Hidden Signs of an Eating Disorder

Eating disorders have the highest mortality rate of any mental illness. The earlier an eating disorder is detected and treated, the better the chances for a successful recovery. To mark National Eating Disorders Awareness Week, we're highlighting hidden signs of eating disorders to encourage you or a loved one to seek help sooner.

Emotional and behavioral signs of eating disorders

In general, most emotional and behavioral warning signs of eating disorders involve actions or attitudes about dieting and control of food. People with an eating disorder may exhibit one or many of the following signs.

Obsessing over weight, dieting and calories

A common behavior of  people suffering from eating disorders is switching to overly restrictive diets, with some sufferers eliminating whole categories of food. A person may also change diets frequently to try to achieve results more quickly. Obsession over weight might also lead to frequent checking in the mirror for flaws in appearance and extreme concern with body size and shape.

Uncomfortable around others and food

Some people with an eating disorder are uncomfortable when eating around others. They may also skip meals or take only small portions of food at mealtimes. Other food rituals, such as cutting food into small pieces, excessive chewing or using a lot of condiments can also signal an eating disorder. Some sufferers may withdraw from friends and activities altogether when food is involved.

Changes in mood

Look for an extreme change in mood. This can include random mood swings, difficulty concentrating and restlessness.

Physical signs of eating disorders

Aside from the obvious fluctuations in weight, both up and down, there are more subtle physical signs that may accompany eating disorders.

Stomach and throat issues

Stomach cramps and other non-specific gastrointestinal complaints may be common. This includes constipation and acid reflux. Other issues like menstrual irregularities may arise.

General weakness

Common signs of weakness from lack of nourishment are common with eating disorders. These includes dizziness, fainting and muscle weakness. Impaired immune functioning, anemia and other nutrient deficiency symptoms are also common.

Dental and skin issues

Dental problems, such as enamel erosion, cavities and tooth sensitivity are common. Dry skin and hair and brittle nails may also be present.

Diagnosing common eating disorders

Diagnosing an eating disorder can be difficult because people battle this mental illness in many ways. But there are some eating disorders that are more common. These are bulimia nervosa, anorexia nervosa, binge eating disorder (BED) and other specified feeding or eating disorder (OSFED).

Signs of bulimia nervosa

Not everyone with an eating disorder appears to be too thin. Most people with bulimia maintain a normal body weight or are just slightly overweight, which is why it is often easy for people with this condition to hide their symptoms.

Most people with bulimia eat a very large amount of food at one time, which is known as “binge eating.” They frequently try to get rid of calories by vomiting, fasting or not eating for long periods of time. Others abuse laxatives because they mistakenly believe laxatives will push calories out before they are absorbed, or over-exercise to counteract the bingeing. Keep an eye out for the following signs of bulimia.

• Losing control around food
• Frequent trips to the bathroom after meals
• Scars or calluses on hands and knuckles from using fingers to vomit
• Hiding food or empty wrappers
• Dental and esophagus issues from stomach acid

Signs of anorexia nervosa

Anorexia is a little easier to diagnose as the signs of dramatic weight loss are more noticeable. Some people who suffer from anorexia have extreme body issues and frequently comment about feeling fat, often weigh themselves and obsessively check their body in the mirror. Here are more signs.

• Dressing in layers to hide weight loss or stay warm
• Resisting or being unable to maintain a body weight appropriate for their age, height and build
• Maintaining an excessive, rigid exercise regime – despite the weather, fatigue, illness or injury
• Chewing a lot of gum or drinking large amounts of water, coffee, diet soda or calorie-free beverages.
• Denying that there is a problem despite weight loss

Binge eating disorder (BED)

People suffering from binge eating disorder have secret recurring episodes of eating an amount of food that is much larger than most individuals would eat under similar circumstances. Although most binge eating is done when they are alone, there are some signs you can spot.

• Eating when they aren’t hungry
• Eating to control emotions
• Losing control while eating
• Hiding food or empty wrappers
• Others noticing food disappearing rapidly
• Hoarding food in hiding spaces
• Displaying feelings of disgust, depression or guilt after overeating
• Feelings of low self-esteem

Other specified feeding or eating disorder (OSFED)

Because OSFED encompasses a wide variety of eating disorder behaviors, any or all the following symptoms may be present in people with OSFED.

• Frequent episodes of consuming a very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting
• Self-esteem overly related to body image.
• Extreme dieting behavior or expressing a need to “burn off” calories after eating
• Evidence of purging behaviors, including frequent trips to the bathroom after meals or packages of laxatives

How to approach a loved one about an eating disorder

The first step in approaching a friend or loved one you may think is struggling with an eating disorder is to do your research. The more you are educated and understand the behavioral signs of the eating disorder, the better the conversation will go.

Approach the issue naturally, without discussing weight loss. For example, mention something about having a happy relationship with your body and food. Having this discussion in a place where it makes sense, like the gym or out at lunch, will make the conversation more natural.

Most importantly, don’t be the therapist – encourage them to seek professional help. Again, the sooner the issue is detected and treated, the better the chance for recovery.

The last week of February is Eating Disorders Awareness Week, which makes it a good time for you to take a mental health screening, or to share this link with others in your life. You might not know who could be silently struggling with disordered eating.  To take a free, anonymous, online screening and for free information and resources:  http://screening.mentalhealthscreening.org/integris.