How to tell if someone has an eating disorder

Eating disorders are life-threatening mental conditions which are typically characterized by an excessive preoccupation with body image and food. Here are the most common types of eating disorders:

• Anorexia Nervosa: Typically characterized by under-eating often out of fear of gaining weight
• Binge-eating disorder: Usually characterized by episodes of binge eating without use of compensatory methods (such as in bulimia)
• Bulimia Nervosa: Typically characterized by repeated episodes of losing control with food and then accompanied by methods to compensate for the binges such as use of laxatives, purging or excessive exercise

Each eating disorder comes with its own challenges and are quite complex but ultimately, all of them could lead to detrimental impacts on an individual’s physical, psychological and social well-being.

However, the earlier the detection is made, the better the outcomes of the treatment for recovery. Hence, it is important to be able to recognize the warning signs of an eating disorder in order to seek professional help.

Physical signs and symptoms

• Fatigue, weakness and feeling dizzy especially when getting up or moving around
• Slowdown or irregularity of heartrate, respiratory rate and of blood pressure
• Sleep disturbance or insomnia
• Gastrointestinal symptoms such as feeling distended in the stomach region (especially after eating), abdominal cramps and constipation
• Irregular periods or absence of periods
• Decrease in body temperature resulting in feeling cold often and as a result the individual could develop lanugo which is sudden hair growth on the body (arms, face and back)
• Swelling of the parotid glands (which is the area located just below and in front of each ear) if purging is done repeatedly
• Dental issues such as cavities, erosion of the enamel if the individual resorts to vomiting
• There could be sudden variations in the weight but it is important to note that the weight is no longer a diagnostic criterion for eating disorders and relying on weight to diagnose someone could lead to under-reporting.

Psychological signs and symptoms

• Mood swings, irritability, lack of concentration, increased withdrawal
• Increased obsessive thoughts about food choices, calories, portions leading to anxiety and guilt around food)
• Intense preoccupation of gaining weight
• Body dysmorphia: perceiving oneself as being overweight/fat even if they are not or if they are even underweight

Behavioral signs and symptoms

• Always checking the nutritional values of food obsessively on the labels or on the internet.
• Tracking calories and portions obsessively
• Episodes of binge-eating
• Frequent body-checking behaviors in the mirror, weighing oneself obsessively, or pinching certain body parts
• Hiding to eat, wanting to eat more by oneself instead of with others
• More food rituals such as cutting food in small pieces, chewing excessively and eating foods in a specific order: for example, vegetables can always be eaten first
• Always going to the bathroom after meals
• Exercising excessively and being very rigid with the frequency, duration, intensity and calories burnt during physical activity

It is important to note that not all people with an eating disorder will experience the above symptoms and the latter are not diagnostic criteria for eating disorders. However, they can definitely be red flags to seek professional help.

It might undoubtedly be a delicate topic to engage in but if you see signs of an eating disorder in a family member or friend, start the conversation by expressing your concern. Use “I” instead of “you” to avoid any accusatory tone. The eating disorder voice is already present constantly in the sufferer’s head and they certainly do not need to feel blamed or criticized as this might make them more on the defensive. For example, instead of saying: “You need to eat more”, try saying “I’m scared to see you skip meals so often.”

Your concerns might be met with denial or a refusal to seek help for their eating disorder. However, try to remain calm, empathetic and continue listening to the individual without judgement. Sometimes, the person might just be afraid to seek help or does not know where to get help. A good starting point for resources could be free helplines offered by some organizations such as Nedic or Aneb where the individual can open about their struggles over the phone, text or by email.

And if you or your loved one is ready to make the first step in seeking help from an eating disorder therapist, we are here to accompany you. Please contact us to see how we can help!