Spotting these signs can be significant, as anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders can be dangerous and detrimental to someone’s health, especially over time.
Learning about the warning signs can help you make an early intervention, getting you or a loved one crucial help before it’s too late.
What Are Signs of an Eating Disorder?
Spotting an eating disorder isn’t always easy. Many people who struggle with these conditions are in denial of their problem, or they may take measures to intentionally hide any outward signs of what’s going on.
It’s also important to remember that developing eating disorders can happen to anyone, at any age, of any gender, race, weight, or body type, at any time.
With that said, there are some signs and symptoms people with eating disorders often showcase, intentionally or not, that signal an issue may be developing.
Behavioral and Emotional Signs of an Eating Disorder
Eating disorders are, above all else, mental health conditions. They develop from a complex interplay of genetic, biological, and environmental factors that cause the brain to develop the unhelpful thinking patterns that ultimately drive the person’s unhelpful eating behaviors.
One of the most common signs of an eating disorder is a fixation on the subjects of:
- Food
- Eating
- Body weight
- Shape and size
- Nutrition
- Exercise
Unfortunately, in a society that is likewise enamored with diet culture, determining whether an eating disorder drives these fixations or not can be tricky.
Other common emotional and behavioral signs of an eating disorder include:6
- An intense fear of gaining weight
- Strange food rituals, such as eating foods in certain orders, cutting food into tiny pieces, or only taking tiny bites of food
- Extreme picky eating, based on a food’s texture, taste, nutritional information, or other otherwise arbitrary measures
- Excessive exercise, even in cases of injury or exhaustion
- Avoiding mealtimes or not eating with others
- Hiding or hoarding food or eating in secret
- A preoccupation with diets, especially fad diets
- Mood swings, irritability, or always feeling tired
- Hypercriticism of other people’s body shapes
- A general rigidity in behaviors or routines or the inability or struggle to change
In nearly every case, someone struggling with an eating disorder will simultaneously struggle with chronically low self-esteem. Some researchers have proposed that chronic low self-esteem may be a necessary prerequisite to developing an eating disorder of any type.2
Physical Signs of an Eating Disorder
Physical Signs of an Eating Disorder
Eating disorders are mental health disorders, but they all manifest as some type of unhelpful relationship to food and eating. Often, this has a consequence on someone’s physical health, which can lead to certain signs and symptoms, including:1
- Rapid weight changes, including weight loss or weight gain
- Menstrual irregularities in people with uteruses
- Dry skin
- Brittle nails
- Thinning hair
- The presence of fine hair around the body (lanugo)
- Scrapes or cuts on the hands or knuckles (often a sign of self-induced vomiting)
- Dental problems, including cavities, tooth sensitivity, and enamel erosion
- Muscle weakness
- Yellowing skin
- Frequently or easily feeling cold
- Swollen cheeks, a result of swollen salivary glands, sometimes called bulimia cheeks
- Gastrointestinal problems, including GERD, acid reflux, and constipation, among other issues
Eventually, the disordered eating behaviors associated with most common eating disorders can lead to chronic malnutrition, which can have more serious health consequences on the body, including:
- Chronic hormonal dysregulation
- Heart health problems, including arrhythmia and a higher risk of cardiac arrest
- Blood pressure issues
- Electrolyte imbalance
- Organ damage or organ failure
As someone’s physical health tends to get worse the longer an eating disorder goes on, it’s important to get someone care as soon as possible if you notice any of these signs.
Eating Disorders and Co-Occurring Conditions
It is also very common for someone struggling with an eating disorder to experience a co-morbid or co-occurring mental health condition. Research indicates that anywhere from 55% to 97% of people with an eating disorder are diagnosed with at least one other psychiatric disorder.3
55-97% of those with an eating disorder also have at least one other psychiatric disorder.
Some of the most common co-occurring psychiatric issues experienced by people with eating disorders of all types include post-traumatic stress disorder (PTSD), depression, a number of anxiety disorders, including obsessive-compulsive disorder (OCD), and suicide ideation (considering suicide).
Those struggling with anorexia are up to 31 times more likely to die by suicide.
Unfortunately, these compounding conditions can take their toll. Research suggests that the suicide rate among the eating disorder population is many times higher than that of the general population, with people struggling with BN 7.5 times more likely to perish this way and people struggling with AN up to 31 times more likely to die by suicide.3
Co-Occurring Physical Conditions
Several physical health complications also commonly co-occur with eating disorders. However, more research is needed in this area to fully explain and understand some of the specifics of these connections.
Among the conditions more commonly found in people with eating disorders are diabetes, hypotension, gastrointestinal problems, headaches and migraines, and menstrual problems.4
Still, it’s important to note that these physical conditions may occur in all types of people for all types of reasons and shouldn’t necessarily be considered a sure sign that someone is struggling with an eating disorder.
How to Talk to Someone About Their Eating Disorder
If you or a loved one are struggling with an eating disorder, it’s important to seek help as soon as possible.
This can be a particularly difficult topic to broach when speaking with a loved one. If your approach comes off as too aggressive or judgmental, you risk damaging your relationship or further alienating the person from the people who may want to help.
Still, there are a few steps that can make this process easier.
The first step you should take when considering talking to someone about getting treated is to research eating disorders and eating disorder recovery thoroughly. Put aside what you think these conditions are like and read what reputable medical experts say.
There are a variety of good medical resources on this topic aimed at helping non-experts broach this difficult topic with people they care about.5
And remember: The goal of bringing up this subject should be getting your loved one help.
Since most people are not trained mental health professionals, it can be difficult to know what to say or not say to best reach your loved one. But one thing that will nearly always help is to be supportive.
When talking to your loved one, use active listening—focus on what the person is saying instead of thinking about what you want to say next. Try to refrain from making snap judgments, offering too much unsolicited advice, or criticizing them.
Take a thoughtful pause if you feel a negative emotion arising, like criticism, disgust, or anger. Tell them you need time to think about what they have said instead of reacting out of emotion.
Remember that their self-esteem is likely very low, and they’re most likely already hurting on an emotional and physical level.
Try to organically bring up how much they mean to you and various things you find valuable about them. At the same time, don’t patronize them. Talking from your heart will likely always lead you in a good direction.
On top of researching what eating disorders are like, it may also be helpful to research potential sources of help or treatment ahead of time. This way, if your loved one feels ready to explore the option further, you’ll already know which direction to go.
Try to remember that this will likely be a long process. Your loved one may feel defensive when approached, lash out, or shut down completely. Try to remain hopeful and supportive. It may take time, but through a caring and concerted effort, you can help your loved one get the treatment they need.
Resources
- Eating Disorders. (2023, January). National Institute of Mental Health. Retrieved February 12, 2023.
- Silverstone PH. (1992). Is chronic low self-esteem the cause of eating disorders? Medical Hypotheses, 39(4):311–315.
- Co-Occurring Conditions. (n.d.). National Eating Disorders Collaboration. Retrieved February 12, 2023.
- Santonicola A, Gagliardi M, Guarino MPL, Siniscalchi M, Ciacci C, & Iovino P. (2019). Eating Disorders and Gastrointestinal Diseases. Nutrients; 11(12):3038.
- How to Help Someone With an Eating Disorder. (2020, July 14). UK NHS. Retrieved February 12, 2023.
- Emotional and Behavioral Signs of an Eating Disorder. (2022). National Eating Disorders Association. Accessed March 2023.