Eating Disorders Awareness Week is an annual event spotlighting the lived reality of eating disorders, championing better literacy in this area, and providing support to those affected. This year, it will be held from February 28th to March 5th, and the theme is how “Eating disorders can affect anyone”. 

As a leading health and fitness education provider in the UK, Eating Disorder Awareness Week is a key date in the calendar for the Fitness Group, and this year, we’re using our platform to educate and empower our students working on the frontline to identify these conditions in clients. 

In this article, we’ll explore what an eating disorder is, dispel some common misconceptions, and explore the signs and symptoms. We’ll also look at some key principles you can follow as a fitness professional to instill a healthier relationship to food and body image among clients.

What are eating disorders? 

Eating disorders are serious, complex and potentially life-threatening mental illnesses characterised by problematic behaviours, thoughts and feelings towards body weight, shape, food and eating. They can affect people of any age, weight, size, shape, gender identity, sexuality, cultural background or socioeconomic group. 

It is estimated that around 1.25 million people in the UK are living with an eating disorder, whilst research from NHS information indicates up to 6.4% of adults display signs of an eating disorder. Contrary to what many people believe, you cannot tell if someone has an eating disorder just by looking at them and they can present very differently from person to person. They can often co-exist with other mental health conditions as well, such as mood and anxiety disorders.

Common types of eating disorders

There are multiple types of eating disorders, but the most common are anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID) and other specified feeding and eating disorders (OSFED). Determining the exact prevalence of eating disorders is difficult, but according to the charity Beat, estimates suggest that anorexia accounts for 8% of cases, avoidant/restrictive food intake disorder (ARFID) 5%, binge eating disorder 22%, bulimia 19%, and other specified feeding or eating disorder (OSFED) 47%. 

Anorexia nervosa

Anorexia nervosa is a serious mental illness that affects a person’s relationship with food, eating, and their body. It often involves restricting how much food or drink they consume, and they may develop strict rules about what, when, or where they eat. While anorexia can sometimes be associated with low body weight, weight alone is not an indicator of how unwell someone is. In addition to restricting food intake, some individuals may engage in excessive exercise, self-induced vomiting, or misuse of laxatives. Others may experience cycles of bingeing (eating large amounts of food in one sitting) followed by purging behaviours.

Bulimia nervosa

Bulimia nervosa is a serious mental illness where individuals experience cycles of binge eating—consuming large amounts of food in a short period—followed by attempts to compensate through behaviours such as self-induced vomiting, excessive exercise, fasting, or the misuse of laxatives or diuretics. These behaviours, known as purging, can feel distressing and difficult to control. Binge eating in bulimia is not the same as occasionally eating more than usual or “overindulging.” It is often driven by emotional distress, with individuals sometimes feeling disconnected from their actions during an episode. The food consumed may include items they would typically avoid, and they may feel overwhelmed by a loss of control over how much or how quickly they eat. Many people with bulimia place a strong focus on their weight and body shape, and they may have a distorted perception of their size (body dysmorphia). 

The SCOFF screening tool for anorexia and bulimia

Developed by Professor John Morgan at Leeds Partnership NHS Foundation Trust, this is a simple questionnaire designed to help identify potential eating disorders. It focuses on some key characteristics commonly associated with anorexia nervosa and bulimia nervosa. 

While not a diagnostic tool, the SCOFF questionnaire can help highlight patterns of disordered eating that may warrant further support from a specialist. Early detection and intervention can make a significant difference in recovery. Answering “yes” to two or more questions may indicate the need for further assessment by a healthcare professional.

SCOFF Questionnaire

• Do you ever induce vomiting because you feel uncomfortably full?
• Do you feel like you lose control over how much you eat?
• Have you lost more than one stone (6.35 kg) within three months?
• Do you see yourself as overweight, even when others say you are underweight?
• Does food preoccupy your thoughts?

The Butterfly Foundation, a leading eating disorder charity based in Australia, have also developed a first-line screening tool for common eating disorders.

Binge eating disorder (BED)

Binge Eating Disorder is a serious mental illness where individuals repeatedly consume large amounts of food in a short period while feeling a loss of control over their eating. It can affect people of any age, gender, ethnicity, or background. Unlike bulimia, binge eating is not followed by compensatory behaviours such as self-induced vomiting, but some individuals may fast between episodes. BED is not about choosing to eat large portions or simply “overindulging”—binges can be highly distressing and involve eating far more than a person wants to. During a binge, individuals may feel unable to stop even if they wish to, and some describe feeling disconnected from their actions or struggling to recall what they have eaten afterwards.

Potential signs and symptoms: 

• Regular episodes of eating large amounts of food in a short time, often in private.
• Feeling unable to stop eating or control how much is eaten.
• Feeling guilt, shame, or distress after eating.
• Hiding, hoarding, or stealing food.
• Planning daily routines around eating episodes.
• Irregular eating patterns, such as eating throughout the day with no set mealtimes, skipping meals, taking very small portions, fasting, or frequently dieting.

Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID) is a condition where a person avoids certain foods, eats a very limited amount, or both. This can be due to factors such as sensory sensitivities, fear of negative experiences with food (such as choking or vomiting), or a lack of interest in eating. ARFID is not related to concerns about body weight or shape. ARFID may exist on its own or alongside other conditions, such as anxiety disorders, autism, ADHD, or certain medical conditions. ARFID is distinct from fasting for religious or cultural reasons, avoiding foods due to allergies, or experiencing appetite loss due to a medical condition. It is diagnosed when restrictive eating leads to nutritional deficiencies, significant weight changes, or interference with daily life and well-being.

Potential signs and symptoms

• Eating a very limited range of foods, which may become even more restricted over time.
• Fear of choking, vomiting, or other negative experiences related to eating.
• Eating too little to meet energy needs, feeling full very quickly, or struggling to recognise hunger.
• Taking a long time to eat, finding mealtimes difficult, or skipping meals when focused on other activities.
• Sensitivity to food textures, smells, or temperatures.
• Eating the same meals repeatedly or only eating foods of a specific colour (e.g., only beige foods).
• Eating different foods from others in social settings or avoiding food-related events altogether.
• Feeling anxious at mealtimes, chewing very carefully, taking small bites or sips.
• Weight loss or, in children, not growing as expected.

Other specified feeding and eating disorder (OSFED)

OSFED (Other Specified Feeding and Eating Disorder) is a diagnosis given when a person’s symptoms do not fully match the criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder, but still cause significant distress and impact daily life. Eating disorders are diagnosed based on specific behavioural, psychological, and physical symptoms, and OSFED accounts for the highest percentage of cases. OSFED is just as serious as other eating disorders and can develop from or into another diagnosis. The symptoms vary widely between individuals, as OSFED is an umbrella term that may describe different patterns of disordered eating. 

Potential signs and symptoms:

• Eating large amounts of food followed by actions to ‘compensate,’ such as vomiting, using laxatives or diuretics, fasting, excessive exercise, or altering insulin dosage.
• Self-esteem is closely linked to body image.
• Following extreme diets, cutting out entire food groups, or avoiding foods for weight-related reasons.
• Rigid and excessive exercise routines, even when tired, injured, or unwell, due to the need to “burn off ” calories
• Becoming overly focused on food and eating habits, sometimes in secret.
• Feeling self-conscious about eating in front of others.
• Struggling with low confidence, poor body image, irritability, and mood swings.
• Feeling tired, struggling to concentrate, withdrawing from social activities.
• Experiencing guilt, shame, or anxiety around food and eating.

Eating Disorders in Sports

Research suggests that individuals engaged in competitive physical activities—including sports, fitness, and dance—are at an increased risk of body dissatisfaction and disordered eating, placing them at higher risk of developing eating disorders. This is due to a variety of factors including performance pressures, body expectations, and industry norms. According to Eating Disorder Hope, a leading UK charity:

• 84% of college athletes have engaged in disordered eating or weight control behaviours at some point.
• High school athletes experience eating disorders at three times the rate of non-athletes (7.3% vs. 2.3%).
• 42% of female athletes in aesthetic sports demonstrate disordered eating behaviours.

Eating disorders present serious health risks to all sufferers, although athletes struggling with eating disorders face particular risks, most notably Relative Energy Deficiency in Sport (RED-S)—a condition where energy output exceeds energy intake, leading to an energy deficiency and compromising crucial physiological functions. If left untreated, RED-S can lead to:

• Increased risk of stress fractures and osteoporosis
• Disrupted menstrual cycles in females
• Impaired immune function
• Gastrointestinal issues
• Cardiovascular complications
• Increased risk of depression

The female athlete triad refers to a cluster of three interrelated conditions in women, namely disordered eating, amenorrhea (loss of a girl’s period) and osteoporosis. Females in any sport can develop this condition, although those competing in sports where thinness is rewarded (gymnastics and figure-skating, for example) are at particular risk. Early detection is crucial to minimise long-term physical damage. 

Best Practice for Fitness & Sports Professionals

Eating Disorder Awareness Week is a crucial time to reflect on the role of fitness and sports professionals in fostering a safe and supportive environment for athletes and clients. Coaches, personal trainers, and nutrition professionals are in a unique position to either reinforce harmful narratives or promote a culture that prioritises a healthy relationship with food, eating and body image.Given the prevalence of disordered eating in sport and fitness settings, it is essential to recognise the signs, use responsible language, and understand when to seek further support. The following best practices can help professionals take a proactive and informed approach.

Coaches & Personal Trainers

• Prioritise health over performance – If an athlete or client is struggling with disordered eating, their well-being and recovery should always take precedence over competition or aesthetic goals.
• Focus on strength and skill, not weight – Avoid using weight, body fat percentage, or appearance as a primary source of motivation. Instead, celebrate improvements in strength, endurance, technique, and overall well-being.
• Use positive, inclusive language – Never promote guilt-based coaching or language that associates food, rest, or body weight with shame. Words matter, and a supportive approach fosters a healthier mindset.
• Encourage proper recovery and rest – Overtraining increases the risk of both physical injuries and mental health struggles. Emphasise rest, adequate nutrition, and periodisation as essential components of training.
• Recognise the signs of RED-S and eating disorders – Learn to identify early warning signs such as chronic fatigue, excessive training, food restriction, or emotional distress around eating. Be prepared to refer athletes to the appropriate medical and mental health professionals.

Sports Nutritionists & Dietitians

• Recognise that food is more than fuel – Nutrition is not just about optimising performance; it is also tied to culture, social connection, and mental well-being.
• Promote flexibility, not food rules – While structure can be helpful, rigid meal plans can create anxiety or guilt around eating. Encourage variety and adaptability in nutrition strategies.
• Challenge diet myths and food guilt – No food should be categorised as inherently “good” or “bad.” Helping athletes build a positive relationship with all foods supports long-term health and performance.
• Know when to refer – If an athlete displays signs of disordered eating, do not attempt to manage it alone. Seek guidance from specialists trained in eating disorder treatment to ensure appropriate support.

Creating a Supportive Culture in Sport

• Develop clear protocols – Establish structured guidelines for recognising and addressing eating disorder concerns, ensuring all staff are equipped to handle situations sensitively and appropriately.
• Foster open conversations – Encourage discussions about food, body image, and mental health without stigma. Creating a safe space for dialogue helps reduce secrecy and fear around these topics.
• Educate staff and athletes – Ongoing education about eating disorders, RED-S, and responsible coaching practices is essential for creating a healthier environment in sport and fitness settings.

Are you equipped to navigate eating disorders and body image?

As we’ve established, athletes as a population are uniquely vulnerable to disordered eating behaviours whilst being at an increased risk for complications owing to their high energy expenditure. With this in mind, those working with these populations in any capacity need to be educated on the signs and symptoms to look out for and how to refer clients to the appropriate treatment. Yet many of those in the industry feel under-equipped to do so.

In honour of Eating Disorder Awareness Week, we’re delighted to announce that we are partnering with Elle Mace, an Anti-Diet Therapeutic Food and Body Coach, to offer her CPD-certified course Eating Disorders and Body Image For Fitness and Sports Professionals. Comprising ten modules in total, this online course has been designed specifically for those working within the fitness industry to help them navigate body image, disordered eating and eating disorders among clients. It offers the tools to identify common eating disorders and offer meaningful first-line support to clients within your professional scope. This course will be available on our website next week with an exclusive £200 launch discount.

Further Support & Resources

If you or someone you know is struggling with disordered eating, the following organisations provide free, evidence-based information and support:

• Beat (UK’s Eating Disorder Charity) – beateatingdisorders.org.uk

• National Eating Disorders Association – nationaleatingdisorders.org

• FREED (First Episode Rapid Early Intervention for Eating Disorders) – freedfromed.co.uk

• Academy for Eating Disorders – aedweb.org

• National Centre for Eating Disorders – eating-disorders.org.uk

• The Butterfly Foundation – butterfly.org.au

These organisations offer a range of free guides, helplines, and professional resources to support individuals and those working in the fitness industry.