dental erosion. The secrecy and distress surrounding symptoms often intensify isolation and anxiety.

​

Evidence-based treatment

Enhanced Cognitive Behavioural Therapy (CBT-E) is the leading evidence‑based approach, helping clients establish regular eating patterns, reduce compensatory behaviours, and challenge unhelpful beliefs about food and body image.

Dialectical Behaviour Therapy (DBT) is effective for those with significant emotional dysregulation.

What is ARFID?

Avoidant/Restrictive Food Intake Disorder (ARFID) is characterised by persistent restriction of food intake leading to significant nutritional deficiency, weight loss, or dependence on nutritional supplements. Unlike other eating disorders, ARFID does not involve concerns about body shape or weight. Instead, restriction stems from sensory sensitivities, fear of aversive consequences (choking, vomiting, allergic reaction), lack of interest in eating, or a combination thereof. It commonly emerges in childhood but can persist into adulthood.

 

Common Signs and Symptoms

• Severely limited food repertoire (often <20 foods)

• Avoidance based on sensory properties (texture, colour, smell)

• Strong sensory aversions to certain foods

• Fear of negative consequences (choking, contamination, allergic reaction)

• Lack of appetite or interest in eating

• Significant weight loss or failure to gain weight

• Nutritional deficiencies and dependence on supplements or tube feeding

• Social difficulties around mealtimes and peer eating

• Anxiety or distress when pressured to eat new foods

• Often comorbid with anxiety disorders, autism spectrum disorder, or sensory processing difficulties

 

Impact on Daily Life

ARFID can affect physical health, energy levels, concentration, and emotional wellbeing. Many people experience social difficulties, such as avoiding meals with others or feeling embarrassed about their limited food choices. Families may struggle with mealtime stress, and adults may find that ARFID interferes with work, travel, or social events. Over time, the restricted diet can lead to fatigue, medical complications, and reduced quality of life.

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Evidence-Based Treatment

Treatment focuses on increasing nutritional intake, expanding food variety, and reducing anxiety around eating. Evidence‑based approaches include Cognitive Behavioural Therapy for ARFID (CBT‑AR), exposure‑based interventions to gradually introduce new foods, and support from dietitians for nutritional rehabilitation. Family-Based approaches support parental involvement in normalising eating.

Multidisciplinary care (psychology, dietetics, medicine) addresses nutritional and psychological needs.

What are Body Image Concerns?

Body image concerns refer to persistent negative thoughts, feelings, and beliefs about one's physical appearance. This may involve dissatisfaction with specific body parts, overall shape or weight, or a pervasive sense of unease with one's body. Body image concerns exist on a spectrum and are highly prevalent in the community, particularly among adolescents and young adults. Whilst some concern is normative, clinically significant body image concerns cause marked distress and may lead to avoidance, compulsive behaviours, or contribute to eating disorders and body dysmorphic disorder.

 

Common Signs and Symptoms

Presentations vary but can include:

• Persistent negative self-evaluation of appearance

• Frequent body checking (mirror checking, comparing to others)

• Avoidance of mirrors, photographs, or social situations

• Excessive grooming, dieting, or exercise

• Rumination about perceived flaws

• Social anxiety and self-consciousness

• Mood disturbance (low mood, anxiety)

• Impact on intimate relationships

• Preoccupation interfering with concentration or daily activities

• Perfectionism and rigid beauty standards

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Impact on Daily Life

Body image concerns can affect mood, confidence, relationships, and participation in daily activities. Many people describe feeling distracted or consumed by appearance‑related thoughts, making it difficult to focus at work, enjoy social interactions, or engage in hobbies. These concerns may lead to avoidance behaviours, reduced self‑esteem, anxiety, and, in some cases, the development of disordered eating patterns.

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Evidence-based treatment

Effective treatment focuses on improving body acceptance, reducing unhelpful behaviours, and addressing underlying psychological factors. Cognitive Behavioural Therapy (CBT) is the leading evidence‑based approach, helping clients challenge distorted beliefs, reduce appearance‑checking, and build healthier coping strategies. Compassion‑focused therapy, mindfulness‑based interventions, and trauma‑informed approaches can also support emotional regulation and self‑worth. Psychoeducation about media literacy and sociocultural influences is beneficial.