Common signs and symptoms of eating disorders can be tough to recognize. They’re sneaky, subtle, and often socially accepted. 

Distinguishing between what’s “normal” and what’s indicative or symptomatic of a disorder is difficult.

Thanks a lot, Diet Culture. (Trigger warning.)

Eating disorders involve so much more than food. They’re not about vanity or attention-seeking.

Eating disorders are treatable. But they are presentations of a serious mental health condition that requires expert medical and psychological care. 

Eating disorders are life-threatening.

Twenty-million American women and ten-million men suffer from eating disorders or have at some point in their lives. Whether or not you’re aware, you probably know people who have or have had an eating disorder.

People can and do recover, with treatment. Recovery is more likely the sooner an eating disorder is identified and treated.

That’s why it’s so important to know common signs and symptoms of eating disorders. This is life-saving knowledge.

People with eating disorders typically don’t volunteer the information.

They tend to deny their symptoms and often refuse treatment. Rarely do they seek help on their own.

Keep in mind that each person with an eating disorder will not exhibit all the signs and symptoms listed below. Signs and symptoms vary across types of eating disorders and across people.

What is generally true is that eating disorders affect all aspects of people’s lives, including emotions, behaviors, and physical well-being. People of all races, religions, sizes, shapes, genders, socio-economic status, and any other variable you can think of develop eating disorders.

What are emotional signs and symptoms of eating disorders?

• attitudes and comments that suggest weight, dieting, and control of food are the most important things in life
• sudden interest in weight loss, diets (e.g., keto), or specialized “lifestyle” (e.g. no carbohydrates)
• preoccupation with food, weight, dieting, carbs, calories, food labels
• mood swings
• irritability
• feeling guilty around food or about eating

Here is a hypothetical example for illustration:

Jess begins a diet because she “feels fat (even though “fat” is not a feeling).

First, she scours the internet for “best diets,” “clean eating,” and “how to go keto.. She follows Influencers on Insta and TikTok for tips. She has no interest in doing anything else, and her moods are up and down. For the first time ever, she refuses to eat her favorite birthday cake (red velvet) on her birthday. 

All she thinks about is food. Her goals in life revolve around weight loss. She feels happiest when the scale indicates weight loss. But the happiness is short- lived and quickly replaced by anxiety about how to keep losing weight. 

She feels “in control” and “out of control” at the same time.

What are behavioral signs and symptoms of eating disorders?

• excessive exercise, including exercising despite injury or illness
• dieting/starving
• binge eating
• self-induced vomiting
• laxative, diuretic, and/or diet pill abuse
• food-chewing and -spitting
• hiding food
• having an artificially low body weight
• impulsive or irregular eating habits
• refusal to eat certain foods or categories of food (e.g. no fats, no dairy, no sugar)
• food rituals (e.g. excessively cutting food, foods cannot touch)
• skipping meals or eating tiny portions
• suddenly becoming vegan
• withdrawal from friends, activities
• frequent mirror-checking
• using the scale multiple times each day and allowing the  number to determine the direction of the day.

Example:

After she weighs herself, Megan starts her day with a strict exercise routine. She has lots of rules she has made up that she has to follow in order to “earn” any food. Recently she declared she is vegan.

In response to dieting and excessive exercising, she binge eats 2x/week. The food she binges on is food she won’t otherwise allow herself to eat. 

Binge eating is secretive, rapid, and a source of shame. It is followed by a promise to herself that she will never do that again and will instead “try harder” to stick with fanatical exercise and extreme dieting. 

She constantly checks her stomach size in the mirror and by grabbing it to see how much flesh is there. Hanging out and chilling with friends no longer interests her. She doesn’t seem to care that so many people are concerned about her.

What are physical signs and symptoms of eating disorders?

• major/rapid weight fluctuations in either direction
• gastrointestinal complaints (e.g. constipation, acid reflux)
• menstrual irregularities (missing periods or having a period only on birth control, which isn’t a “true” period)
• difficulty concentrating
• abnormal laboratory results (anemia, low potassium, low white and red blood cell counts)
• dizziness, especially upon standing
• fainting
• 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, discoloration, and tooth sensitivity
• dry skin and hair and brittle nails
• swelling around salivary glands
• fine hair on body (lanugo)
• muscle weakness
• poor wound healing
• decreased immune functioning
• irregular ekg

Example:

At his recent physical, Sam’s doctor told Sam his pulse and body temperature are abnormally low. His PCP also told him he is “x” number of pounds lighter than he was a year ago. 

Sam reports sleeping poorly, despite feeling tired most of the time and dizzy when he goes from sitting to standing. He also complains of burning in his throat from acid reflux. 

The doctor’s visual impression of Sam is that he looks gaunt and has an empty look in his sunken eyes. She orders a blood draw and ekg.

The doctor is well aware that ‘even’ people with serious eating disorder symptoms often have normal labs. She also knows negative lab results don’t mean they “are “fine” or that their symptoms are benign.

There are several different types of eating disorders.

These include:

anorexia nervosa; bulimia nervosa, binge eating disorder, and other specified feeding or eating disorder (OSFED). Others include avoidant restrictive food intake disorder (ARFID), pica and rumination disorder.

You can’t tell from looking at someone if they have an eating disorder.

People showing signs and symptoms of eating disorders need professional help. 

There are many approaches to treatment. It’s definitely not a one-size-fits-all.

Because there’s no singular approach that is ideal for everyone, finding what’s best-suited for each person is the way to go.

It all starts with recognizing the signs and symptoms of eating disorders and not being afraid to acknowledge them. 

You just might save a life.

Dr. Elayne Daniels is an international coach and psychologist specializing in eating disorders, body image, and High Sensitivity. She is anti-diet, Intuitive Eating certified and passionately believes comfort in your body at any size is your birthright.  Contact her here for more information.

Contact her here to learn more. And, if you’re struggling with overcoming an eating disorder, this e-book might be useful.