Recognizing the Signs and Symptoms of Disordered Eating
In a world consumed by diet culture and unrealistic beauty standards, disordered eating can silently infiltrate the lives of individuals, affecting their physical and emotional health. Many people engage in disordered eating without ever realizing it. Especially in January, with New Year's Resolutions and messages around weight loss, diets and “health” are running rampant. It is important to be aware of the signs and risks of disordered eating that can lead to a variety of eating disorders. The earlier one can identify disordered eating, the quicker someone can gain insight into their behaviors, access support and prevent worsening of symptoms. Disordered eating can be sneaky because depending on who you ask or talk to, some might not consider certain habits disordered. Diet culture is so pervasive that many harmful behaviors are normalized and even glorified. Here are some things to look out for:
Obsessive Calorie Monitoring: One of the initial signs of disordered eating is an unhealthy obsession with counting calories, meticulously tracking macronutrients, or rigidly adhering to strict dietary rules. Individuals might track calories through apps (huge eye roll at MyFitnessPal), pen and paper or even more discreetly in their head. This is more tempting and accessible than ever with so many restaurants posting calories on menus.
Cutting Out Whole Food Groups or Food Avoidance: This can escalate quickly for example switching from white bread to wheat or multigrain to eating less bread to not eating any bread to not eating carbohydrates. Our bodies need a variety of macro and micronutrients and cutting out whole food groups (with the exceptions of legitimate allergies) can harm our body and increase cravings for this food group. Society has definitely exacerbated this with labeling certain food groups as “bad” and normalizing cutting out things like dairy and carbs or gluten.
Overall Restriction: This could mean limiting portions, cutting out snacking, only buying “fat-free” or “sugar-free” or low calorie options or it could be as blatant as skipping whole meals.
Distorted Body Image or Attempts to Control One’s Body: Individuals with disordered eating often have a distorted perception of their bodies. They may perceive themselves as being overweight or "flawed". This negative body image can fuel restrictive eating habits or excessive exercising in an attempt to achieve an idealized body shape or size. This could be an internal experience or this could be apparent by someone’s comments about their own body, trying to cover up their body with baggy clothes or body checking behaviors (excessive looking in the mirror and evaluating their body).
Rigid Exercise: We might all have days where we don’t feel like moving our bodies but we feel better when we do, that’s not what I am referring to here. Rigid exercise is referring to when you experience distress if your exercise routine is interrupted. This could be foregoing social activities to center exercise, not listening to your body and exercising despite feeling exhausted/run down or being injured, or not incorporated rest days. This could also look like choosing a certain form of exercise/workouts based on what you think is going to impact your body composition versus what you actually find enjoyable.
Compensation: This means shifting what you give yourself permission to eat based on how active you were that day or week or what or how much you have already eaten. This could be someone not eating or eating a smaller amount of food earlier in the day knowing they are going out to eat later or restricting or increasing exercise due to having what they deem as “too much” earlier in the day or week (not based on genuine hunger and fullness cues).
Rigidity/Rules around eating: Some common examples of this include rigid portion control, not eating past a certain time in the evening, not drinking one’s calories, not eating out at restaurants or bringing one’s own food at events, having to have a certain amount of time between meals, not eating sweets or only allowing oneself certain foods on weekends and then becoming more restrictive come the start of the week.
The Scale being scary: Assigning meaning to the number or an obsession with what the number is a sign of unhealthy patterns with food and body. For some people what they see on the scale might impact their mood for the day or what they eat for the day. Others might completely avoid the scale and not be able to tolerate seeing the number. Ideally, we would be able to tolerate the number on the scale when it is seen (like at the doctor) but not obsess over it or need to weigh ourselves at home or the gym. This number is not a measure of your worth as a human.
Drastic and/or Rapid Weight Changes: Disordered eating can lead to significant and rapid weight fluctuations. This may include unexplained weight loss or gain within a short period of time. These fluctuations can be damaging to both physical and emotional health and may indicate an unhealthy relationship with food and body image. This one is especially challenging to navigate as weight loss is often complimented in our society. Disordered eating can impact one’s weight, but not always and someone can be feeling the negative effects without it ever impacting their body size or shape.
Binge Eating Episodes: Disordered eating can manifest in different ways, including episodes of excessive food consumption known as binge eating. Individuals may restrict their food intake and that leads to increased hunger and episodes of eating past the point of fullness. Binge eating episodes involve consuming unusually large amounts of food accompanied by feelings of guilt, shame, and loss of control. The struggle with this sign of disordered eating is because there is so much shame around it, individuals often go to great lengths to hide the evidence of binge eating or do it in secret/when alone. Please know that binge eating is actually more common than you probably think.
Emotional and Behavioral Changes: Individuals may become preoccupied with thoughts of food, body, and weight making them less present in conversations or bringing up food and their body frequently in conversation. They may exhibit signs of irritability, anxiety, or depression. Changes in social behavior, such as withdrawal from social gatherings involving food, or excessive secrecy around eating habits, can also indicate the presence of disordered eating.
Physical Health Consequences/Symptoms: Disordered eating takes a toll on physical health as well. Individuals may experience fatigue, dizziness, weakness, hair loss, brittle nails and disrupted sleep patterns. Digestive issues, hormonal imbalances, compromised immune function, and injury are also common. Something I and dietitians I often collaborate with see all the time from clients is GI distress/symptoms from restrictive patterns. Clients often think they are trying to be “healthy” and creating a host of other negative symptoms.
Seeking Help and Support:
If you notice these signs and symptoms in someone you care about. Here are some steps you can take:
Speak up: Let’s dismantle diet culture!! Approach conversations with non-judgment, empathy, and compassion. Express your concerns and make space for them to share their feelings and experiences. Oftentimes, these conversations can be met with defensiveness so it is important to hear the person out and not turn the conversation into an argument. While we can’t control someone else’s behavior, we can express concern and let them know you are there should they want support in making changes.
Encourage Professional Help: Encourage the individual to reach out to healthcare professionals who specialize in eating disorder treatment. This could be a licensed mental health therapist that specializes in providing Health at Every Size/weight-inclusive and anti-diet or intuitive eating aligned care as well as a dietitian with similar experience/specialty. The Association for Size Diversity and Health directory is a great resource to find providers that fit this. Personally, I would steer clear of providers that say they specialize in “weight management” or “weight loss” as they might unintentionally cause harm through weight biases or reinforce food rules/disordered eating if they are not well informed on eating disorders.
Learn more about disordered eating and eating disorders and the impact they can have on individuals' lives. Greater understanding will help you provide better support and reduce stigma.
Let’s make sure we are clear on a few things: You cannot look at someone and tell from their body if they engage in disordered eating or have an eating disorder. Anyone in any body size or shape of any age, gender, race, ethnicity or socioeconomic status can struggle with disordered eating or an eating disorder. While some of the signs above are behavioral/visible, it is also about the mental distress one’s relationship with food and their body causes. Plus, as previously mentioned, it is common for individuals to go to great lengths (both intentionally and subconsciously) to hide their behaviors so it is not always obvious.
Many of the signs listed above are considered socially acceptable which is why it is important to name and identify them as potentially really harmful and disordered behaviors. For example, self-induced vomiting (purging) is more widely recognized as an eating disorder behavior. Similar to binging, because it is less socially acceptable, there is often shame around engaging in this behavior leading individuals to suffer in silence.
Recognizing the signs and symptoms of disordered eating is an essential step in supporting individuals on their path to recovery and intervening prior to a severe eating disorder developing. Wherever you are in your relationship with food and your body, reaching out for help is brave and should be taken seriously. If you aren’t sure how to find the right therapist for you, check out my other article that walks you through how to do that and if you want to learn more about how to support a loved one with an eating disorder, check out this article! It is possible to value health and nourish yourself with a balanced diet without feeling bogged down by disordered eating or an eating disorder. Eating disorder therapy can provide you with the education, tools, and support to have a healthy and enjoyable relationship with food and your body.
Resonate with any of the signs listed above? Reach out to schedule your free consultation call today here!
*Disclaimer - this blog post is referring to disordered eating but there is great overlap between disordered eating and clinical eating disorders. Disordered eating can be a strong precursor to an eating disorder, but not always. This is why it is so important to seek professional help from someone who specializes in disordered eating/eating disorders. This is not an exhaustive list of symptoms.