What are the warning signs of an eating disorder?

Today marks the start of the National Eating Disorder Awareness Week for 2019. It can be extremely difficult to identify people who suffer from eating disorders; you may not even know if you’re dealing with one yourself. I’ve talked previously about the most common eating disorders and how they present themselves, but I’d like to go give you tools to identify them and how to start getting help.

You cannot tell if someone has an eating disorder just by looking at them. They can affect literally anyone of any size, ethnicity, age, gender or background; eating disorders do not discriminate. They are caused by “long-standing behavioral, biological, emotional, psychological, interpersonal, and social factors.” Any misconceptions we, as a society, have about who is “allowed” to have an eating disorder can lead to less available treatments, fewer diagnoses, and increased stigma.

How to determine if you need help

NEDA Screening Tool:

  • If you’re unsure if you have disordered eating patterns, or if someone in your friend group might be dealing with them, the NEDA Screening Tool is a simple questionnaire that may open your eyes.

  • This tool can help you determine if you need to seek professional help, which can be an important first step toward recovery.

What to look for

There can be many warning signs and symptoms surrounding eating disorders, but this (condensed) list from NEDA by no means a comprehensive/”for sure” list. Eating disorders are often a private disease thanks to the extreme amount of shame and stigma associated with them.

  • Emotional and behavioral

    • In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns

    • Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting

    • Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

    • Appears uncomfortable eating around others

    • Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)

    • Skipping meals or taking small portions of food at regular meals

    • Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)

    • Withdrawal from usual friends and activities

    • Frequent dieting

    • Extreme concern with body size and shape 

    • Frequent checking in the mirror for perceived flaws in appearance

    • Extreme mood swings

  • Physical 

    • Noticeable fluctuations in weight, both up and down

    • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

    • Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)

    • Difficulties concentrating

    • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)

    • Dizziness, especially upon standing

    • Fainting/syncope

    • Feeling cold all the time

    • Sleep problems

    • Cuts and calluses across the top of finger joints (a result of inducing vomiting)

    • Dental problems, such as enamel erosion, cavities, and tooth sensitivity

    • Dry skin and hair, and brittle nails

    • Swelling around area of salivary glands

    • Fine hair on body (lanugo)

    • Cavities, or discoloration of teeth, from vomiting

    • Muscle weakness

    • Yellow skin (in context of eating large amounts of carrots)

    • Cold, mottled hands and feet or swelling of feet

    • Poor wound healing

    • Impaired immune functioning

What to expect from treatment

Becoming diagnosed with an eating disorder, or an Otherwise Specified Feeding or Eating Disorder, should then lead to treatment. There are many types of treatment and therapies, depending on what specifically you’ve been diagnosed with.

According to NEDA, treatment “must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder.”

eating disordersSami Main