Eating disorders aren’t as easy to spot as you may think. They are so sneaky that people that have eating disorders don’t realize they have an eating disorder. Family members and loved ones miss them all the time. Nobody is to blame but yet parents and family members lament that they can’t believe they had no idea. When I worked at an eating disorder hospital, I facilitated a family support group. Time and time again family members expressed having immense guilt for not knowing sooner. It’s a common experience, and many wonder how it could be possible to not have a clue that someone they love was engaging in eating disorder behaviors.
Eating Disorder Symptoms are easy to miss
One reason why you may not recognize eating disorder symptoms in a loved one or in yourself is that our society glorifies disordered eating behaviors. Intermittent fasting can be a symptom of anorexia but it’s rebranded as something else. Eating disorder symptoms can have a different name but it doesn’t change that it’s disordered. Dieting and body bashing is such common practice that nobody even bats an eye anymore. It’s scary. As an eating disorder therapist, I’m losing sleep over seeing eating disorder symptoms hidden in plain sight.
It’s not your fault for not knowing about eating disorder behaviors and symptoms. However, if we all know more and educate ourselves on them we can prevent the people we love from experiencing more suffering and pain. When you understand the harmful impact of dieting and place emphasis on appearance, you can stop using those behaviors and thus prevent more eating disorders. It’s my goal to help educate you on eating disorders and their behaviors.
What are the different types of eating disorders?
I don’t know about you but when I was in health class I learned about two eating disorders and the gist of it was: either you don’t eat or if you do eat then you throw it up. Even as a type that I’m cringing. There are more to eating disorders than that and there are more eating disorders than you might know about. Here are some of the most common types of eating disorders.
Anorexia Nervosa
Anorexia nervosa involves restrictive eating, weight loss, and distorted body image. People with anorexia may also fail to maintain a healthy body weight even if they aren’t losing weight. Individuals with anorexia tend to restrict food groups, count calories, and have fear around eating certain foods. These individuals may engage in compulsive exercise, purge through vomiting and laxatives or binge eat. While yes, individuals experience anorexia in their teen years, people of all ages can have anorexia nervosa. It’s important to know that you cannot tell someone has anorexia by their outer appearance. In fact, we don’t diagnose anyone with an eating disorder based on their outside appearance. People with anorexia can be a normal body weight and even cases of “atypical anorexia” (most insulting name ever) people can be at higher weights. It’s important not to assume someone has an eating disorder based on their body weight.
Bulimia Nervosa
All eating disorders can be potentially life-threatening but bulimia is one of the most life-threatening eating disorders. This eating disorder involves episodes of binge eating followed by self-induced vomiting known as purging. Purging is medically concerning for the significant health risk it poses. Individuals with bulimia feel out of control during episodes of binging and feel powerless over how much they are eating. People with bulimia will purge as a way to prevent weight gain. They will utilize overexercise, laxatives, fasting, and diuretics as purging behaviors as well. This eating disorder is scary because of the havoc it wrecks on the body and how unbelievably secretive it is.
Binge Eating Disorder
Binge eating disorder (BED) is the most common eating disorder in the United States. Binge eating disorder is the eating disorder where I notice the most shame. This eating disorder involves eating large quantities of food in a short period of time. People report feeling out of control during binge episodes as well. People with this eating disorder often eat in private and are discrete during these episodes. They feel guilt for their behaviors and may begin periods of restriction after binge eating episodes. Binge eating disorder is newly recognized by the DSM-V but is not a new eating disorder.
Other Specified Eating Disorder
Other Specific Eating Disorder (OSFED) is an eating disorder that can be compromised of many different symptoms but doesn’t fit the specific criteria of the other eating disorder behaviors frequency. Many people would meet the criteria for OSFED and have no idea because it doesn’t fit in the box of Binge eating disorder, Anorexia, or bulimia. OSFED can be life-threatening just like other eating disorders. People are diagnosed with OSFED when they didn’t demonstrate the strict diagnostic behaviors required by other eating disorders. This eating disorder has just as many medical risks and dangers as more known eating disorders.
Avoidant/restrictive Food Intake Disorder
Avoidant/restrictive Food Intake Disorder (ARFID) may be the least known eating disorder. ARFID like anorexia involves restricting foods and food types. However, ARFID doesn’t have the same fears around weight gain and body image that anorexia does. People with ARFID often have anxiety around textures and the sensory experience around food. Those diagnosed with ARFID have shared having anxiety around eating foods that aren’t deemed safe. Often people with ARFID seem like picky eaters and have limitations on what they will eat resulting in weight loss and nutritional deficiencies. People with ADHD, autism and intellectual disabilities are more likely to develop ARFID.
What are eating disorder symptoms?
Each eating disorder has a different set of symptoms and how frequently they are demonstrated. Regardless of the type of eating disorder, it can be helpful to recognize that they are symptoms of an eating disorder and that professional help may be needed. The list I have compiled of symptoms is not an exhaustive list but some of the common symptoms of eating disorders.
Emotional and behavioral symptoms:
Weight changes, Dieting, and control over food
People with eating disorders often have changes in their weight through weight loss, weight gain, or cycling between both of them. Eating disorders often begin with dieting and progress to disordered eating. People with eating disorders often feel they have no control over food or make effort to try and control food.
Preoccupation with weight, food, and nutrition
A common eating disorder symptom is thinking about food, body image, and calories in an obsessive way. It can be difficult to not think about these things and these topics tend to be all-consuming for a person with an eating disorder.
Discomfort with eating in front of others
A symptom of an eating disorder is being afraid to eat in front of others. This may be because they don’t want anyone to judge the food they are eating or be seen as someone that “overeats” or doesn’t eat enough. Eating with other people can cause a lot of distress to those with eating disorders.
Refusing to eat certain food groups or restricting certain foods
Not eating certain food groups or specific foods is a common eating disorder symptom. People with eating disorders may allow eating specific foods but only in a very limited quantity. They do this in an attempt to gain control.
Extreme concern with body size and weight
We live in a society that is obsessed with appearance and losing weight. In fact, this is often a precursor to an eating disorder. However, those with eating disorders have extreme concerns about their weight and appearance. They are willing to do drastic things to maintain this.
Engaging in body checking
Everyone has a different form of body checking. It can range from examining their bodies in a mirror, taking note of how much room they take up in a chair, measuring their body parts, etc. This helps calm anxiety and provides reassurance that their body is the right size. If not, they might increase their eating disorder behaviors.
Withdrawal or isolation from activities and people
People with eating disorders have higher instances of anxiety and depression. Those with eating disorders may worry about being seen by others and believe others will be critical of their bodies. They avoid spending time with people to avoid potential criticism or judgment.
Avoiding situations where food is involved
An eating disorder symptom that is common is avoiding social events or situations where they might have to eat. They might avoid a birthday party because they don’t want to eat the cake or just don’t want to be seen eating in front of others.
Abnormal rituals with food
There are numerous rituals with food that people with eating disorders can have that I couldn’t even name them all. Some examples include cutting food into tiny pieces, chewing for long periods of time, tearing food apart, etc. Doing these behaviors may be obsessive-compulsive behaviors to relieve anxiety or to help the person not feel as overwhelmed to eat.
Physical symptoms:
Fluctuating weight gain or weight loss
For many eating disorders, a goal is to lose weight. Restricting can lead to weight loss but also edema and swelling, which can lead to the number on the scale going up. This can reinforce more restricting, which may also increase water retention and inflammation. Binging behaviors can also lead to weight gain.
Gastrointestinal issues
It’s extremely common for people with eating disorders to have GI issues. From gastroparesis to heartburn and everything in between. Constipation, diarrhea, stomach aches, and more are all common for individuals with an eating disorder.
Insomnia and sleep issues
Nutritional deficiencies, stress, anxiety, depression, and more all can impact the ability to sleep. It’s common for people with eating disorders to have insomnia or other sleep issues.
Menstrual cycle irregularities
People who have been restricting calories can experience a loss of their period. A new cycle on binge eating and menstrual cycles has shown those that who binge eat are more likely to lose their period or have infrequent periods than those that don’t binge eat. No eating disorder is exempt from menstrual irregularities.
Hair loss or baby hair growing on the body
Lack of proper nutrition leads to hair loss. Those who have been restricting food and calories may also start to grow baby hair over their body as a way of protection.
Muscle loss
Lossing of muscle mass is common in eating disorders. Not only does restricting calories cause fat loss (including in the brain) but it leads to losing muscle mass as well.
Swollen glands
Individuals with eating disorders who engage in purging especially can have swollen glands around their faces. This ends up reinforcing to them that they are “fat” and need to continue their eating disorder behaviors. The good news is swollen glands disappear when the individual stops engaging in binging and purging.
Remember eating disorders require a diagnosis from an eating disorder therapist or another specialist
In order to be diagnosed with an eating disorder, you need to be assessed by an eating disorder therapist or other eating disorder specialist. Many people with eating disorders don’t realize they have an eating disorder and go on with their behaviors. Being able to meet with a therapist specializing in eating disorders can help you understand your diagnosis, and to make a plan to get help.
If you aren’t experiencing eating disorder symptoms it doesn’t mean you don’t need help
If you look through this list, and you don’t believe that you are experiencing these symptoms, I don’t want you to walk away believing that you don’t need help. Not only do you need help but you deserve it. Everyone’s body responds in different ways, and that doesn’t mean you should prolong reaching out for support. If you don’t have eating disorder symptoms yet, it means that you’re in an even better place to work on your mental health. You don’t have to stay in disordered eating until you develop symptoms in order to warrant help. You deserve help now. You deserve eating disorder treatment.
Eating disorder therapy can help
If you are feeling overwhelmed by realizing your relationship with food is not where you want it to be, it’s not too late for help. Eating disorder therapy can help you regardless of how long you’ve been in your eating disorder. Eating disorder therapy can help you focus on changing your thoughts and beliefs about yourself and your body. You can learn to heal from past experiences that made you feel like you aren’t good enough. When you have an eating disorder it requires a team approach: a dietitian, a psychiatrist, and a medical professional. I can help you find people that are trained to help you but reaching out for therapy is the first step in helping you in eating disorder recovery.
Begin working with an eating disorder therapist in Utah
You don’t have to feel anxiety about eating and food. You can find relief from your negative thoughts. Eating disorder therapy can help. This Utah Counseling Practice has an eating disorder therapist specializing in eating disorder therapy. To begin counseling follow the steps below:
Meet with a Utah therapist
Start eating disorder recovery
Online Eating Disorder Therapy in Utah
Online eating disorder therapy allows women all throughout Utah to have access to and the opportunity to work with an eating disorder therapist. There are many parts of Utah that don’t have an eating disorder therapist in their city that has the specialized training and experience to work with eating disorders. This is why I provide online therapy in Utah. It’s just as effective as in-person therapy without you having to leave home.
I work with clients in Salt Lake City, St. George, Logan, Heber City, Cedar City, Provo, and more. Online counseling can suit your needs wherever you’re located.
Other mental health services provided by Maple Canyon Therapy
Eating disorder therapy isn’t the only service this Utah Counseling Clinic provides. Other mental health services provided by Maple Canyon Therapy include anxiety therapy, EMDR therapy, birth trauma therapy, binge eating disorder treatment, and body image therapy in Utah. Sign up for a free 15-minute phone consultation to see how I can help.
About the Author
Ashlee Hunt is a licensed clinical social worker and founder of Maple Canyon Therapy in Utah. She has a bachelor's degree in psychology and a bachelor's degree in family life and human development from Southern Utah University. Ashlee obtained her Master's in Social Work from Utah State University. Ashlee has been working with eating disorders since 2013 when she graduated from a university counseling center. Her passion for eating disorders first started by working with college students. She has worked at an inpatient psychiatric hospital for eating disorder treatment and worked with women at all levels of care. Through professional training and conferences, Ashlee continues to expand her understanding and knowledge of eating disorders. When Ashlee isn’t doing therapy, she enjoys exploring Utah with her husband and two Goldendoodles.