Eating Disorders: Warning Signs and Symptoms

Young women's version of this guide
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You can’t tell whether a person is struggling with an eating disordered just by looking at them, but there are often warning signs. Warning signs or “red flags” might suggest that a teen may develop or already has an eating disorder. Below is a list of signs that are linked to certain types of eating disorders. A person who has an eating disorder may have one or more of these signs. These signs may also mean that a person has another kind of health condition, so it’s best to talk with a trusted adult about your concerns before jumping to any conclusions.

Red flags for Anorexia Nervosa:

  • Skips meals
  • Makes excuses not to eat
  • Over-exercises (makes exercise a top priority)(exercises too often, too strenuously or for too long)
  • Eats only “safe” foods (low calorie, low-fat)
  • Doesn’t eat certain food groups (ex. carbs, fats)
  • Has unusual behaviors around food (measuring food, cutting food into small pieces, always finding something wrong with food, pushing food around the plate)
  • Cooks or bakes food for others but doesn’t eat it
  • Watches food shows or visits food websites often
  • Obsessively reads nutrition information or counts calories
  • Constantly weighs themselves, or “body checks” (looks at their body in the mirror or feels their body with their hands)
  • Chews a lot of gum or drinks large amounts of water, coffee, diet soda, or calorie-free beverages
  • Denies that there is a problem despite weight loss

Red flags for Bulimia Nervosa:

  • Uses the bathroom after eating or in the middle of meals
  • Consumes unusually large amounts of food at one time
  • Loses control around food
  • Hides food or empty wrappers
  • Diets often
  • Food may be missing from cabinets at home or disappears rapidly

Red flags for Binge Eating Disorder:

  • Frequently eats very large amounts of food in one sitting
  • Loses control around food
  • Eats when not hungry
  • Eats alone
  • Eats as a way to control emotions
  • Hides food or empty wrappers
  • Others notice food disappearing rapidly
  • May hoard food

Anorexia Nervosa: Symptoms of anorexia can be hard to notice because people with this condition can be very good at hiding their eating disorder behaviors. They may take small bites, organize their food , or “pick” at food when they eat. They often avoid eating around others to hide their behavior or because it causes anxiety.

Some of the signs of anorexia nervosa are:

Physical:

  • Brittle nails
  • Constant tiredness
  • Constipation (trouble having regular and soft bowel movements)
  • Dehydration (not enough fluids in the body)
  • Dizziness
  • Dramatic weight loss
  • Dry skin
  • Extreme thinness
  • Growth of lanugo (soft furry hair) on face, back, and arms
  • Hair loss
  • Low blood pressure and irregular heartbeat
  • Orangey color to the skin
  • Paleness
  • Poor concentration
  • Sensitivity to cold
  • Slow heart rate
  • Slow or stunted growth
  • Swelling of legs, feet, or ankles
  • Weak bones (that can lead to fracture and osteoporosis)

Emotional:

  • Anxiety or nervousness
  • Denial of a problem
  • Depression
  • Distorted body image (believes their body looks different than it actual does)
  • Fear of weight gain
  • Irritability
  • Lack of emotion
  • Low self-esteem
  • Obsession with food
  • Perfectionism
  • Withdrawal from friends and activities

Bulimia Nervosa: Most of the time, you can’t really tell if someone has bulimia just by looking at them because many of the symptoms aren’t as obvious as with anorexia nervosa. People with bulimia can be average weight and often hide their eating habits and behaviors so friends and family won’t always notice there’s a problem.

Some of the signs of bulimia nervosa are:

Physical:

  • Constipation (trouble having regular and soft bowel movements)
  • Dehydration (not enough fluids in the body)
  • Dry, flaky skin
  • Electrolyte problems (not the right balance of the fluids in the body)
  • Irregular heartbeat (caused by low potassium levels)
  • Sore throat
  • Swollen face (from extra fluid in the body or enlarged salivary glands)
  • Tooth decay/loss (cavities, loose teeth)
  • Weight fluctuations (weight loss and gain)

Emotional:

  • Anger that is hard to control
  • Denial of a problem
  • Depression or anxiety
  • Distorted body image (believes that their body looks different than it actually does)
  • Fear of weight gain
  • Impulsivity
  • Intense focus on “flaws” and physical appearance
  • Shame or guilt
  • Withdrawal from friends

Binge Eating Disorder: Most of the physical signs of binge eating disorder are related to overeating and the obesity that may develop. Binge eating disorder is very different from obesity, though, because the loss of control that happens in binge eating disorder can lead to significant emotional distress.

Some of the signs of binge eating disorder are:

Physical:

  • Gallbladder disease
  • High blood pressure and cholesterol levels
  • Insulin resistance
  • Joint pain
  • Type II Diabetes
  • Weight gain

Emotional:

  • Anxiety
  • Depression
  • Shame, loneliness, and self-hatred
  • Withdrawal from friends

What happens when a person doesn’t eat?

Our bodies use food as fuel to keep all the important organs and cells running well. When a person doesn’t eat, their body doesn’t get the fuel it needs and then organs and body parts can suffer.

  • Heart & Circulation: The heart is a muscle that can shrink and weaken when a person doesn’t eat. This can create circulation problems and an irregular and very slow heartbeat. Blood pressure can get very low during starvation and make a person feel dizzy when they stand up.
  • Stomach: The stomach becomes smaller when a person doesn’t eat so when they start eating again, the stomach is likely to feel uncomfortable (stomach aches and/or gas). Also, the stomach will not empty as fast making a person feel full longer.
  • Intestines: The intestines will move food slowly often resulting in constipation (trouble having a bowel movement) and/or stomach aches or cramps when eating meals.
  • Brain: The brain, which controls the rest of the body’s functions, does not work properly without food. For example, a person may have trouble thinking clearly or paying attention and/or they could also feel anxious or sad.
  • Body Cells: The balance of electrolytes in the blood can be changed with malnutrition or with purging. Without food, the amount of potassium and phosphorous in your blood can get dangerously low which can cause problems with muscles, changes in brain functioning, and cause life-threatening heart and rhythm problems.
  • Bones: When a person doesn’t eat, their bones often become weak due to low calcium and low hormone levels, which increases the risk of getting broken bones now and developing weak bones when older.
  • Body Temperature: The body naturally lowers its temperature in times of starvation to conserve energy and protect vital organs. When this happens, there is a decrease in circulation (blood flow) to fingers and toes which will often cause hands and feet to feel cold and look bluish.
  • Skin: Skin becomes dry when the body is not well hydrated and when it does not get enough vitamins and minerals from food. The skin will naturally protect the body during periods of starvation by developing fine, soft hair called “lanugo” that covers the skin to keep the body warm.
  • Hair: When hair doesn’t get enough nourishment from the vitamins and minerals that are naturally found in healthy food, it becomes dry, thin and it can even fall out.
  • Nails: Nails require nutrients in the form of vitamins and minerals from the diet. When a person doesn’t eat, they deny their body what it needs and the nails become dry and brittle and break easily.
  • Teeth: Teeth need vitamin D and calcium from food sources. Without both of these minerals, a person can end up with dental problems such as tooth decay and gum disease. Vomiting can also destroy tooth enamel.