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Eating Disorders Awareness Week is an opportunity to focus our attention on eating disorders, extending awareness through conversations and education. In this blog, Senior Clinical Advisor Dr Fiona Pienaar highlights the complexity of eating disorders and the importance of seeking help, along with how we provide a crucial means of connection to people with eating disorders through our text support service, Shout.

A clinical lens on eating disorders

Eating disorders are described by the NHS as ‘a mental health condition where you use the control of food to cope with feelings and other situations. Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape.”

Eating disorders can affect anyone, but teenagers aged between 13 and 17 are mostly affected. According to the charity BEAT, it’s estimated that around 1.25 million people in the UK have an eating disorder. Around 25% of them are male.

The most common eating disorders are: Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED). There are also Other Specified Feeding and Eating Disorders (OSFED) and the focus for EDAW 2024, Avoidant/Restrictive Food Intake Disorder (ARFID).

At a Royal Society of Medicine event, ‘Eating disorders: Advances in science and treatment’, experts reported on the seemingly inexorable rise in eating disorders hospital admissions, particularly Anorexia Nervosa, which they noted was very hard to treat. The complexity of eating disorders was highlighted, specifically social, genetic and psychological risk factors. The presenters also drew attention to the increase in referrals, hypothesising that this could be attributed to greater awareness of eating disorders and improved service availability.

Eating disorders are associated with both psychiatric (depression, anxiety, self-harm - most common) and physical comorbidities (cardiovascular, reproductive health, musculoskeletal, gastro-intestinal). One of the great psychiatrists and neuroscientists of our times, Professor Karl Deisseroth (Stanford University), declared that he had ‘found no greater mystery than eating disorders, anywhere in psychiatry or medicine. None greater in all of biology’. He also noted that ‘though no drug can cure these two diseases (AN and BN), words can reach them as one human being reaches another.’ (Connections: The new science of emotions, Deisseroth, Penguin, 2022, pgs 161 and 163).

“thank you for talking with me about my eating disorder. it really helped me and gave me newfound confidence to talk to someone in my life”

Shout texter

Aged 13 or under

The importance of connection through conversation in helping Shout texters with eating disorders

Indeed, through our text support service, Shout, we utilise the power of words to connect with texters struggling with issues such as eating challenges or body image, helping to guide them to a state of calm and empowering them to take their next steps to seeking further help, whether that’s by talking to a friend, family member or their GP.

In 2023, Shout Volunteers took more than 20,000 conversations with around 12,000 texters about eating disorders or body image issues - around 80 conversations every day. The majority of texters were female (80%), with 7% male, 4% transgender and around 9% identifying as non-binary.

Texters who discuss these issues were mostly likely to be aged 13 and under, followed by 14-17 year olds. They were more likely to also talk about anxiety, depression and self-harm than people texting about other issues.

In June 2023, Shout was added to the Google OneBox for eating disorder searches. When people use related terms, the OneBox appears above results to signpost to support services. We’re proud to appear here alongside eating disorder charity, Beat, and as a result, have seen the number of texters Shout supports with eating disorders and body image almost double.

Of the texters who contacted Shout for support about eating disorders and body image in 2023, 81% rated the service as helpful and feedback we’ve received reflects the kindness and the non-judgemental attitude Shout Volunteers offer texters. Taking the time to listen to the stories people share, acknowledging the challenges they face and reflecting their courage in reaching out for support. Complex as eating disorders are, sometimes a conversations is all someone needs in the moment.

We have a number of resources available if you are looking to support a family member, friend or colleague that you may be concerned about or indeed, if you’re looking for information or support for yourself:

  • Visit for more advice about eating disorders and information on how to start a conversation with a trained Shout Volunteer
  • The UK’s leading eating disorder charity, Beat Eating Disorders offers advice and education for those struggling with eating disorders and their support networks
  • The NHS has a comprehensive overview of eating disorders and further information available on its website

At Mental Health Innovations, we offer a number of services, including consultancy and training, and partner with a wide range of organisations to help support people with their mental health.

“Thank you for listening to me and helping me to come up with a plan for next time I'm feeling like I'm going to binge. I appreciate what you did.”

Shout texter

Aged 35 - 44