Recognizing an Eating Disorder
Recognize common emotional symptoms of eating disorders. Many individuals with disordered eating habits are excessively concerned with body size, weight, and appearance. Some common behavioral and emotional symptoms that someone with an eating disorder might have include: feeling depressed or anxious having a strong fear of gaining weight or of being “fat” desiring to withdraw from friends and family paying an unusual amount of attention to food and calorie intake having an intense fear of certain foods, like those containing sugar or fat steering clear of situations involving food denying issues with food or changes in weight attempting to purge after overeating by exercising, vomiting, or using laxatives weighing yourself every day
Notice symptoms of anorexia nervosa. People who suffer from anorexia are unwilling to stay at a healthy body weight. They are also quite frightened of gaining weight, and they see themselves as fat, even though they are thin or even underweight. A person with anorexia can starve the body for days, or eat a very strict diet of a low amount of calories each day. There is typically a sense of accomplishment in maintaining such strict guidelines. You may have very strict “rules” of eating, such as specific colors of food you avoid, times of day you refuse to eat, or strict caloric boundaries you observe. You may fear being fat or experience your body as fat, even if you are several pounds underweight. Even if you are extremely thin, you are never happy with your appearance and feel like you can always lose more weight to feel better about yourself. Ask yourself if your parents or friends have commented on your weight or weight loss. Ask yourself whether you base your personal value on your weight, clothing size, or what you eat.
Get clear on symptoms of bulimia nervosa. People who have bulimia will binge on a large amount of food and then purge to try to get rid of what they just consumed before it causes weight gain. While you know you want to avoid binge eating and gaining weight, you cannot seem to stop eating or having recurrent episodes of binge eating. Once the episode ends, you may find yourself desperate to get rid of any weight that may result from the binge. Efforts may include purging (vomiting), using laxatives, or diuretics. Even if you do not purge right after eating, you may still have bulimia if you tend to starve yourself for days following a binge, exercise more than usual, or follow another type of drastic diet to avoid gaining any weight. You may try to eat healthy and follow a healthy (or restrictive) diet for a while, but be overcome with tension or cravings and end up caving under pressure into a binge.
Recognize binge eating disorder. People who have binge eating disorder will eat large amounts of food in a short space of time and they feel like they cannot control themselves during these episodes. The binge is not pleasurable. While bingeing, you may feel lots of negative emotions. These feelings can continue after the binge is over as well. People who binge eat do not purge after a binge. People with binge eating disorder may feel depressed, disgusted, and guilty over their bingeing episodes. You may find that you have put on a lot of weight in a short amount of time if you binge eat.
Understand orthorexia. Orthorexia involves an obsession with only eating "healthy" food. People with orthorexia may or may not care about their weight or figure. They worry excessively about the purity and health of their food. This can look like: Compulsively checking food labels Cutting out large groups of foods (e.g. all sugar or all carbs) without medical reason Refusing to eat "unhealthy" or "impure" foods Obsessively following "healthy eating" and lifestyle pages on social media
Recognize Avoidant Restrictive Food Intake Disorder (ARFID). People with ARFID aren't battling cravings or fears of body image, but fear about food. They feel anxious about food or potential causes of eating (like choking). In some cases, ARFID resembles extreme "picky eating," in which the person will only eat certain "safe foods." Signs of ARFID include: Disinterest in eating Fear of vomiting or choking (in some cases) Significant anxiety about trying new food (in some cases) Refusing large groups of foods based on their texture, taste, smell, or color Weight loss and associated health issues Stunted growth in childrenDid you know? Many people with ARFID have co-occurring conditions. These can include OCD, sensory processing disorder (which is common in autism and ADHD), and depression. Treatment should include help for any sensory or mental health problems.
Recognize pica. Pica involves repeatedly eating things that aren't food and aren't nutritious. People may eat things like paper, ice, chalk, hair, leaves, rocks, string, and more. They generally have no issues eating regular food. Here's what you should know: Iron deficiency or malnutrition sometimes cause pica. A doctor can check for any deficiencies. Mouthing, and occasionally eating, objects is normal in children under 2. If you aren't sure whether it's a problem (e.g. eating ice cubes on occasion), ask your doctor.
Know that the label "Eating Disorder: Not Otherwise Specified" (EDNOS) is for other types of eating disorders. If you're struggling with a disorder that doesn't neatly fit into one of these categories, a doctor may diagnose you with EDNOS. Treatment will depend on your symptoms. If you suspect something is wrong with your eating habits, then that's worth exploring, even if you don't have a name for it. Make an appointment with your doctor and write down what's going on.
Addressing Psychological Factors
Explore feelings of control. Some people use anorexia or orthorexia as a way to stay in control and feel powerful. For those with bulimia, it is common to feel out of control and powerless. And those with binge eating disorder may also feel like they lack control over what they eat. If you feel like your life is out of control, you may turn to disordered eating to harness the feeling of control in your life, and feel accomplished when you “succeed’ in starving yourself. Ask yourself about your relationship with control and whether you are happy with it. Do you find yourself wanting more or less control in your life? Do you feel like you have enough control over your life, or do you take out that control on your food?
Identify feelings of shame about your behaviors. You may feel ashamed of your eating habits, especially if you binge eat. You may try to binge or purge in secret, or take food off your plate discreetly so that nobody will notice. While these behaviors try to cover up what you do, deeper within them may lurk shame for the lengths you will go in order to keep your eating disorder. If you find yourself feeling ashamed of your eating behaviors, then you may have symptoms of an eating disorder.
Consider your feelings about your body. People who do not like their bodies are more likely to develop an eating disorder. Not liking your body may include feeling fat, ugly, undesirable, or having shame or embarrassment about a specific part of your physical appearance, such as scars. These feelings may also be influenced by images of celebrities or the people that you see every day. You might feel like the only way to accept your body is by losing weight. You may think, “When I lose all the weight, I’ll finally be happy.” Reflect on your own beliefs about weight and body satisfaction and ask yourself if losing weight or “being skinny” is the only way to feel good about your body.
Reflect on your excuses. Do you find yourself hiding your habits? When asked about your eating choices, do you lie about why you’re not eating? What do you say when people comment about your weight fluctuation? If you find yourself making up excuses for your behaviors, you may have an eating disorder. Bending the truth may be one way for you to keep living with an eating disorder without anybody finding out. Do you find yourself making excuses for how you eat? What about finding ways to get out of meeting people for dinner or coffee?
Take a good look at yourself. This doesn’t necessarily mean go look in the mirror, but think about how you perceive your body. There are many ways to understand body image. For instance, you may perceive your body as overweight when it is actually underweight as measured by a medical doctor. Next, reflect on how you feel about your body: if you feel positive or negative about your body image, and how you see your general shape and ability. Your thoughts and behaviors also affect your body image, such as having thoughts of “I’m too fat” and then isolating yourself due to how you perceive your body. Think about the ways you perceive your body and ask yourself whether you see yourself accurately. Ask yourself how you perceive your flaws and if it’s okay to have flaws.
Notice if someone is influencing you. Sometimes, people's friends, romantic partners, or family members push unhealthy eating habits. This person may make negative comments about your body, criticize what you eat, or try to control whether and how much you eat. Identifying bad influences in your life can help you tease out what's happening. For example, if your boyfriend calls you names and criticizes what you eat, dumping him is a good first step towards a better life.
Dealing With Physical Symptoms
Know the risks of not eating enough. Restricted eating, such as in anorexia or ARFID, takes a major toll on the body. If you start noticing changes in your body’s functioning, you may be experiencing the effects of a restricted diet. Not only does restrictive cause dangerous weight loss, it also can have other negative side effects, such as: constipation or bloating damaged teeth and gums dry, yellow skin brittle nails headaches fainting, weakness, and dizziness bone density loss a layer of fine hair that grows all over the body and face (thicker than typical "peach fuzz") memory problems and sluggish thinking depression and moodiness not having a period
Notice the physical effects of excessive vomiting. People with bulimia tend to show some physical symptoms as a result of the disorder, especially those who purge (vomit). If you vomit after meals, you may experience the following: pain in your abdomen or bloating weight gain swollen hands or feet always having a sore throat or sounding hoarse having broken blood vessels in your eyes having sores in your mouth puffy cheeks (from vomiting) tooth decay due to acid from vomit having lots of stomach issues such as constipation, ulcers, and acid reflux
Observe changes related to binge eating. While the most obvious effect of overeating is obesity, other health risks can occur as a result of binge eating. In order to fully understand any health risks associated with binge eating, go to your medical physician and get some blood work. Changes to health and body related to binge eating can include: type 2 diabetes high cholesterol high blood pressure joint and muscle pain gastrointestinal problems sleep apnea heart disease some types of cancer
Getting Help
Contact a medical professional. Your eating disorder may have caused harm to your body, so it’s best to see a medical doctor and run some tests to assess your overall health. Follow up regularly with your medical physician when going through treatment for an eating disorder. Don’t be fooled into thinking eating disorders are not severe. Mortality rates related to untreated eating disorders are higher than any other mental disorder. An analysis of 35 studies showed that out of 12,800 people with anorexia, 639 (about half) died. An analysis of 12 studies showed that out of 2,585 people with bulimia, 57 died. And an analysis of six studies showed that out of 1,879 people with an eating disorder not otherwise specified, 59 died.
See a therapist. It’s really hard to let go of an eating disorder without help. Work with a trained therapist who specializes in treating eating disorders. A therapist may help you confront your relationship with food and your body, reframe negative thoughts, and work on self-worth issues with you. Family therapy can also be very helpful in treating eating disorders, as some issues relating to control and eating habits are passed down or experienced through the family. See a therapist as someone who is there to challenge and support you in your healing journey. For more information on how to find a therapist, check out How to Choose a Therapist.
Consider inpatient treatment. For more severe or life threatening eating disorders, you may consider inpatient treatment. Inpatient care has the benefit of monitoring mental, emotional, physical, and medical health in one location. Treatment is intense and acute, meaning problems around eating disorders are confronted daily. Inpatient care is best suited for people with more intense needs who cannot manage the eating disorder on their own. If you’ve become a master at hiding your eating disorder and making everything look “normal” in your life, yet still struggle to be emotionally or physically healthy, inpatient treatment may be a good option for you.
Support yourself. Out of everyone who helps you on your recovery, it’s most important for you to never give up on yourself. Believe in yourself and believe in your journey that you can make a full recovery. It may not seem possible to you now, but don’t give up. Many people have made full recovery from eating disorders, and you can, too. For more information, check out How to Treat an Eating Disorder.
Surround yourself with friends. You don't have to suffer your eating disorder on your own. Surround yourself with friends and family who want to see you succeed and see you happy. Avoid people in your life who make you feel bad about yourself, don't believe in you, or influence you to return to your eating disorder. You need time to recover, and recovery will be very difficult if you have those types of influences in your life.
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