Recognizing the warning signs of an eating disorder

Eating disorders like anorexia nervosa, bulimia, binge eating disorder (BED), and orthorexia are serious, potentially life-threatening mental health conditions. They’re also common, affecting around nine percent of U.S. adults and 22% of children and teens worldwide. Left untreated, an eating disorder can significantly damage a person’s mental and physical well-being. However, through early detection and intervention, these negative effects can be minimized.

Eating disorder symptoms can be subtle and difficult to detect, especially in the beginning. But by learning to spot the early warning signs in yourself or others, you’ll know when to seek professional help.

How signs of an eating disorder can start subtly

Evidence of diet culture is all around us. From celebrity-endorsed diet-and-exercise routines to rampant #thinspo on social media, we’re surrounded by images of edited, idealized bodies. The pressure to achieve and maintain an unrealistic beauty standard can feel relentless, and, for some people, this can contribute to the onset of an eating disorder.

An eating disorder can start slowly, and it can be difficult to tell whether someone is trying to make healthier choices (i.e. cutting back on processed foods as suggested by their doctor) or engaging in disordered eating habits (i.e. cutting out entire food groups or severely restricting their caloric intake).

Understanding these subtle differences can help you identify the possible signs of an eating disorder in yourself and others.

Possible signs of an eating disorder to have on your radar

Occasionally forgoing breakfast or ordering a salad instead of a steak for dinner doesn’t necessarily mean someone has an eating disorder. But if a person exhibits an ongoing pattern of any of the following behaviors, it could signal that they’re living with an eating disorder and may need professional help.

• Fixating on preparing food, collecting recipes, or making meals for others but not actually eating the food themselves

• Skipping meals, eating alone or in secret, or refusing to eat in front of other people (i.e. in the cafeteria at work or school)

• Encouraging others to eat food they consider “off-limits” themselves

• Refusing to eat anything that doesn’t fit into their strict caloric limits or preferred “macros”

• Becoming highly interested in other people’s eating habits

• Developing rigid eating routines and becoming distressed whenever they’re asked to deviate from them (i.e. if they order their food with the sauce on the side and their server forgets the request, they won’t eat the meal)

• Spending less time with friends and family, instead preferring to spend time alone

• Having trouble regulating their mood or emotions

• Expressing dissatisfaction with their body or appearance

Why eating disorders may go unnoticed

There are many reasons why an eating disorder might go unnoticed. People can go to great lengths to conceal unhealthy behaviors from their loved ones, and changes can take place gradually.

Additionally, some disordered habits have become normalized in our culture. For example, most people will attempt to lose weight at some point in their lives. Going on a diet isn’t the same thing as having an eating disorder, but the difference isn’t always clear. We receive so many mixed messages about what it means to be healthy, and that can make eating disorders harder to detect.

Clinican's take

A subtle sign of an eating disorder that I have noticed with my clients is a negative self-view. It often comes out in their self-talk, how they view themselves in comparison to others, and is exacerbated by stress.

Ashley Ayala, LMFT

Clinical reviewer

What to do if you think you’ve spotted an eating disorder

If you suspect that you have an eating disorder, professional support is essential to your recovery. A therapist can help you address the underlying concerns that may be contributing to your eating disorder, learn new coping skills, and collaborate with your other providers (i.e. your doctor or nutritionist) to ensure you receive integrated care as you work to heal your mind and body.

And if you think a friend or family member might have an eating disorder, know there are things you can do to help. While it isn’t always easy to bring up sensitive topics, the following tips can help you prepare for these important conversations. Sharing your concerns with your loved one and offering support can help keep them safe and potentially save their life.

• Educate yourself. Learning more about the signs, symptoms, and causes of eating disorders can help you have a more informed conversation with your loved one. It can also help you better understand their experiences.

• Choose a time and place. Before speaking with your loved one, consider the environment. Find a private, quiet space where you won’t be interrupted and a time when neither of you will feel rushed.

• Expect resistance. If your loved one isn’t ready to talk about their eating habits or listen to your concerns, you can still offer support in a nonjudgmental way. Let them know that you’ll be there to listen when they’re ready to talk and you care about their safety. You can also ask them if it would be OK for you to check in again in a few days.

• Suggest professional help. If your loved one is open to it, suggest they meet with a therapist or enter an eating disorder treatment program. You can also offer to help them find a provider, transport them to and from appointments, or do anything else that would make it easier for them to access care.

• Be mindful of compassion fatigue. Watching someone you care about struggle with an eating disorder can be an emotionally draining experience. So, throughout this time, prioritize your own self-care to ensure you don’t experience compassion fatigue. Taking good care of yourself will give you more capacity to support your loved one.

Find care with Rula

With how eating disorders are portrayed in media, you might assume that the signs and symptoms are obvious. But in reality, disordered behavior often flies under the radar and can be difficult to detect — especially in the early stages.

Early detection and intervention are critical for promoting positive outcomes in eating disorder treatment. So if you think you might be living with an eating disorder, don’t hesitate to ask for help. A mental health professional can provide an accurate diagnosis and help ensure you get the eating disorder care you need to achieve recovery.

When you need support for an eating disorder or another mental health condition, we want to invite you to Rula. Our therapist-matching program makes it easy to find an in-network provider you can meet with from the comfort of home. In just a few minutes, you can sift through over 15,000 mental health professionals to find the right therapist or psychiatrist for your needs and make your first live video appointment for as soon as tomorrow.