Our families and friends, our brothers and sisters, moms and dads, best friends and roommates – they mean everything. We’re always looking out for them. However, it’s not always easy to look for them if we don’t know what to look for. The signs and symptoms of eating disorders don’t always fall into the stereotypes or expected tropes we’re used to. Sometimes those symptoms are less obvious, and easier for your loved one to hide.
Like any mental health disorder, you can’t simply look at someone and immediately know they have an eating disorder. There are certainly some physical changes that are associated with eating disorders like anorexia nervosa or binge eating disorder, but these are not hard and fast rules. As an example, the usual perception of a person with anorexia nervosa is of a person who’s lost a lot of weight, is extremely thin, and malnourished. However, anorexia nervosa sufferers aren’t necessarily underweight; it’s a series of behavioral criteria that determine the disorder.
Even if you’re close to someone who has an eating disorder, you might not be able to spot the more subtle signs and symptoms of their condition. Here’s we’re going to outline some of the common signs and symptoms of a variety of eating disorders, like anorexia nervosa, bulimia nervosa, binge eating disorder, ARFID, and more. Some of the behaviors will be specific to a single kind of eating disorder, and some will be shared by several kinds. If you are concerned about your loved one’s eating patterns but don’t know what to look for, check out these common signs and symptoms of eating disorders:
1. Physical Changes Can Happen
We don’t want to harp on the stereotypes of people with eating disorders; too often they are based on advanced cases of anorexia nervosa and disregard the noticeable physical consequences (or lack thereof) of other eating disorders. However, extended disordered behaviors can cause physical changes. As mentioned, people with anorexia nervosa do lose weight; they may become medically underweight or have difficulty maintain viable body weight. This isn’t guaranteed. In cases of atypical anorexia nervosa, the person might restrict food intake and still remain overweight or even obese. Other common eating disorders can cause weight loss, but that isn’t a part of the criteria for their diagnosis. Bulimia nervosa sufferers can be underweight but are just as likely to be of “normal” weight or overweight. Binge eating disorder, the most common form of eating disorder by far, does not denature the purging behaviors of bulimia nervosa or the restrictions of anorexia nervosa, and people with BED are often overweight.
If someone you care about suddenly loses lots of weight or has been severely underweight for a long time, it’s definitely an indicator that there could be a problem – but other, more behavioral signs are just as important.
2. They Only Wear Baggy or Heavy Clothes That Hide Their Body
There are two different reasons why a person with an eating disorder might only wear baggy clothes, both revolving around hiding the shape or size of their body. First, many people with eating disorders have a skewed and negative body image (formally called body dysmorphia) that makes them insecure about the way their body looks. Even if they are underweight, they will perceive themselves as fat or overweight. In these cases, they might wear baggy clothes to hide their irrationally perceived “big” body.
Another common cause, especially for people with anorexia nervosa, for wearing oversized or baggy clothes is to hide the results of disordered eating behaviors. People with eating disorders often feel guilty or ashamed about their eating behaviors and will make an effort to hide them from the people around them. If a person has become severely underweight, wearing baggy clothes will help them mask the weight loss, which may otherwise draw comments from others.
3. They’re Often Uncomfortable or Distracted During Meals
This symptom is common in almost every form of eating disorder. Over time, eating disorders interfere with the way a person eats at regular meals with family and friends. Often, the person with an eating disorder is publicly “on a diet” and feels pressure not to eat very much when around other people. This is very common in both bulimia nervosa and binge eating disorder, both of which feature regular private binge eating episodes as part of their diagnostic criteria. This discomfort might show up in the form of food rituals, such as cutting off certain parts of food and refusing to eat them (such as bread crusts or the fatty part of a steak), or refusing to eat different foods if they touch on the plate.
With eating disorders like ARFID (Avoidant Restrictive Food Intake Disorder), the cause of the food rituals and extremely “picky” eating is different. Instead of being a response to distorted body image and a need for control over some aspect of their lives, people with ARFID compulsively avoid certain foods and even entire food groups. Their “fear foods” might be avoided because the individual is worried (irrationally) about choking, getting food poisoning, or vomiting rather than because they fear gaining weight or losing control over their eating patterns. People with ARFID might be extremely uncomfortable at meals, especially if one of their feared foods is present.
4. They’re Always on a Diet
It’s a sad fact that in the United States at least, “diet culture” is pervasive and acceptable at every level of society. While being on a diet is not a certain sign of an eating disorder, almost everyone with one other three most common eating disorders (binge eating disorder, anorexia nervosa, and bulimia nervosa) experiments with various fad diets and is trying to lose weight. If someone close to you is always talking about their new diet / cleanse routine, especially if they also frequently complain about their weight or appearance, it’s a cause for concern. They may be crossing the line from “watching what they eat” to disordered eating behaviors.
Another indicator that there is a blooming eating disorder is when the individual is constantly on a diet but never seems to lose weight. For a person with binge eating disorder, dieting is the norm. They usually tell their friends and family they are on this or that diet and follow through in public. In private though, they repeatedly and frequently engage in binge eating episodes. These episodes consist of the person eating large amounts of food, past the point of being satiated or even eating so much it causes pain. Dieting influences these binge eating episodes as well, as the person is even hungrier due to not eating enough at regular meals.
5. There Is Evidence of Binge Eating Episodes or Hoarded Food
Both binge eating disorder and bulimia nervosa involve regular binge eating episodes; bulimia nervosa involves purging the food out of a sense of guilt and to avoid gaining weight, while binge eating disorder does not. In both cases, the food eaten is sugary, fatty, and salty “junk” foods like candy, chips, or pizza. One indication that a person might be engaging in binge eating episodes is evidence of binge eating episodes. If the person close to you is routinely binge eating, you might find mysterious pizza boxes, fast food wrappers, or other kinds of junk food wrappers in the trash, although the individual might surreptitiously throw them out without you knowing. You might also come across evidence of their favorite snack foods being hoarded or hidden for later binges.
In cases of bulimia nervosa, the binge eating episodes are followed by purging episodes, where the person removes the food eaten during the binge. Most commonly, this is done by self-induced vomiting (and the sounds of vomiting regularly are definitely a warning sign that someone has bulimia nervosa), there are other ways they might purge. Chief among these are abusing laxatives and diuretics. These cause the body to process and digest foods faster. A person with bulimia nervosa might buy lots of laxatives, or you might find their packaging in the trash as well.
You Can Help Your Loved One
As we’ve seen, the stereotypical signs of an eating disorder in the general population mostly revolve around a specific trope of what a person with advanced anorexia nervosa might look like. The fact is, eating disorders come in many forms, many shapes, and sizes, and you can’t rely on stereotypes to identify an eating disorder. However, if you care about the person you think might have developed disordered eating behaviors, you can’t just ignore these signs.
Eating disorders can be very detrimental to a person’s health – they can affect a person’s brain function, energy levels, endocrine system, cause anemia and diabetes, and increase the risk of other mental health disorders –and not to belabor the point, but eating disorders also cause more deaths than only other kind of mental health disorder. That’s why it’s important to be aware of these and other symptoms of eating disorders. If you spot them, you can begin to plan a way to get your family member or friend help.
That help might be professional eating disorder treatment at a residential or outpatient facility. It might be helping them plan meals and providing support once they’ve admitted to, attended, and graduation from those programs. Or it might even be something as simple as providing a listening ear. Many people with eating disorders find it hard to discuss them. If you’re educated about what they are going through, you might be able to help them find the courage to take the difficult first step to recovery – asking for help.