How to Recognize the Signs and Symptoms of Eating Disorders
“I don’t think I’m sick enough to have an eating disorder.” That is often one of the first comments my clients will make when coming to see me about their struggle with food and body image concerns. It is so common, in fact, that Jennifer L. Gaudiani wrote the book Sick Enough: A Guide to the Medical Complications of Eating Disorders to help emphasize the impact of eating disorder behaviors for individuals who struggle to recognize their need for treatment. Unfortunately, due to stereotypical representations in the media, many signs and symptoms of eating disorders are overlooked. In this article, we will explore four of the different types of eating disorders and ways to reach out for help.
Anorexia Nervosa
Individuals with anorexia nervosa struggle with intense fear of weight gain. As a result, they engage in patterns of restricting behaviors. Restricting behaviors may involve calorie counting, avoiding certain foods and food groups, or only allowing a certain amount of food to be present on one’s plate. High levels of restriction result in a significantly low body weight. Individuals with anorexia may also struggle with high levels of body image distress caused by an inability to accurately perceive their body shape or size.
Common signs and symptoms of anorexia include:
Rapid weight loss
Preoccupation with food, calories, and body image
Avoidance of meals or certain food groups
Excessive exercise
Social withdrawal and isolation
Loss of menstrual periods (in biological females)
Bulimia Nervosa
Bulimia nervosa is characterized by a pattern of binge eating behaviors followed by a compensatory behavior. An episode of binge eating occurs when more food is consumed in a discrete period of time than most people would eat in a similar period of time or under similar circumstances (National Eating Disorder Association, 2023). A compensatory behavior is any behavior that is used to compensate for the amount of calories consumed during the binge. This may take the form of self-induced vomiting (also known as purging), laxative misuse, diuretics, enemas, fasting, and excessive exercise.
Common signs and symptoms of bulimia include:
Eating in secret or hiding and hoarding food
A feeling of being out of control during binges
Disappearing to the bathroom after finishing meals
Swollen salivary glands and dental problems
Irregular menstrual periods (in biological females)
Binge Eating Disorder
Binge eating disorder (BED) is characterized by recurrent episodes of eating significantly more food in one sitting than others would typically consume under similar circumstances. Typically, food is consumed quickly and to the point of discomfort often resulting in the individual feeling out of control and shameful. BED does not involve the use of compensatory behaviors (self-induced vomiting, laxatives, etc.) after the binge eating episode.
Common signs and symptoms of BED include:
Eating rapidly
Eating when not physically hungry
Eating in secret
Emotional distress including guilt, shame, embarrassment, and self-loathing related to the eating experience
Avoidant Restrictive Food Intake Disorder
Avoidant Restrictive Food Intake Disorder (ARFID) is a newer diagnosis that involves highly selective eating. Individuals with ARFID have a severely limited diet, similar to that of anorexia nervosa, however, it is not due to the desire to lose weight or manage body image distress. In children, ARFID can result in struggles to meet appropriate growth needs. ARFID behaviors are different from picky eating that may be seen in some children. ARFID can result in low body weight, impaired growth, and nutritional deficiencies in both children and adults.
Common signs and symptoms of ARFID include:
Limited food variety
Avoidance of certain food groups and textures
Only being willing to eat “safe” foods or specific textures
Fears of choking or vomiting
Anxiety or avoidance of unfamiliar foods
Weight loss or failure to thrive (in children)
According to Goodwin and Fazil (2014), eating disorders have the second highest mortality rate of all mental health disorders, surpassed only by opioid addiction. They affect all genders, ages, and backgrounds. Taking steps to receive help can be scary, but with the help of an effective treatment team, recovery is possible. The National Eating Disorder Association (NEDA) offers a free screening tool to help determine if it may be time to seek professional help. Below is a list of resources, including the screening tool, to help learn more about eating disorders and the recovery process.
Resources:
NEDA Eating Disorder Screening Tool
National Eating Disorder Association
ANAD
Project Heal
Sources
National Eating Disorders Association. (2018a, February 22). Avoidant Restrictive Food intake Disorder (ARFID).
National Eating Disorders Association. (2018, February 22). Binge eating disorder. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed
National Eating Disorders Association. (2018, February 22). Bulimia nervosa. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bulimia
National Eating Disorders Association. (2018, February 28). Anorexia nervosa. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia
National Eating Disorders Association. (2021, July 14). Statistics & Research on eating disorders. https://www.nationaleatingdisorders.org/statistics-research-eating-disorders