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Eating disorders are serious mental illnesses affecting just over 10% of the population of the United States. Negative habits around food and body image are considered eating disorders when they significantly impair their health, emotional stability, and function. While eating disorders are most common in young women, they affect people of every age, sex, and gender identity.
Types Of Eating Disorders
Any list of eating disorders includes anorexia nervosa and bulimia nervosa. But these are not the only types of eating disorders. Binge eating disorder, rumination disorder, and avoidant/restrictive food intake disorder are all lesser-known but important eating disorders to be aware of.
Each eating disorder has its own specific set of effects and symptoms that doctors and mental health professionals consider when diagnosing and deciding on a treatment plan. However, many of these eating disorders share common habits and behaviors. Here are six symptoms of eating disorders that you can be on the lookout for in yourself, friends, and family.
Skipping Meals And Finding Reasons To Avoid Eating
People skip meals occasionally for a variety of reasons. Breakfast and lunch can sometimes get crowded out by our schedule, and dinnertime can fly by as we work late or meet up with friends. Some people feel better when they don't eat at particular times of the day. However, when people skip meals, it can be a red flag for an eating disorder. To maintain energy levels and regulate blood sugar, our bodies need fuel regularly.
A person who has started to develop disordered habits around their eating may begin by skipping meals or finding reasons to avoid situations where food is present. It's important to pay attention to these signs early on because fast intervention can help prevent the disorder from becoming dangerous.
Adopting A Very Strict Diet
Orthorexia is an eating disorder that is categorized as an unhealthy focus on eating only healthy foods. Though eating nutritious foods that are good for you is important, becoming obsessed with only eating food deemed "good" can cause concern. People who struggle with this kind of eating disorder may be extremely restrictive of what they put into their bodies and avoid anything considered unhealthy.
This can also be seen with certain diets that eliminate food groups, as with skipping meals occasionally, adopting a vegetarian diet is not a cause for concern. However, any version of a diet that is overly restrictive can be a symptom of an eating disorder. Vegetarian or vegan diets should include a wide variety of foods for proper nutrition and sufficient calories. If this is not the case, these diets can be signs of an eating disorder.
Eating Very Little Food
Eating disorders like anorexia nervosa and avoidant/restrictive food intake disorder can cause people not to get enough calories (energy) through their food. In addition, they might not be getting enough nutrients to support various body systems. People may limit their caloric intake over time to lose weight or because the act of eating makes them feel uncomfortable.
In anorexia nervosa, calorie restriction is often due to fear of gaining weight. People with the avoidant/restrictive food intake disorder, on the other hand, can find it difficult to eat certain foods because of taste, texture, smell, or sight of the food. Both eating disorders are serious mental health disorders that should be treated with the help of mental health professional.
Eating Too Much Food
Because anorexia nervosa is one of the most well-known eating disorders, people might not realize that eating in excess can also signify an eating disorder. Bulimia nervosa and binge eating disorder can both include eating abnormally large amounts of food. In these circumstances, the person may feel out of control of their consumption and continue long after their body has sent signals that they're full. After a binge, a person often feels deep feelings of shame or sadness. This can lead them to purge their food with laxatives, forced vomiting, or exercise. This cycle can be incredibly damaging for both the mind and body.
Eating In Secret
Some eating disorders can make people ashamed of how they eat, and they start to do their eating in secret. Eating alone, of course, is not the same as eating secretly. A late-night snack doesn't have to indicate an eating disorder. But eating alone because of fear or shame is a sign that something may be wrong.
People who feel ashamed of their eating may also avoid social situations where food is involved. This can make them isolated and cause more additional mental health challenges. It's important to remember that eating is necessary for our bodies and that you don't have to go through these feelings alone. Speaking to a licensed therapist can help you work through your feelings and help improve your relationship with food.
Like skipping meals and making excuses around food, as discussed above, joining a group of people for mealtime and not eating can be a red flag for an eating disorder. This can be true in the home with family or roommates or out with friends. People may also use techniques to appear as though they've eaten more than they have, such as cutting their food into many pieces or eating very slowly. These behaviors can become more present over time, but the more serious an eating disorder gets, the better a person may be at hiding it.
Leaving The Table To Use The Bathroom Often
One of the common aspects of bulimia nervosa and some forms of anorexia nervosa is inducing vomiting to get rid of the food eaten. If you feel compelled to leave the table to vomit during or after a meal, that is a very large signal to reach out for help. As a friend or family member, if you notice that your loved one often leaves for an extended amount of time in the middle of a meal, this can be a warning sign of an eating disorder.
There are other indicators that a person may be inducing vomiting. These include a person smelling like vomit after returning from the bathroom, bloodshot eyes, a puffy face, and issues with the throat. Continued induced vomiting can cause many long-lasting symptoms, and people need to seek treatment immediately.
Being unwilling to eat the same food as other friends or family members can be a symptom of an eating disorder. This is not always the case, as some people have legitimate reasons to prepare or bring their food. However, in combination with other problematic behaviors, it can indicate that a person is concerned with which kinds of food they eat or restrict their eating.
People with eating disorders, especially anorexia nervosa and bulimia nervosa, can become fixated on getting food or calories out of their bodies after they have taken them in. This can take many different forms.
Bingeing and induced vomiting are widely known as common signs of bulimia nervosa. Induced vomiting, however, is not restricted to people who experience bulimia nervosa. People with anorexia nervosa may also vomit food that they eat, even though they are not as likely to have binged in the first place. One sign of vomiting in friends or family can be calluses that form on the knuckles from using the fingers to induce vomiting. Another symptom of vomiting can be losing tooth enamel from the acidity of vomiting.
Laxatives, Supplements, And Herbs
Instead of inducing vomiting, some people with eating disorders use laxatives or other supplements to make food move through their digestive system faster. This makes it difficult or impossible for their body to absorb energy and nutrients from the food. Any supplement or herb intended to block or change how bodies absorb food can also be a symptom of an eating disorder.
These can take the forms of teas, pills, or liquids. Not only do these prevent food from being absorbed by the body, but they can also cause dehydration and other gastrointestinal issues.
Sometimes, rather than removing food from their bodies, people with eating disorders will exercise to burn off calories consumed. This can be especially true with anorexia nervosa. Sometimes people will become so anxious after eating food that they feel compelled to exercise until they think "worked it off." If exercise is associated with significant anxiety or compulsion, it can signify that something is wrong.
Though exercise is generally a healthy activity, too much of it can be hard on the body. It can also be damaging for a person's mental health to exercise, with their primary focus being on calories burned. This is especially true for individuals who are not consuming enough food to sustain muscle growth and healing.
It can be difficult not to worry or talk about our weight or body image. After all, it's easy to compare ourselves to what is supposed to be a standard or ideal shape and size. It's also normal to want to eat in a way that helps us maintain energy and feel healthy. However, if any of these things become an obsession, it can be a red flag for an eating disorder.
Lots Of Talks
If you, or someone you know, often talks, complains, or worries about their size, shape, or weight, this can signify an eating disorder. This can be especially clear with anorexia nervosa, where people are often underweight but remain anxious, ashamed, or disgusted with what they perceive as "being fat." Anorexia nervosa can change how a person perceives their body, so a mismatch between how they look and how they perceive themselves can indicate a problem.
Body dysmorphia is another mental health disorder that can affect the way a person sees. Though not all people with body dysmorphia have eating disorders, the two often co-occur. People with body dysmorphia see an altered version of themselves in the mirror, and they may become fixated on certain body parts that they feel are unattractive.
People who are normal weight or overweight can become obsessed with their appearance as well. This is sometimes overlooked because cultural signals can indicate that it's appropriate to be ashamed of or obsessed with bodyweight if you aren't thin. It's important to note that people of all body types can struggle with body image and eating disorders.
Shame Or Disgust
Any time a person expresses a lot of shame or disgust about their body, it can be a symptom of an eating disorder. While people with anorexia nervosa often misperceive the size and shape of their body, disgust or self-loathing is no more appropriate for people who see themselves more accurately.
People who struggle with eating disorders may have shame or disgust when it comes to food as well. They may avoid certain foods altogether or feel uncomfortable in situations when food is around. It's also possible for them to seem judgmental of others who indulge in foods they restrict from.
Hyperfocus On Healthy Eating
While eating for energy and health is good, an obsessive focus on what a person perceives as healthy eating can be a red flag for an eating disorder. This is especially true if their idea of healthy eating is very restrictive. In addition, if they are afraid, disgusted, or ashamed at the idea of eating something that they don't think is healthy, this can indicate a problem.
Checking Yourself Out (In An Unhappy Way)
If you, or someone you know, obsessively check the mirror to find and criticize imperfections, this might be a sign of an eating disorder or other mental health disorder. Mirrors are a handy tool for making sure that we look presentable before heading out the door, but eating disorders can turn them into traps. If your friend or loved one is spending a lot of time with the mirror, and if they come away from it sad, angry, or disgusted, it might be time to reach out to them.
For people with a binge eating disorder, eating is not necessarily connected with enjoyment. In fact, during a binge, they might feel uncomfortable or even want to stop eating and feel unable to stop. People who engage with this disordered eating habit may use food as an unhealthy coping mechanism. It can be a way to cope with difficult emotions, and they may seek the comfort of food. Often after a binge, a person will feel shameful for their behavior. This can lead to a continued cycle that is difficult to manage without effective treatment.
In addition to feeling out of control while bingeing, people with an eating disorder might feel like they can't control how often it happens. Birthdays, holidays, and special occasions are times when people sometimes eat more than they normally would. On the other hand, Bingeing may happen much more often, and the person doing it may feel like they can't control the times when they binge. They may also start bingeing in private to avoid judgment from others. This behavior can feel isolating and take the enjoyment away from food.
If you find yourself eating very large amounts of food while not enjoying the food or feeling out of control, this can be a symptom of an eating disorder.
Some people with anorexia nervosa, or other eating disorders that restrict food intake, are unaware that their habits are problematic. However, other people who struggle with an eating disorder are aware that their food restrictions are not healthy, but they feel unable to stop them. This restriction can be focused on caloric content or specific kinds of food. People who excessively restrict their food will often look at certain foods as "good" or "safe" and other foods as "bad." This can heighten emotions in situations when those "bad" foods are present.
The emotional aspects of an eating disorder such as shame, fear, and disgust can be a factor in this lack of control. Other people may not purposely restrict calories but follow diets that don't eat certain foods. If these restrictions feel out of control and are accompanied by negative emotion, it can be a sign that a supposedly healthy diet is not very healthy at all.
One way to tell if your or a loved one's exercise is problematic is to consider the emotions attached to it. If you feel compelled to exercise or are afraid of what will happen if you stop, it could mean that the exercise is part of an eating disorder.
While so many of the symptoms that we've looked at so far are behaviors, a large part of what makes problematic patterns of eating disorders is what goes on mentally.
Previous trauma is a risk factor for eating disorders. This is probably because disordered and harmful eating patterns can emerge from trauma's other psychological effects. Things like low self-worth and misdirected blame or anger can add to an eating disorder. In addition, trauma can sometimes make a person feel like they are not controlling themselves or their lives. Eating disorders can be part of their efforts to regain or hold onto control.
Other Mental Health Disorders
Eating disorders often follow or exist alongside other mental health diagnoses like anxiety disorder, depressive disorders, or obsessive-compulsive disorder. If you or your loved one has a history of being anxious, depressed, or compulsive, it's especially important to be on the lookout for signs of an eating disorder.
What Comes Next?
Could This Be You?
Do you recognize yourself in these symptoms? Do you see a loved one? If so, recognize that a wide variety of emotions are normal and okay. You might be relieved or overwhelmed. In any case, it's important to remember that acknowledging the issue is the first step in addressing it.
Treatment for eating disorders usually involves a team of medical professionals and a support network of friends and family. There are a few places to start if you suspect that you may have an eating disorder. Your primary care physician can help with a diagnosis. They can also help you get in touch with other professionals who can help. You can also start the process by reaching out to a mental health professional. A therapist or counselor, including the ones at BetterHelp, can help you get started on your eating disorders treatment.
You could also look at the National Eating Disorders website. They have multiple ways to reach out if you need someone to talk with, including their helpline: 800-931-2237.
Medical treatment for eating disorders might involve a primary care physician, a trained dietician, and other specialists as necessary. Medical treatment aims to care for the body, including reaching a healthy weight and stabilizing any body systems impacted by the eating disorder. Some medications can be prescribed. Medications for binge eating disorders include certain stimulants and anti-seizure drugs that have been found to reduce bingeing behavior. Doctors can also prescribe antidepressants, which can help people to moderate their problematic behaviors.
Mental Health Treatment
Mental health treatment is an extremely important part of treatment for eating disorders. Therapies such as cognitive-behavioral therapy (CBT) can help people with eating disorders recognize the disordered thought patterns that often precede disordered eating. CBT then helps people to replace unhealthy or false thought patterns with healthy ones. In cases where eating disorders stem from past trauma, talk therapy can help people process trauma and learn healthy coping strategies.
When You're Not The One Who Needs Help
Being the friend or family member of a person experiencing an eating disorder can be difficult. Many times, the people around a person recognize that they may have an eating disorder before themselves. People with eating disorders might be very resistant to acknowledging that something is wrong. They might not believe their loved ones. Sometimes they could be angry and become defensive.
It's important to be cautious when approaching someone with your concerns. If handled incorrectly, these conversations can cause people to retreat and become more private with their eating habits. Feeling supported by loved ones can be incredibly helpful for people who are in the recovery process.
Keep The Love
When you're talking with someone who may have an eating disorder, it's important to remember that eating disorders often come with a large amount of shame. They don't need extra shame from you. Keep your concerns positive and proactive. In addition, check into your relationships with your body. If you use shaming or hurtful words for yourself, it's hard to convince others that they shouldn't do the same thing. You may find that you need to adjust some of how you talk about bodies to support your loved one. Doing so can create a space where they feel more comfortable opening up about their disorder and how it is causing difficulty.
Your loved one may not acknowledge your concern right away. They might even be angry. It's important not to let yourself be driven away by this. Recognize that eating disorders affect how people think and process things, making them very difficult to recognize for those who experience them. Be patient with the person. When they are ready to recognize their eating disorder and understand that they need help, you want to be one of the people they feel safe coming to.
Taking A Long View
Eating disorders treatment can be a difficult process; it is, however, worth it. As a person with an eating disorder, a friend, or a family member, it's important to reach out for help as soon as you can. It's also important to build strong support networks. A person working to recover from an eating disorder isn't the only one who needs support. If you are that support person, make sure that you're taking care of your mental health.
A therapist or counselor from a place like BetterHelp can help you help the ones that you love.
We mentioned that CBT is one possible way to work on recovering from an eating disorder. CBT is also one of the most well-studied therapies when it comes to its effectiveness online. HuffPost recently ran an article about the strengths of online therapy and cited some of the studies that state that CBT works just as well online as it does face to face.
Online therapy can sometimes help people feel more comfortable because you can do your sessions inside a tight space, such as your home, as long as you have a secure internet connection. In addition, online therapy is often less expensive than traditional therapy.
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