About eating disorders

EATING DISORDERS BACKGROUNDER

EMBARGOED: 12:01AM AEST, THURSDAY, JULY 24, 2025

The ‘inside out’ of eating disorders

An eating disorder is a complex mental illness that for
some, can lead to severe and permanent physical
complications, and even death.1
Eating disorders can affect anyone, of any gender, age,
or cultural background.1
The prevalence of eating disorders appears to be on the
rise, with a 21 per cent increase in the prevalence of
disordered eating behaviour observed in Australian
communities over 11 years.2
In 2023, 1.1 million Australians were living with an eating
disorder, equating to one in 23 people, or almost five per
cent of the adult population.2
There are approximately:3
o 38,711 Australians currently living with anorexia nervosa (AN);
o 125,374 Australians living with bulimia nervosa (BN);
o 233,948 Australians living with binge eating disorder (BED); and o 704,944 Australians living with other forms of eating disorders.
In 2023, 27 per cent of Australians living with an eating disorder were under 19 years of age –
12 per cent higher than in 2012.2
Importantly, eating disorders among men are significantly under-diagnosed.2
Like women, men experience disturbances in body image, binge eating, and maladaptive weight/shape control behaviours.4
The prevalence of binge-eating disorder (BED) may be as high in men as in women, while the prevalence of extreme weight control behaviours, such as extreme dietary restrictions and purging, may be increasing more rapidly in men than women.4,5
Some research suggests those who identify as lesbian, gay, bisexual, transgender or gender diverse may be at heightened risk of developing eating disorders.6,7
People experiencing some eating disorders may hold an inaccurate perception of their body size and shape, and attempt to control their weight and appearance through excessive dieting, exercising and/or purging.2,8
Eating disorders are not a choice – they are a serious illness.9
There are several types of eating disorders, including binge eating disorder (BED), bulimia nervosa (BN) and anorexia nervosa (AN).10
Many factors influence eating disorders, including genetics, developmental transitions (puberty, childbirth, and menopause), thinking styles (such as perfectionism), body dissatisfaction, and sociocultural pressures to be thin.11
Eating disorders cause significant distress to the lives of an individual, their family, carers, partners and friends.12
Commonly co-occurring conditions associated with eating disorders include mood disorders (such as depression), anxiety disorders (especially social anxiety disorder and obsessive-compulsive disorder or OCD), substance abuse disorders (such as alcohol problems), and personality disorders.13,14
Medical complications of eating disorders include cognitive impairment, heart complications, growth retardation and osteoporosis.14,15
Those with an eating disorder are at a higher risk of mortality. In 2023, there were 1,273 premature deaths in Australia resulting from an eating disorder.2
Eating disorders have one of the highest mortality rates of any mental illness.3
Eating disorders can improve with the right treatment and time. Recovery is possible for everyone, regardless of severity or stage of illness.16,17
In 2023, the total socio-economic cost of eating disorders in Australia was AUD 66.9 billion.2

About binge-eating disorder (BED)

Binge-eating disorder (BED) involves episodes of consuming unusually large amounts of food, and a loss of control.18,19
The age of onset for BED most commonly occurs in later adolescence and young adulthood, and has a much more even gender frequency.18
Binge-eating episodes are associated with three (or more) of the following:18
o Eating much more rapidly than normal;
o Eating until feeling uncomfortably full;
o Eating large amounts of food when not feeling physically hungry;
o Eating alone due to embarrassment by how much one is eating; and
o Feeling disgusted with oneself, depressed, or very guilty after over-eating.
Feelings of guilt, disgust and depression often follow a binge-eating episode.18-20
Unlike bulimia nervosa, BED does not involve purging or other compensatory behaviours like excessive exercise. The illness can, however, involve sporadic fasting and repetitive diets, as well as weight gain.21
In 2023, there were 233,948 Australians living with BED.2
The lifetime prevalence of BED in Australia is 2.20 per cent.2

About bulimia nervosa (BN)

Bulimia nervosa (BN) is characterised by recurrent binge-eating episodes (consumption of unusually large amounts of food in a relatively short space of time) followed by compensatory behaviours.18
Similarly to binge eating disorder, the age of onset of BN is more commonly seen in later adolescence and young adulthood.22,23
According to the DSM-5 criteria, to be diagnosed with BN, a person must display:18
o Recurrent episodes of binge eating, characterised by eating in a discreet period of time and consuming larger volumes of food than what most people would consume during a similar period of time, and under similar circumstances;
o A sense of lack of control over-eating during the binge episode (e.g. a feeling one cannot stop eating or control what, or how much they consume);
o Recurrent, inappropriate behaviours to compensate for over-consumption in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting or excessive exercise;
o Binge eating and inappropriate compensatory behaviours occurring at least once a week for three months; and
o Self-evaluation influenced by body shape and weight.
Accompanied by a sense of loss of control, binges are often followed by feelings of guilt and shame. Binges are often counteracted by self-induced vomiting, fasting, over-exercising and/or misuse of laxatives, enemas or diuretics.24,25
Eating disorders occur at any body size.23 People with BN can remain in the normal weight range, or be slightly under or over the average weight status.26
Because some mistakenly assume a person must be under-weight to have to an eating disorder, BN and other eating disorders can often be missed, or go unnoticed for some time.16, 27
In 2023, there were 125,374 Australians living with BN.2
Around 200 people living with BN are expected to succumb to the disorder each year.28

About anorexia nervosa (AN)

Anorexia nervosa (AN) is a serious, complex mental illness with psychiatric and physical symptoms.18,29
The peak age of onset of AN is in early to mid-adolescence, but may occur at any age, including childhood.30
AN is characterised by severe restriction of food intake and generally results in significant (and dangerous) weight loss.31
Factors contributing to the development of AN are complex, and include a strong genetic component. Genes can be triggered by environmental influences, such as dieting or extreme exercise.32,33
Personality traits of perfectionism and fear of failure, low self-esteem, and emotional avoidance are common among those living with AN.31
People living with AN often adhere to intense exercise routines.34,35
In 2023, there were 38,711 Australians living with AN.2
In 2023, mortality rates were highest among those with AN versus other eating disorders. Medical complications are the leading cause of death, followed by suicide.2, 36
AN claims the lives of approximately 450 people in Australia each year.28
Of those living with AN, around 90 people are expected to die from suicide.28

Barriers to care

The number of people living with an eating disorder who access treatment in a year is considerably less (19 – 36 per cent) than people with other types of mental health disorders, such as depression.37-39
Of those individuals who do receive treatment, only 35 – 40 per cent will receive targeted treatment for their eating disorder.40,41
Estimates suggest treatment for an eating disorder is sought an average of 5 to 15 years after onset of the disorder.42
Delays in accessing treatment vary depending on the type of eating disorder. People with BN or BED experience a significantly longer delay from symptom onset to receiving eating disorder-specific treatment compared with those with AN.43
Multiple factors contribute to low rates of accessing tailored and timely eating disorder treatment, including stigma, access to care, mental health literacy, personal factors and healthcare professional knowledge and skills.42
People living with eating disorders, and those caring for them, often lack a clear understanding of how and when to access help.4

About digital therapies

Online therapy, or eTherapy provides psychological
support via digital devices. eTherapies can include
screening tools, structured therapy programs and
webinars.44
eMental health (digital) interventions or therapies can
help overcome existing barriers that stand in the way of
people receiving help for an eating disorder.45
eTherapies can bridge geographical gaps by providing
mental health support to individuals living in remote
areas where face-to-face services are unavailable.46
eTherapy benefits may include:

o Accessibility:

- available to every individual when they are
emotionally ready, at a time that suits them
(e.g. out of work hours, late at night, when

children are asleep and on weekends);
- available to all who have a device that can
access the internet;

- immediate access to support, reducing the
wait times associated with traditional mental
health services.47
o Greater comfort: online therapy may be less
confronting than speaking directly (face-to-face)
with a counsellor or psychologist.

eTherapies can be used as a first step in a stepped care model, where individuals with mild to moderate
conditions can receive self-guided support before progressing to more intensive interventions.48
By removing geographical and social barriers, e-therapies contribute to a more equitable mental health system.47

ends#

Should you suspect that you, or a loved one, may be living with an eating disorder, speak to your local healthcare professional without delay, or head to www.insideoutinstitute.org.au to complete their online screener and assessment, and to access more information and professional support.

Australian professional patient support services offering 24/7 helpline services include:

Butterfly National Helpline: 1800 334 673
Beyond Blue: 1300 22 4636
LifeLine: 13 11 14
Men’s Line Australia: 1300 78 99 78
Kids Help Line: 1800 55 1800

References

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Deloitte AE. Paying the Price, Second Edition: The economic and social impact of eating disorders in Australia. Report commissioned by The Butterfly Foundation. 2024.
Dal Brun D, Pescarini E, Calonaci S, Bonello E, Meneguzzo P. Body evaluation in men: the role of body weight dissatisfaction in appearance evaluation, eating, and muscle dysmorphia psychopathology. Journal of Eating Disorders. 2024;12(1):65.
Gorrell S, Murray SB. Eating Disorders in Males. Child Adolesc Psychiatr Clin N Am. 2019;28(4):641-51.
Solmi M, Monaco F, Højlund M, Monteleone AM, Trott M, Firth J, et al. Outcomes in people with eating disorders: a transdiagnostic and disorder-specific systematic review, meta-analysis and multivariable meta-regression analysis. World Psychiatry. 2024;23(1):124-38.
Bell K, Rieger E, Hirsch JK. Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model. Front Psychol. 2018;9:2692.
Mölbert SC, Klein L, Thaler A, Mohler BJ, Brozzo C, Martus P, et al. Depictive and metric body size estimation in anorexia nervosa and bulimia nervosa: A systematic review and meta-analysis. Clin Psychol Rev. 2017;57:21-31.
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