Eating Disorders: Understanding, Treatment, and Recovery
This article is general information published by the practice of Dr. Sholeh Toobaei, Specialist Psychiatrist, Dubai. It has not yet been individually reviewed by a clinician and is not a substitute for personal medical advice. Published: 1 September 2026.
Scope: This article is general information about eating disorders. It is not a diagnosis or treatment plan. If you or someone you know is struggling with eating or body image, a professional assessment can help.
Eating disorders are mental health conditions, not lifestyle choices
An eating disorder is a serious mental health condition characterised by persistent disordered eating behaviours and a distorted relationship with food, weight, and body shape. Eating disorders have the highest mortality rate of any mental health condition. Anorexia nervosa, in particular, has a mortality rate approximately 5–6 times higher than the general population, primarily due to medical complications and suicide.
Eating disorders are not about food. They are about control, perfectionism, coping with difficult emotions, and — in the case of binge eating disorders — managing distress through a behaviour that temporarily reduces emotional pain. The food-related symptoms are the visible expression of a much deeper psychological struggle.
The misconception that eating disorders are a "first-world problem" or a "privileged illness" is not just wrong — it is dangerous. Eating disorders cross all cultural, socioeconomic, and ethnic boundaries. In Dubai's diverse expatriate population, eating disorders affect people from every culture represented in the city, and cultural attitudes toward food, body image, and mental health vary enormously.
The main eating disorders
Anorexia nervosa. Characterised by restricted energy intake leading to significantly low body weight, an intense fear of gaining weight, and a distorted body image (seeing oneself as overweight even when underweight). Two subtypes: restricting type (weight loss through dieting, fasting, or excessive exercise) and binge-eating/purging type (weight loss accompanied by recurrent binge eating or purging behaviours). Anorexia is often stereotyped as affecting young women, but it affects people of all genders, ages, and backgrounds. Men with eating disorders are significantly underdiagnosed because clinicians and families often do not recognise the possibility.
Bulimia nervosa. Characterised by recurrent episodes of binge eating (consuming an unusually large amount of food in a discrete period with a sense of loss of control) followed by compensatory behaviours to prevent weight gain — self-induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise. People with bulimia are typically within or above the normal weight range, which is why the disorder is often not recognised by others. The binge-purge cycle is often done in secret and can continue for years without detection.
Binge eating disorder. Characterised by recurrent binge eating episodes without the compensatory behaviours seen in bulimia. Binge eating disorder is the most common eating disorder in the general population. It is strongly associated with obesity, metabolic syndrome, depression, and anxiety. The shame and secrecy surrounding binge eating often prevents people from seeking help.
Other specified feeding or eating disorder (OSFED). Characterised by eating disorder symptoms that cause significant distress and impairment but do not meet the full criteria for anorexia, bulimia, or binge eating disorder. Examples atypical anorexia (all criteria for anorexia met but weight is within or above the normal range), purging disorder (purging without binge eating), and night eating syndrome. OSFED is just as serious as the other eating disorders — the severity is determined by the distress and impairment, not by whether the symptoms fit a specific category.
What causes eating disorders?
Eating disorders are caused by a complex interplay of factors:
Genetic predisposition. Eating disorders run in families. Twin studies suggest that 50–60% of the risk for anorexia nervosa is genetic. Certain personality traits associated with eating disorders — perfectionism, harm avoidance, rigidity — also have a genetic component.
Psychological factors. Perfectionism is one of the strongest personality predictors of eating disorders, particularly anorexia. Obsessive-compulsive traits, low self-esteem, body image dissatisfaction, and difficulty identifying and expressing emotions are all associated with increased risk. In many people, the eating disorder begins as a seemingly harmless attempt at dieting or self-improvement that gradually becomes a maladaptive coping mechanism.
Social and cultural factors. Cultural emphasis on thinness as a marker of beauty, worth, and self-discipline contributes to body dissatisfaction, particularly in young women. But the risk extends beyond Western beauty standards. In many cultures, body image concerns intersect with cultural expectations, family dynamics, and migration-related stress in complex ways.
Neurobiology. People with eating disorders show differences in brain function, particularly in areas involved in reward processing, cognitive control, and emotional regulation. These differences are both cause and consequence of the disorder — some may predate the illness, while others develop as a result of starvation or disordered eating.
The physical consequences
Eating disorders affect every organ system in the body:
Cardiovascular. Slow heart rate, low blood pressure, arrhythmias, and in severe cases, sudden cardiac arrest. These are the most common causes of death in anorexia nervosa.
Gastrointestinal. Delayed gastric emptying, constipation, abdominal pain, and in the case of bulimia, oesophageal tears and dental erosion from repeated vomiting.
Endocrine. Disruption of hormones that regulate appetite, menstrual function, bone density, and thyroid function. Amenorrhoea (absence of periods) is common in anorexia. Reduced bone density (osteopenia or osteoporosis) can be permanent, even after recovery.
Neurological. Brain shrinkage (reversible in many cases after weight restoration), difficulty concentrating, obsessive thinking, and depression.
The medical complications of eating disorders are not "warnings" that people can simply choose to ignore. The starvation state that accompanies anorexia impairs cognitive function and decision-making capacity. It is genuinely difficult — for many people, impossible — to "just eat" when the body and brain have adapted to starvation. This is not stubbornness or resistance. It is the biological reality of the disorder.
Treatment
The gold standard for anorexia nervosa. For adolescents, family-based treatment (FBT, also known as the Maudsley approach) is the most evidence-based treatment. It involves parents actively refeeding their child as the first priority — restoring weight is not a later step, it is the first step. For adults, specialised outpatient therapy combined with nutritional counselling and medical monitoring is the standard. No amount of "motivation" or "willpower" can overcome the biological and psychological changes caused by starvation. Weight restoration is medically necessary.
The gold standard for bulimia nervosa. Cognitive behavioural therapy adapted for eating disorders (CBT-E) is the single most effective treatment. It addresses the core maintaining factors: dietary restriction, overevaluation of shape and weight, and the binge-purge cycle. Medications (particularly SSRIs) can be adjunctive but are not a replacement for therapy.
The gold standard for binge eating disorder. CBT is the most effective treatment. Interpersonal psychotherapy (IPP) is also effective but works more slowly. Lisdexamfetamine is the only medication specifically approved for binge eating disorder in adults, and it is used when CBT alone is insufficient.
The multidisciplinary team. Effective eating disorder treatment typically involves a psychiatrist, a psychotherapist, and a dietitian. In severe cases, medical monitoring is needed. In cases of severe malnutrition, hospitalisation may be necessary to stabilise the person medically before psychological treatment can begin.
The Dubai context
Eating disorder treatment in Dubai has specific considerations:
Specialist availability. Eating disorders require specially trained clinicians. Not all psychiatrists, therapists, or dietitians have experience with eating disorders. Finding a team with specific eating disorder expertise is important because general approaches to disordered eating are often insufficient and can sometimes be harmful.
Cultural attitudes toward food and body image. In many cultures represented in Dubai, food is central to family life, hospitality, and social connection. Disordered eating intersects with cultural expectations about eating together, refusing food, and body image ideals that may differ from Western standards. A clinician who understands these cultural nuances is essential.
Body image and social media. The global reach of social media means that people in Dubai are exposed to the same beauty standards and body image pressures as people anywhere in the world. This is particularly relevant for young people, who may be navigating conflicting cultural messages about body image from their family culture and the global (largely Western) media environment.
Insurance. Eating disorder treatment — particularly residential or inpatient programmes — can be expensive. Some insurance plans cover psychiatric treatment but have significant limits on psychotherapy sessions or may exclude eating disorder treatment altogether. Check your coverage early.
What you can do
If you are worried about yourself. Bring it up with a professional. You do not need to have it fully articulated. "I am struggling with my relationship with food" is enough. Eating disorders are treatable, and early intervention leads to better outcomes. The most important thing is to take the first step — reaching out.
If you are worried about someone else. Express your concern without judging their eating or body shape. Focus on how they seem — "I have noticed you seem distressed around food" rather than "You have changed so much." Avoid commenting on their appearance, even positively — "You look healthy" can be interpreted as "You look fat." Encourage them to seek professional help. Do not try to be their therapist.
When should I seek help?
If you or someone you know has persistent concerns about food, weight, or body image that are affecting daily life — restrictive eating, binge eating, purging behaviours, excessive exercise driven by guilt rather than health — seek a professional assessment. Eating disorders are treatable, but they rarely resolve without professional help.
Seek urgent help — call 999 (police) or 998 (ambulance) in the UAE, or go to the nearest emergency department — if the person has a very low body weight (BMI below 13 in adults, or significant weight loss in children and adolescents), if they are experiencing fainting, chest pain, or heart palpitations, if they are having thoughts of self-harm, or if you are in any way a danger to yourself. For non-urgent enquiries, use the appointment request form on this website. This practice does not operate a monitored telephone line, and a message sent through the form may not be read straight away.