Restricted intake self-harm (RISH) is deliberately limiting food or fluids as self-harm, distinct from weight or body image driven eating disorders.
RISH is a formulation-led construct developed with lived experience; existing labels often misrepresent intent and cause clinical misunderstanding.
Emerging evidence suggests RISH may be common in young people, under-researched and misclassified; recognising it supports appropriate adapted treatment approaches.
BJPsych Bull. 2026 Nov 9:1-3. doi: 10.1192/bjb.2026.10325. Online ahead of print.
ABSTRACT
Restricted intake self-harm (RISH) refers to intentionally limiting food or fluids as a form of self-harm rather than for weight or body image reasons. RISH is an emerging formulation-led construct, rather than a diagnosis, that was developed with lived-experience input. Experts by experience highlighted how existing labels like ‘disordered eating’ often misrepresent intent and lead to clinical misunderstandings. Individuals describe restriction to regulate emotions, express distress, seek care or commit suicide. Emerging evidence suggests this behaviour could be relatively common among young people yet is under-researched and frequently misclassified. Recognising RISH can help ensure appropriate adapted treatment approaches are created.
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