Eating Disorder Symptoms: Signs Of Disordered Food Habits

If you are experiencing a crisis related to an eating disorder or would like further resources, contact the ANAD Eating Disorders Helpline at 1-888-375-7767 from Monday through Friday, 9 am to 9 pm CT.

If you suspect a loved one has an eating disorder, you may be at a loss as to how to proceed. You might worry that their health will worsen if you don't say anything. At the same time, you might question whether your suspicions are based on reality. In this case, looking at common signs of an eating disorder and how to help your loved ones find professional support can be helpful.

Understanding eating disorder symptoms 

The signs of an eating disorder will vary depending on the type of eating disorder and the person experiencing them. They might also vary depending on other mental health conditions the individual is diagnosed with, if any. 

However, general symptoms of eating disorders may include the following: 

• Binge eating large amounts of food in a short period

• Restricting food intake or severe dieting

• Excessive concern about body weight and shape

• Obsessive calorie counting, food rituals, and eating behaviors related to weight loss

• Eating in secret or hiding food

• Purging behaviors such as vomiting or laxative abuse

• Excessive exercise to compensate for food intake

• Distorted body image and dissatisfaction with one’s appearance

• Intense fear of gaining weight 

The signs of an eating disorder will also vary depending on what eating disorder(s) an individual experiences. Types of eating disorders include:

• Anorexia nervosa

• Bulimia nervosa

• Binge eating disorder

• Avoidant/restrictive food intake disorder (ARFID)

• Other specified feeding or eating disorders (OSFED)

• Orthorexia nervosa (obsession with healthy eating)

• Rumination disorder

• Pica (eating non-food items)

• Night eating syndrome

Support groups and early intervention for these complex mental health conditions can help the recovery process. Talk therapy, cognitive behavioral therapy, and other mental health options are available. 

An overview of eating disorders

The three most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. However, multiple eating disorders are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). 

Note that body weight is not necessarily an indicator of whether someone is struggling, as some people may be partaking in restrictive behaviors without losing or gaining weight. These behaviors can still be dangerous, so looking at behaviors instead of body type is often essential in recognizing an eating disorder.

Some people have a few symptoms of one or more eating disorders but not enough to meet the full diagnostic criteria. If someone has not been diagnosed or does not meet specific criteria, it may not mean they're not living with an eating disorder or aren't at risk of one. Early detection is often crucial to preventing the progression of a severe eating disorder.

Below are further explanations of the symptoms of some of the most common eating disorders in the US. 

Anorexia nervosa 

Anorexia nervosa occurs when a person severely restricts food intake and is obsessed with weight loss, counting calories, and checking their weight. Those with anorexia often have a distorted perception of their appearance. When they look in the mirror, they may believe they are overweight and could feel disgusted by their appearance. Regardless of their appearance, they may strive to lose as much weight as possible. 

Anorexia may not only involve a desire to be thin. It can also be seen in those who use food to control their circumstances or mental health. In some cases, eating habits may seem to be the only area of their life they believe they have control over. Perhaps they have perfectionist tendencies and find the ritual and routine of counting calories and controlling food intake comforting.

In many cases, anorexia goes unnoticed until it impacts someone's weight. However, early signs of the condition may include dizziness, fainting, or a bluish discoloration of the fingers. You might also notice that their hair is thin, falling out, or brittle. They may have an intolerance to cold or be more prone to dehydration. Behavioral signs of anorexia can include the following: 

• Attempting to control food intake and eating

• Insisting on eating alone

• Skipping meals and food-related activities such as barbecues or tailgating 

• Moving food around on their plate to make it seem like they ate

• Feeding food to their pets or throwing it away when no one is looking

• Drinking coffee or eating non-edible items to avoid hunger 

• Drinking a significant amount of water or soda 

• Hiding one's body with baggy clothing 

• Avoiding going to the beach or anywhere where they may be seen with less clothing 

Bulimia nervosa 

Bulimia nervosa is another serious eating disorder. This condition is marked by binging, followed closely by methods to "avoid weight gain." Purging, which is self-induced vomiting, is the most common way those with bulimia attempt to lose weight. Other methods may include obsessive exercising, laxatives or diuretics, and fasting for extended periods between binges. 

A significant indicator of bulimia is spending time in the bathroom after meals, usually within the hour directly following eating. Someone with bulimia may also binge eat. They might eat normally around others but binge and purge when they're alone. Bingeing and purging may occur at night or before taking a shower, as the noise of the shower can cover the sound of vomiting. 

Physical symptoms of bulimia are red, watery eyes and swelling in the face and throat due to forced vomiting. Dizzy spells, fainting, and dry skin are other symptoms due to dehydration from vomiting. A dentist may notice tooth decay and enamel erosion from the acid associated with frequent purging. If someone has been purging for a significant period, you may see scars on the backs of their hands from contact with teeth while purging. In addition, they might complain of a sore throat, depression, and mood swings. 

Bulimia is sometimes associated with swollen glands in the face or neck. Bloating, indigestion, and heartburn are other possible symptoms, and one's menstruation may not be regular if they are losing weight or nutrition. 

Binge eating disorder (BED) 

Binge eating disorder is a newer diagnosis added to the DSM-5. This condition may be diagnosed when someone binges on significant amounts of food within a short period. Individuals with BED do not purge or attempt to lose weight like they might with bulimia. After eating, the person might feel ashamed or guilty because of the amount of food consumed. They can also become depressed, which may lead to significant weight gain. 

Those with binge eating disorder may try to keep others from discovering their condition by eating secretly or avoiding socialization. For example, these individuals might eat in their cars or late at night when they are less likely to be disturbed. If you live with them, you may hear them getting food in the kitchen at night or see food kept in their room or hidden around the house. You may also notice food disappearing from the house more frequently.

If someone you know has a binge eating disorder, they might appear reluctant to eat around you. They may diet frequently or seem withdrawn and unwilling to engage in social activities. You might see them checking their appearance in the mirror frequently for real or perceived flaws or notice lifestyle rituals that allow them to binge eat. For instance, there might be a time of day when they often insist on being alone.

What to do if a loved one has eating disorder symptoms

If you believe one of your family members or loved ones is exhibiting the symptoms of an eating disorder, you may be concerned and want to help. Your first impulse may be to intervene or to stage an intervention. However, below are some suggestions to try first. 

Tread carefully

A single symptom does not constitute the existence of an eating disorder. For example, being thin or overweight does not automatically mean one is living with an eating disorder. Some people with an eating disorder are not thin or overweight, and many people gain weight before they lose weight when restricting food intake. 

If you strongly believe someone you know has an eating disorder, compare notes with those who know and care about them. If it's someone in your family, like a sibling, try talking to your parents. However, be cautious speaking to their friends or family members who might not be aware of their eating disorder, as outing their condition to someone unsafe may cause them more stress. 

If you have concluded that the person may be living with an eating disorder, ask them about the signs you've noticed, doing so with care. Regardless of their condition, it may be challenging for them to open up about a vulnerable topic. They may lie or deny having a condition, as many people with eating disorders may struggle to accept that they are living with a mental illness. 

Suggest professional support 

If you believe someone you love has an eating disorder, consider giving them support resources. For example, you might drive them to the doctor or therapy appointments. You can also help them find more flexible resources, such as online therapy, through a platform like BetterHelp.  

Seeking support for an eating disorder is often difficult. Some individuals with these disorders are ashamed of their behavior and may fear judgment, even from a mental healthcare professional. A clinical setting, like a therapist's office, sometimes makes the situation more intimidating. Online therapy may provide convenience since it can be reached from home or anywhere there's an internet connection. In addition, the individual can sign up with a nickname if they don't want to show their real name. 

Effectiveness of online therapy for eating disorder symptoms

Online therapy is effective when used to treat eating disorders. A recent study showed no significant difference between in-person and online treatment of bulimia in terms of effectiveness. Moreover, researchers found that individuals who underwent online therapy for this eating disorder were more likely to show continued improvement post-treatment than those who received in-person therapy.