Suspect a loved one might be experiencing an eating disorder? Here’s what to look out for.
If someone close to you had an eating disorder, would you know it? Many people assume they would—thinking that telltale symptoms like rapid weight loss or looking emaciated would be easy to spot. But the truth is, warning signs of an eating disorder can be more subtle, especially at first. Here are the red flags for the three main types of eating disorders—anorexia nervosa, bulimia, and binge eating disorder—and how to get help.
Signs of Anorexia Nervosa
Anorexia nervosa is when someone heavily restricts their eating in order to be thin. “People with anorexia see themselves as much bigger than other people might see,” says Susan Samuels, MD, a psychiatrist at NewYork-Presbyterian Hospital and Weill Cornell Medicine—even if they are dangerously underweight. Due to complications associated with starvation and instances of suicide, anorexia has the highest mortality rate of any mental health disorder.
People with anorexia tend to:
- Look emaciated (extremely thin)
- Restricts their eating
- Have an intense fear of gaining weight
- Have a distorted body image
- Think or talk about food often
Other physical symptoms to watch out for, include:
- Muscle weakness
- Dry, yellowish skin
- Brittle hair and nails
- Growth of fine hair all over the body
- Signs of Bulimia Nervosa
Signs of Bulimia Nervosa
Bulimia involves two main elements: binging uncontrollably, then vomiting or partaking in other behavior that compensates for the overeating, such as excessive exercise or use of laxatives.
Besides this binging and purging pattern, the signs of bulimia are not as obvious. “With bulimia you’re not going to see someone who is particularly skinny or particularly overweight,” says Dr. Samuels. In fact, they’re usually at a healthy or relatively normal weight. What you may notice, however, is other physical changes as a result of frequent vomiting, like:
- Chronically inflamed or sore throat
- Swollen salivary glands
- Worn tooth enamel
- Acid reflux
- Dehydration (from lack of fluids)
Signs of Binge Eating Disorder
People with binge eating disorder lose control over their eating, and tend to consume unusually large amounts of food whether they’re hungry or not. Unlike bulimia, these episodes are not followed by purging, which means people who suffer from this disorder are often overweight or obese. Those with binge eating disorder might:
- Eat until they’re uncomfortably full
- Eat alone to avoid embarrassment
- Diet often
- Feel guilty or ashamed after eating
How to Help Someone with an Eating Disorder
Emotional support and expressing concern is extremely important. “I think we tip-toe around asking if someone’s OK, when the best thing you can do is just say, ‘hey, I’m worried about you, here’s my observation,’ without any judgement,” says Jennifer Hartstein, PsyD, a psychologist based in New York City. “People who are not well will be defensive and fight back, [but] some of them might be relieved that you’re noticing.”
If you suspect someone has an eating disorder, it’s important to get help—from a medical professional or the National Eating Disorder Association hotline (1-800-931-2237)—right away.
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an eating disorder is really
a clinical issue with food.
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So there are generally three types,
there's anorexia, bulimia, and
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binge eating disorder.
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Anorexia is a specific type
of eating disorder that
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involves restrictive eating in particular,
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the body mass index is significantly
lower than what the average should be.
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People with anorexia really see
themselves as much bigger than other
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people might see.
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Some women or men are really get
emaciated and that's certainly scary.
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They're very good at hiding it,
they wear baggy clothes where though
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kind of wear oversized things so
it looks like everything's fine.
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If you're sitting and
eating with their person maybe
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their food just gets moved around on their
plate, but they're not actually eating it.
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Some when you get to a certain point your
body has to produce some sort of body
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heat, so there's become a layer of
hair that grows on someone's skin.
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Bulimia is an eating disorder that
involves two elements, one is bingeing and
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one is purging.
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So you might eat a ton of food, and
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then you throw it up,
those two things usually work together.
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Sometimes with bulimia
you may not see as many
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obvious symptoms of the illness
as you would with anorexia.
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With anorexia, you generally see a very,
very thin person.
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With bulimia, you're not gonna see
somebody who's particularly skinny, or
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The enamel on their teeth might get
damaged because they're throwing up.
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Sometimes they might have marks on the
back of their hand because they're making
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themselves throw up.
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That their teeth make marks on
the back of their hands, or
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maybe they just are hoarding food,
and that's just a sign you
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see that there's it's just like they don't
share, or they wont give food away, or
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you find wrappers all over their room,
or in their bag.
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Binge eating disorder, is another type
of eating disorder that is as it sounds,
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where somebody is taking in many,
many calories in a short amount of time.
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With binge eating disorder people
might eat when they're already full,
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but continue to eat.
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They might feel uncomfortably
full after they've eaten,
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and they certainly would want to eat
alone, because they're sort of embarrassed
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about how much they consume
in how little amount of time.
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I think it's really important not
to be afraid to express concern.
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People who are not well
will be defensive and
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fight back, some of them might be
relieved that you're noticing.
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So I think we tiptoe around
asking if someone's okay,
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when it maybe the best thing you
could do is to just say hey,
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I'm worried about you here's my
observation without any judgment.
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But here's what I noticed, can we talk
about it and then see what they say,
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and if you're really worried,
encourage them to get to a doctor.
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Eating disorders. National Institutes of Mental Health, 2016. (Accessed on January 8, 2018 at https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml)
Eating disorders: Overview of prevention and treatment. UpToDate, 2017. (Accessed on January 8, 2018 at https://www.uptodate.com/contents/eating-disorders-overview-of-prevention-and-treatment)
Warning Signs and Symptoms. New York, NY: National Eating Disorders Association. (Accessed on January 8, 2018 https://www.nationaleatingdisorders.org/learn/general-information/warning-signs-and-symptoms)