How you can tell if someone has an eating disorder

One of the many myths about eating disorders is that you can tell by looking at someone that they have an eating disorder; you cannot tell. Most people who have eating disorders may appear to be healthy, yet they are extremely ill. Unfortunately, in our weight-obsessed society we think someone must be emaciated to have an eating disorder. This is not true, and this belief keeps many who are suffering from reaching out for help.

Over 30 million people of all ages and gender suffer from eating disorders in the United States. Every 62 minutes someone dies because of their eating disorder. Eating disorders have the highest mortality rate of any mental illness. The research shows that early detection increases the chances of full recovery.

So, what are the signs and symptoms of someone with anorexia, bulimia and binge eating disorder? It is important to educate yourself so you can be aware and notice certain emotional, behavioral and physical signs. Here’s how you can tell if someone has an eating disorder:

Emotional and behavioral

• Behaviors that indicate weight loss, dieting, and control of food
• Preoccupation with body, weight, shape, and dieting
• Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, no fat, etc.)
• Has difficulty eating around others
• Engages in food rituals (e.g. excessive chewing, cutting food into small pieces)
• Skipping meals or taking small portions of food at regular meals
• Participate in fad diets
• Cut out whole food categories (such as carbohydrates)
• Isolation from usual friends and activities
• Frequent dieting and/or desire to lose weight
• Body checking for perceived flaws in appearance
• Extreme mood swings/emotion dysregulation

Physical 

• Weight fluctuations, both up and down
• 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)
• Difficulty concentrating and staying on task
• Abnormal lab findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)
• Dizziness
• Fainting
• Feeling cold all the time (especially hands and feet)
• Insomnia/trouble sleeping
• Cuts across the top of finger joints (a result of inducing purging)
• Dental problems, such as enamel erosion, cavities, and tooth sensitivity
• Dry flaky, skin and hair, and brittle nails
• Swelling around area of salivary glands (often called chipmunk cheeks)
• Fine hair on body (lanugo)
• Muscle fatigue
• Impaired immune functioning

Anorexia Nervosa

• Dramatic weight loss
• Dresses in layers (to stay warm and/or to hide body)
• Intense fear of gaining weight or becoming “fat”
• Preoccupation with body, weight, shape, calories, dieting
• Disturbance in the way in which one’s body weight or shape is experienced
• Makes frequent comments “I feel fat”
• Unable to maintain a body weight appropriate for their age, height, and build
• Maintains compulsive exercise regime – despite feeling tired, ill or injured

Bulimia Nervosa

• Evidence of binge eating, including disappearance of large amounts of food in short periods of time
• Evidence of empty wrappers and containers indicating consumption of large amounts of food
• Evidence of purging behaviors (frequent trips to the bathroom after meals, signs and/or smells and/or sounds of vomiting, putting on the shower/faucet to drown out sound, diuretics or laxative containers)
• A sense of lack of control of eating during the episode (cannot stop or control what one is eating)
• Self-evaluation is unduly influenced by body, weight and shape
• Drinks excessive amounts of water or non-or-low caloric beverages
• Uses large amounts of mouthwash, mints, and gum
• Has calluses or cuts on the back of the hands and knuckles from self- induced purging
• Swelling around salivary glands (often called chipmunk cheeks)
• Dental problems (enamel erosion, cavities, discoloration of teeth from vomiting, and tooth sensitivity)

Binge Eating disorder

• Binge eating (eating in a discrete period of time an amount of food that is much larger than most individuals would eat under similar circumstances
• Lack of control over the ability to stop eating
• Binge episodes are done in secrecy
• Feelings of disgust, guilt after eating, depression
• Feelings of low self-esteem
• Marked distress over binge eating
• Steal or hoards food in their bedroom, cars or other strange places
• Money may go missing to purchase food
• Creates schedules so the binge-eating rituals can take place
• Evidence of binge eating (disappearance of large amounts of foods in a short period of time, empty wrappers or empty containers indication consumption of large amounts
• The bingeing is not associated with the use of inappropriate compensatory behaviors (restricting, purging, compulsive exercise)

If you or someone you know is suffering from eating disorders or related behaviors do not hesitate to reach out to a professional counselor or therapist that specializes in helping those with eating disorders. This professional will help you to create a treatment team that consists of a therapist, psychiatrist, eating disorder coach, primary doctor, nutritionist, and medical doctor.

You can also contact the NEDA helpline at 1-800-931-2237. For crisis situations you can text “NEDA” to “741741.”

Contact Meredith O’Brien & Affiliates, LLC at 732-977-9729 or at mereditheob@gmail.com for help and guidance.

Full recovery is possible!