What Are the Signs and Symptoms of Eating Disorders?

Amanda Gardner
·11 min read

Medically reviewed by Karis Cho, MD

Eating disorders are not occasional concerns about health, weight, or appearance. They are medical conditions that negatively affect a person's eating habits. Warning signs of eating disorders can include symptoms such as dry skin, a negative body image, or excessive exercise.

These illnesses, which can become life-threatening in some cases, affect a person's physical and mental health. With treatment, people can fully recover from eating disorders, which is why it's essential to know the signs and symptoms of one. Here's more about the signs of eating disorders and what to do to get or find help.

What Is an Eating Disorder?

Eating disorders are called Feeding and Eating Disorders in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5). They involve a persistent disturbance of eating behavior that impacts a person's physical and/or mental well-being. People with an eating disorder may become obsessed with losing weight, examining their body weight or shape, and controlling their eating habits.

Eating disorders can affect anyone. People of any race, ethnicity, body weight, sexual orientation, or gender experience eating disorders. While eating disorders often appear during adolescence, children and adults can also show signs of illness.

Eating Disorder vs Disordered Eating

When a person engages in disordered eating, they may not eat mindfully or stop when satisfied. For example, some people may eat out of boredom. Others may decide to remove certain types of food from their diet when they don't have to.

Eating disorders may begin because of disordered eating. However, that does not mean everyone who starts disordered eating will have an eating disorder.

Common Eating Disorders

There are various types of eating disorders. Common ones include:

  • Anorexia nervosa: This condition is identified by a restricted intake of food that leads to significantly low body weight, an intense fear of gainging weight, and/or a distorted view of one's body shape or weight. It may also include denial of the seriousness of one's low body weight.

  • Avoidant or restrictive food intake disorder (ARFID): ARFID goes beyond being a picky eater. It occurs when a person restricts the variety of food they consume so much that they don't meet their nutritional needs.

  • Binge eating disorder (BED): This condition is characterized by uncontrollably eating large amounts of food in a short time. However, a person will not try to restrict their eating or rid their body of the food they've eaten through actions like vomiting or excessive exercise. These are known as purging behaviors.

  • Bulimia nervosa: Bulimia is similar to BED but includes restrictive eating and purging behaviors. A person may also have a healthy weight but possess a fear of gaining weight.

  • Pica: People with pica may desire to eat inedible things such as chalk, paper, or soap.

  • Rumination disorder: People with this disorder may bring up food they've already swallowed and chew it another time. After that, they will either re-swallow the regurgitated food or spit it out.

Other Eating Disorders

Additional eating disorders belong to the other specified feeding and eating disorders (OSFED) category. OSFED eating disorders include:

  • Atypical anorexia nervosa: Atypical anorexia has the same features as anorexia, except a person's weight is considered to be in an adequate range.

  • Night eating syndrome: People with night eating syndrome overeat after waking up from sleep or after the evening meal.

  • Purging disorder: Purging disorder is when a person engages in purging behaviors, such as self-induced vomiting, or misuse of laxatives, diuretics, or enemas, but not binge eating.

  • Subthreshold bulimia nervosa and binge eating disorder: A person with this eating disorder has not had symptoms that meet the specific criteria of bulimia or BED.

Also, another condition called compulsive exercise may be related to eating disorders, but it is not a DSM diagnosis. With compulsive exercise, people become obsessed with exercise. For example, they may use it to cope emotionally or as a purging behavior.

Signs and Symptoms of Eating Disorders

Some eating disorder symptoms are apparent, such as:

  • Low body weight

  • Losing a lot of weight quickly

  • Refusing to eat

  • Regularly retreating to the bathroom for long periods after meals

However, anorexia, bulimia, and binge eating disorder may reveal themselves more subtly. In fact, a person may be very ill even if they look healthy.

Not everyone with an eating disorder has the same symptoms, and most people with eating disorders won't display all warning signs at once. However, the following symptoms might suggest a problem.

Physical

It's important to note that physical symptoms will vary widely based on the specific eating disorder a person is diagnosed with. In addition, most physical symptoms could be attributed to other conditions, so it's important to look holistically at a person's symptoms in order to determine if an eating disorder is the cause.

Dry, blotchy skin, a symptom of dehydration sometimes signals ongoing anorexia or bulimia. Another skin change that's a telltale sign of bulimia is the appearance of calluses on the knuckles or the back of the hand, called Russell's sign.

Feeling cold is a symptom more often associated with anorexia than with bulimia or binge eating disorder. Malnutrition and low body fat may be the causes. Body fat stores energy and helps the body withstand cold. People with too little body fat can have difficulty maintaining their internal body temperature and, in some cases, may even develop hypothermia.

Fine hair may be a sign of an eating disorder. People continuously deprived of nutrition for extended periods may develop soft, downy hair—almost a thin film of fur—all over their bodies. This is called lanugo. This hair growth is a physical adaptation to the perilously low weight and body fat loss seen in some people with eating disorders.

Emotional

Feeling shy or self-conscious about eating around other people can be related to anxiety associated with eating disorders. A person may think that others are watching and judging them. They may also seem uncomfortable when eating with others.

Negative or obsessive thoughts about body size are critical in all eating disorders. People may feel unsatisfied with their bodies and think their bodies have flaws.

Behavioral

Being eager to see others eat is one behavior to watch for. Sometimes, people with eating disorders may go so far as to prepare meals for friends and family without eating the meals themselves. Studies have also found that people with negative eating habits are likelier to watch videos in which people eat copious amounts of food.

Compulsive behaviors similar to those seen in obsessive-compulsive disorder (OCD) can also appear with eating disorders. Also called rituals, some people may cut their food into tiny morsels or arrange food into specific patterns that feel "right." Rituals are mainly associated with anorexia (which often occurs alongside OCD). Still, they are sometimes early symptoms of other eating disorders.

Excessive exercise can go hand in hand with disordered eating. Defining "excessive" exercise can be tricky, especially with athletes or highly active young people. Research has suggested a higher rate of eating disorders among elite female athletes than among non-athletes (14% versus 5.1%, respectively) in Norwegian high school students. However, if a person panics about a missed workout or exercises despite injuries or illness, an eating disorder could be the cause.

A preoccupation with foods deemed to be "safe" or "healthy" is the hallmark of a condition that has come to be known as orthorexia. Studies have noted that orthorexia is an approach to eating that "reflects a clinically meaningful, pathological obsession with eating only healthy, 'pure' foods."

Preparing dishes using an odd mixture of ingredients can be a behavior of people who binge. Research has demonstrated that people who binge may be more likely to create unusual food concoctions. In addition, people who restrict their diets may concoct more often, largely due to cravings.

Related: Are Eating Disorders a Form of Addiction?

How to Support Someone With an Eating Disorder

Many people with eating disorders report that the support of friends and family is vital to their recovery, so you're in a unique position to help a loved one if they need it.

Reach Out to Your Loved One

Knowing the signs and symptoms of eating disorders is the first step. You'll also want to learn more about the facts and myths about nutrition, exercise, and weight.

The next step is to have a private chat with your loved one. You may want to rehearse beforehand what you plan to say. This is when you will calmly raise your concerns about behaviors and changes you've noticed, including those that may not relate to weight and eating.

The following tips may be helpful:

  • Avoid overly simple solutions: Saying something like "just eat," for example, is likely to leave your loved one annoyed or defensive.

  • Avoid stigma: Reassure your loved one that having an eating disorder or other mental health issue is nothing to be ashamed of. Plenty of people have an eating disorder at some point in their lives, and it's possible to recover fully.

  • Don't make rules or promises you will not keep: For example, it's best not to make statements like "I won't tell anyone" or "I'll never talk to you again if you keep doing this."

  • Use "I" statements: Consider "I" statements such as "I've noticed you run to the bathroom after meals, and I'm worried you might be making yourself throw up." Comments like this one are less likely to make a person feel defensive than statements like "You're exercising too much."

  • Prepare for negative responses: While some people with eating disorders may feel relieved that someone has reached out, others may become hostile or dismissive. These are all normal responses. If you receive a negative reaction, repeat your concerns, reassure them that you care, and leave the door open for future conversation.

At first, some people may feel more comfortable focusing on the side effects of their eating disorder, such as depression, social isolation, or feeling cold. This can be a stepping stone to addressing the eating disorder itself.

Offer your loved one a listening ear when they need it. Also, remind them of some reasons they may want to recover—for example, if they have life goals of going to college or having children.

Encourage Your Loved One to Get Help

Treatment increases a person's likelihood of recovering from an eating disorder. You'll want to encourage the person to get professional help—including therapy and medical checkups. If they don't have a therapist or healthcare provider, offer to help them find one and set up an appointment.

Ask if they would like you to accompany them to the appointment. Otherwise, follow up to ensure they are making appointments and seeing a healthcare provider.

If all else fails, you may need to tell someone else about their symptoms. Parents and guardians of children under 18 can often require their children to receive help if they have an eating disorder. Call 911 or seek immediate medical attention if there is a medical or psychiatric emergency.

While you should regularly follow up to see how your loved one is doing and whether they are seeking or receiving treatment, they may try to avoid you if you force the topic. Make sure that your relationship doesn't revolve around the eating disorder. Help them feel included and valued by inviting them to join activities and telling them how much you appreciate having them in your life.

Resources for People With Eating Disorders

You or your loved one can text or call the National Eating Disorders Association (NEDA) Helpline at 1-800-931-2237 for support, information, and resources. NEDA also has an online chat and can help you find treatment.

NEDA can point you or your loved one toward affordable treatment options even if they don't have insurance. They can also offer help with finding free and affordable support options to supplement professional help.

Let your loved one know that in a crisis, they can text “NEDA” to 741741 to receive support from a volunteer counselor at the Crisis Text Line. Alternatively, they can text or call the Suicide & Crisis Lifeline at 988. Both of these resources are available 24/7. For more mental health resources, see our National Helpline Database.

A Quick Review

Eating disorders can harm a person's physical and mental well-being and even be life-threatening. People with eating disorders are more likely to recover when they have support from friends and family.

Understanding the warning signs can help you recognize whether a loved one might have an eating disorder and allow you to offer help if needed. Contact the National Eating Disorders Association (NEDA) Helpline for support and resources if you or a loved one have an eating disorder.

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