Eating disorders can look different across individuals and can look different within diagnoses. And while the stereotypical eating disorder patient is portrayed as incredibly thin, avoiding food, and over-exercising, eating disorders do not discriminate. They can take many forms.
By: Elizabeth Foot
If you think a loved one is struggling, consider the signs below before considering how you might approach them or look to support them.
This misconception that eating disorders look only one way is outdated. There is any number of diagnoses – all with characteristics that differ drastically. We’ve gone ahead and outlined a handful of eating disorder symptoms below. While eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder are included in the DSM-5, some diagnoses are not included in the DSM-5 (such as OSFED, orthorexia, and ARFID). These can still be incredibly serious. Disordered eating would also fall into this category. As defined by the National Alliance for Eating Disorders, the difference between disordered eating and eating disorders is that disordered eating “does not interfere with one’s ability to function, but may include irregular eating patterns along with judgment around food and/or body.”¹
What are Some Symptoms of an Eating Disorder?
Expressed Weight Concern
This can be direct comments (“I’ve gained so much weight”) or indirect comments or actions (“I feel so heavy,” or weighing themselves constantly) even when they do not look any different.
Increased Focus on Movement
This can look like a strict workout regime, cutting out rest days, or becoming anxious when a schedule change limits their ability to work out for that day.
Refusing to Eat With Others
Does your loved one now eat by themselves? Are they uncomfortable going out to a meal with others or eating in public? Do they let you make their meals, or do they only eat what they’ve made? Have they recently cut out an entire food group for no medical reason? Will they make meals for you but refuse to eat themselves?
A Decline in Mood and Energy
Do they seem to drag most days? Are they sleeping a lot more than what is normal for them? Are they more irritable?
Odd Routines Around Food
This can look like going to the bathroom or exercising after every meal. Other behaviors could include eating little at dinner and noticing that many leftovers (or other food stocks) are gone the next day.
Physiological Changes
If your loved one is someone who menstruates, have they missed their period for a handful of months but are not pregnant? Do they complain their hair is falling out or their nails are brittle? Have they mentioned increases in constipation, dehydration, or feeling faint?
This list of symptoms – especially the physiological changes – can look different across individuals, even if individuals share a diagnosis. Understanding the nuances between diagnosis criteria can help you know how to support your loved one and what the next steps might be when addressing the behaviors you’ve noticed.
An additional consideration is to recognize that while sudden weight loss can be a signal of anorexia nervosa, for individuals in larger bodies, this might be celebrated as weight loss. The idea that individuals in larger bodies do not suffer from eating disorders is a myth. These clients are at a higher risk of a missed diagnosis because of the weight bias and diet culture that exist so strongly in our society. If you know someone who fits this description, it can be imperative to validate their experience and help them advocate to doctors about their symptoms. Other symptoms or health outcomes to evaluate when assessing someone in a larger body for an eating disorder could be blood pressure, heart rate, food security status, restricted diet (e.g., veganism), loss of menstrual cycle, or self-reported food consumption to regulate emotions.²
While it can be overwhelming and scary, being there for a loved one struggling with an eating disorder is vital to their healing. Getting support for yourself and your loved one will help you to navigate the recovery process safely for everyone involved. Above all, begin by showing up for your loved one without judgment. Your genuine care and willingness to support them can make all the difference.
At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. BALANCE offers a bi-monthly free virtual support group open to individuals seeking help and to family and loved ones. The group provides a supportive forum within which members can explore issues, including ambivalence about engaging in treatment, recovery, resources, and treatment options, and knowing when and how to take the next steps toward making change. RSVP for our next group here.
Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below, or read more about our philosophy here.
This post was written by BALANCE Blog Contributor, Elizabeth Foot (she/her).
Elizabeth is currently pursuing her Master’s of Public Health in nutrition and dietetics from the University of Michigan, on track to become a registered dietician. Prior to returning to school, Elizabeth received her B.A. in Public Policy from Hamilton College in 2020.
Since graduating Hamilton, Elizabeth has worked for an infertility insurance company as a marketing associate, has volunteered with Multi-Service Eating Disorder Association (MEDA), and has advocated on Capitol Hill for expanding insurance coverage to registered dietitians as part of the Eating Disorders Coalition (EDC). Elizabeth is also a strong supporter of intuitive eating, HAES, and is excited to become a licensed practitioner working in the ED field. In her free time, Elizabeth can be found creating recipes, practicing yoga, or counting down the days until she can get a dog.
References
National Alliance for Eating Disorders. How to Know if You Have an Eating Disorder. 2021 Apr 22. https://www.allianceforeatingdisorders.com/8-signs-you-may-have-an-eating-disorder/?gclid=CjwKCAiAwomeBhBWEiwAM43YIFVQnT5IyqUr_G3YlP-bvTm-rj7XegYCcrRBCs2hhRKb_HVvcwSJ2BoCp6MQAvD_BwE.
Ralph, A.F., Brennan, L., Byrne, S. et al. Management of eating disorders for people with higher weight: clinical practice guideline. J Eat Disord 10, 121 (2022). https://doi.org/10.1186/s40337-022-00622-w.
