Dr. Elayne Daniels

Diagnosing an eating disorder is hard. Symptoms are hidden, by design. And you can’t tell just by looking at someone if they have an eating disorder. So then how do you know if someone has an eating disorder? For that matter, how can you tell if you have an eating disorder?

Let’s be honest. Denial is common, even to oneself. Many eating disorder signs aren’t obvious. And those that are obvious are easy to conceal. 

It doesn’t help that caloric restriction, dieting, and overexercising are considered normal. (Thanks, Diet Culture.) But they’re not normal. 

Common, but not normal.

Distinguishing between thoughts and behaviors that are “normal” versus symptomatic of an eating disorder is super tricky.

In fact, sometimes behaviors that are bona fide eating disorder symptoms are exactly the same as behaviors “recommended” (by the medical profession and others) for “weight loss/health”. 

Concepts like “healthy lifestyle” are often just Diet Culture in disguise.

If you are all “rah rah shish boom ba” about your disciplined, healthy lifestyle, would you even know how to tell if you have an eating disorder?

Making an accurate eating disorder diagnosis can be complicated.

It’s especially difficult to tell if you have an eating disorder when you live in Diet Culture (as all of us do).

Medical schools rarely teach anything on the topic. And that makes getting an accurate diagnosis and expert guidance all the more difficult.

What is Diet Culture, anyway?

Diet Culture is a system of cultural beliefs that worships thinness and equates weight with morality. It’s more than being on a constant diet. 

Clear messages from Diet Culture dictate how we should eat and look. Certain foods are “good” and others are “bad”, as if food has a moral quality. 

Pursuing weight loss, i.e. dieting, is a way to attain higher status. 

You don’t have to be on a “diet” to be affected by Diet Culture.

Because it’s all around us, Diet Culture is difficult to avoid. It’s in the air we breathe and in the spaces where we work, play, and live. 

We naturally internalize Diet Culture messages, such as believing we must lose weight or be a certain size and shape to be attractive and successful. 

Diet Culture is dangerous and harms people of all sizes, sexes, and ages.

Internalizing Diet Culture messages is harmful and can set the stage for an eating disorder.

Just sign onto Instagram or TikTok to see what I’m talking about. You’ll be hit with a sea of dangerous content about diets, exercise, and weight-loss rules. 

Just think about the popularity of the “what I eat in a day” posts.

Clear messages from Diet Culture promote harmful behaviors such as dietary restriction, purging, and cutting out entire food groups in pursuit of the so-called “ideal” body.

Those behaviors happen to be exactly what eating disorder behaviors look like.

Diet Culture is very sneaky. One of its most popular myths is that thinness and health are one and the same. They’re not.

Being aware of the features of Diet Culture AND eating disorder warning signs is a two-fold step in the right direction.

Thanks to Diet Culture, we often believe we don’t have value unless we have an “ideal” body — thin for women and muscular for men. 

If our bodies don’t meet the impossible Diet Culture standards, which most of us will not, shame and guilt often follow. 

The shame cycle can be difficult  to recognize, easy to blame on oneself, and a source of stuckness. 

It can also be the sign of an eating disorder.

Is disordered eating the same as an eating disorder?

No, disordered eating isn’t the same thing as an eating disorder, at least from a technical perspective. 

Disordered eating refers to a type of eating that’s detrimental and often driven by body dissatisfaction. 

It includes binge eating, smoking, fasting, dieting, eating according to self-imposed or external rules, and distorted thoughts about one’s worth. 

Disordered eating isn’t a diagnosis, but a description of a person’s pattern of eating rampant in Diet Culture.

In my opinion, disordered eating is more often than not the norm. 

And, in my opinion, the norm of disordered eating can be very difficult to distinguish from an eating disorder.

These behaviors can be a symptom of an eating disorder or they can increase the risk that someone will develop an eating disorder. 

But they do not necessarily constitute an eating disorder in and of themselves. 

Disordered eating increases the risk of developing an eating disorder. And disordered eating is a direct result of internalizing Diet Culture rhetoric.

Here are some classic eating disorder themes:

  • Defining your value solely on your body size/shape and/or on how minimally you ate today.
  • Having rigid rules about what and when you’re allowed to eat.
  • Believing your body size and shape is the most important thing that defines your worth.
  • Developing unusual rituals around food and body image.
  • Being secretive about eating.
  • Lying about your intake and/or exercise.

What to do?

Rejecting Diet Culture requires a lot of unlearning. We’ve all been exposed to this messaging for our entire lives.

Messages promoting restriction and deprivation are just about everywhere, despite the fact that dieting is a risk factor for developing eating disorders.

Dieting, especially with the intent to lose weight, is ineffective at leading to sustained weight loss. It can, however, easily lead to disordered and all-consuming behaviors.

Stop dieting. Consider learning instead about Intuitive Eating.

If you’ve been dieting and it has become an obsession, you may wonder if you are starting to show signs of an eating disorder.

There are online screening tools that will show you how to tell if you have an eating disorder.

Here are some other common indicators that you might be on your way to developing a full-blown eating disorder.

While dieting increases the risk of developing an eating disorder, people develop eating disorders for additional reasons. 

Trauma, other mental health conditions like anxiety and depression, bullying, food insecurity, stress, physical illness, and many other factors can also contribute.

Eating disorder signs

Here are some possible indicators of an eating disorder:

  • Obsessing about calorie and/or nutritional content in food.
  • Focusing primarily on weight and control of food intake, to the point that other areas of life, such as socializing, fall by the wayside.
  • Being extremely concerned about weight or body size and frequently checking the mirror.
  • Restricting entire groups of food or restricting more foods over time.
  • Experiencing intense mood swings.
  • Withdrawing from family, friends, or usual activities because of a fixation on weight and food control. 
  • Continuing to engage in disordered eating behaviors, even when it causes health problems, life disruption, or extreme distress. 
  • Physical symptoms like dizziness, muscle weakness, dry skin, and constantly feeling cold.

There are various eating disorder diagnoses. What they have in common is the focus on dieting and body shape and how this hyper-focus leads to huge distress. 

Sufferers continue to engage in unhealthy behaviors, even when doing so makes daily life difficult and leads to significant consequences, such as health problems or social isolation.

Some people become aware of their eating disorder when they realize they feel out of control, unable to stop their behaviors, and significantly derailed from other aspects of life. 

The glory of thinness or of weighing a certain number of pounds ends up not having the benefits Diet Culture promised.

No one starts dieting with the intention of developing an eating disorder.

But, if you’re afraid your dieting has turned into an eating disorder, what’s the most important thing to do? Get help!

If you would like to speak with someone about your eating disorder concerns, contact the NEDA helpline.

If you show signs and symptoms of an eating disorder, you could also reach out to your doctor, parents, or other professional who can help evaluate your symptoms and recommend care.

Seeking help now can prevent dieting behavior and body dissatisfaction from becoming an eating disorder down the road.

Having an eating disorder is no fun. I’ve never ever heard anyone say they regret seeking treatment for an eating disorder. 

I have, however, heard people say they wish they had gotten help for an eating disorder sooner.

Dr Elayne Daniels is an international coach and private-practice psychologist and consultant. Areas of expertise include eating disorder recovery, body image, and helping Highly Sensitive People thrive. 

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