Signs & Symptoms of Eating Disorders

Approximately 30 million people in the United States suffer from some type of eating disorder, but there are even more who are dealing with disordered eating that doesn’t quite qualify for an official diagnosis. These unofficial issues can still have an extreme impact on a person’s daily life. The signs of an eating disorder can be difficult to catch because those who deal with these diseases are notoriously good at covering them up. However, understanding what the common eating disorder traits are and how they vary by disorder can help you recognize these serious diseases in yourself or a loved one.

The Effects of Eating Disorders and How They Begin to Manifest

Eating disorders usually start slowly and are often the result of a legitimate attempt to eat healthier that goes to the extreme. For example, someone might actually be 10 pounds overweight and start tracking their food in an attempt to make healthier choices — like water instead of soda — but 6 months later they’ve lost 35 pounds and are eating less than 1,000 calories a day. Because of the slow build up, it can be difficult to tell what’s an attempt at healthy change and what’s a legitimate mental health issue, and it’s important to be aware of some of the common early signs.

Early Eating Disorder Traits

When many people think of eating disorder traits, they picture someone who is very thin and refuses to eat, but this isn’t always accurate. Especially in the beginning stages, eating disorders can look very different from the stereotypes. Many eating disorders are also rooted in a feeling of being out of control instead of necessarily being centered around weight loss, so the early signs can often reflect this. Some common things to watch out for include:

• Obsessively tracking food and nutrition content: Keeping a food log can be a healthy habit, but if someone refuses to eat something because they can’t track it or their calories might be a little off, that’s a sign of a deeper issue.
• Being overly focused on appearance and weight: This includes their own or others’ weight gain or loss.
• Working out excessively: If someone is working out for hours a day, missing out on sleep, work or social activities or becomes very anxious and upset if they can’t work out, this could indicate a problem.
• Not enjoying previous activities or social groups: Food, weight, and exercise become the most important things to someone with an eating disorder, and focusing on these can start to edge out previously enjoyed hobbies and relationships.
• Falling behind on work or in school: Eating disorders can make it difficult to focus due to lack of proper nutrition and sleep.
• A change in clothing tastes: Those with eating disorders will often try to hide their bodies under big, baggy clothes.

If you start to notice any of these early eating disorder traits, it’s important to seek help because eating disorders are extremely serious and can result in permanent damage to the organs and even death.

Recognizing the Signs of an Eating Disorder

It’s often much easier to recognize the signs of an eating disorder in someone else. We can be more objective about whether their behaviors and relationships with food are healthy, and in the case of loved ones, we are able to compare their current state to how we knew them to behave and interact with people and food prior to the changes.

However, recognizing an eating disorder in yourself can be much more difficult. By the time you realize that there’s a problem, it’s often gotten to the point of affecting you physically, such as with very low energy levels, difficulty sleeping and missed menstrual periods. And while eating disorders have very physical effects, they are classified as a mental health issue for a reason. Once your brain becomes set into that way of dealing with food and weight, it can be terrifying to even begin to think about changing paths or trying to get healthy.

An important note:

Extreme changes in weight can also be caused by other things, which means it’s important to talk to a healthcare professional to rule out an underlying physical issue. It’s common for people to assume that someone who is very thin has an eating disorder, but this could also be the product of a thyroid issue, hormonal imbalance or even a drug problem.

Different Types of Eating Disorders

There are several types of eating disorders, and each one manifests in a different way and has different characteristics required for diagnosis. While this is not an exhaustive list, below are some of the most common eating disorders and common identifying signs.

Anorexia

Anorexia, formally known as anorexia nervosa, is perhaps the most commonly recognized eating disorder and is characterized by extreme weight loss and a refusal to eat normal amounts of food. It is also one of the most serious with the highest fatality rate. To be diagnosed with anorexia, a person must:

• Be restricting food to the point of being significantly underweight for their sex, age and body type. In some cases, a BMI of less than 19 is used to help determine this, but this is not an overall clinical standard.
• Extreme anxiety and fear of being overweight or gaining weight
• A misperception of body weight and size — such as thinking they are overweight or large while still being very underweight — and/or being in denial about their weight loss being an issue

Bulimia

Bulimia nervosa is characterized by sessions of extreme overeating (called bingeing) followed by purging that food, which can be done either through inducing vomiting or through the use of laxatives. Bulimia can be a more difficult eating disorder to catch because many people suffering from it are of normal weight or can even be slightly overweight. The diagnostic criteria for bulimia nervosa are:

• Experiencing recurring episodes of binge eating, which is usually defined as a 2-hour or less period where the person eats a more than normal amount of food and feels out of control while eating
• Engaging in behaviors to compensate for the binge eating, including but not limited to vomiting, excessive exercise, laxative use, and fasting
• The binge/purge episodes must be occurring at least once a week for three months
• Excessive focus on weight and appearance

Binge-Eating Disorder

Binge-eating disorder, sometimes referred to as compulsive overeating, involves the same binge-eating sessions as described in the bulimia section but doesn’t involve purging behaviors. The bingeing episodes must average once a week for three months and not be related to bulimia or anorexia.

Other Specified Feeding or Eating Disorder

Previously called EDNOS (eating disorder not otherwise specified), other specified feeding or eating disorder (OSFED) is any problematic eating behaviors that have an impact on the person’s mental health and quality of life but don’t meet the diagnostic criteria for any other eating disorder listed in the DSM-V.

Diagnosing Eating Disorders

While it’s possible to look at a list of criteria and see that you meet the standards for an eating disorder diagnosis, you do need to actually be diagnosed by a mental health professional in order to move forward with formal treatment. Eating disorders can also overlap to a degree, such as anorexia that includes episodes of bingeing and purging. Eating disorders can also be co-occurring with other issues such as depression, anxiety and self-harm. In these cases, a treatment plan needs to be developed to deal with all of the issues and not just the eating disorder.