How to Tell if Someone has an Eating Disorder including Risk Factors

How to tell if someone has an eating disorder and knowing when to ask for help isn’t always obvious. Whether you’re concerned for yourself or a loved one, you may be feeling confused about how to proceed.

Perhaps you aren’t sure what constitutes “disordered eating” or can’t tell if you’re “sick enough” to ask for help.

Maybe the behaviors are new and you’re waiting to see how it plays out. Or maybe the behaviors have been going on long enough that you just assumed they were normal.

Whatever the reason for your apprehension, I encourage you to trust your intuition.

If something feels “off,” you’ve already done the right thing by looking for additional resources like this blog. Sometimes just acknowledging there is a problem—and knowing there are professionals who can assist you—can relieve some of the anxiety that comes with asking for help.

As scary as it may seem, there is no harm in having yourself or your loved one get an evaluation by an eating disorder professional.

Often, this can be as simple as setting up a “getting-to-know-you” session with a therapist or dietitian that specializes in disordered eating.

Early intervention is important when it comes to minimizing medical risks and creating the best outcomes, but asking for help at any time along the way is better than suffering alone.

How to tell if someone has an eating disorder: Know the Risks

Be aware of eating disorder risk

Eating disorders are complex mental health illnesses with very serious physical side effects.

Knowing what to look for early on can help get you or your loved one the expedient help they need in order to recover. Here are some things to keep in mind as you begin to assess symptoms and behaviors:

1. Eating disorders don’t have a “look”

Eating disorders can affect anyone in ANY body size. Just because someone is in the “normal” BMI range or “looks healthy” doesn’t mean they are immune to suffering from an eating disorder.

The same goes for individuals in larger bodies with BMI’s considered “overweight” or “obese.” In many cases, these individuals are the last to get diagnosed for eating disorders because dieting and weight loss for people in larger bodies is often celebrated as a “healthy lifestyle” change.

An eating disorder professional can discern weight loss as a result of healthy, sustainable habits from weight loss as a result of disordered behaviors.

Remember: Weight loss is not healthy if it comes at the cost of your mental health, regardless of your size.

2. Eating disorders can affect very intelligent individuals

It is a mistake to assume that just because someone “is smart enough to know better” they don’t have or won’t get an eating disorder. Eating disorders can affect individuals who are sensitive, intuitive, and often very intelligent.

They may feel things very deeply and may dwell or fixate on troubling experiences more so than others.

Often individuals with eating disorders identify as having “addictive” personalities and struggle with obsessive or perfectionist tendencies.

3. Eating disorders may run in your family

Eating disorders are hereditary, meaning they can run in families. Having a complete family medical history that includes mental health is important.

This includes instances of eating disorders, substance abuse, alcoholism, depression, and suicide.

Having these diagnoses in the family does not mean that someone is “doomed” to suffer from an eating disorder. And in the end, it can help identify risk and make early diagnosis easier.

4. Eating disorders flare when triggered

Triggers are life events that may stir up disordered thoughts in an individual with an eating disorder.

Common triggers include puberty, an illness in the family (especially one that requires dietary intervention), times of transition like divorce, moving, or going to a new school, and trauma.

Triggers may also be anything that exceeds the individual’s ability to cope, as disordered behaviors often provide a sense of comfort when situations or emotions feel out of control.

These events do not “guarantee” the onset of an eating disorder in all people but it is important to be aware of them, especially for individuals who may be at greater risk due to their genetics or personality.

How to Tell if Someone has an Eating Disorder: Signs to look out for

1. Changes in food behaviors

One indicator that your loved one may be struggling with disordered eating is a drastic change in their eating habits. Ask yourself the following about your loved one’s eating habits.

While a positive response to a single question may not be cause for alarm, several positive responses may warrant further investigation:

• Are they suddenly skipping meals? Maybe they say they already ate or that they will be eating at a friend’s house. Or maybe they simply claim they aren’t hungry?
• Do they spend lots of time cutting their food up or moving it around their plate at the dinner table?
• Do they seem to get anxious when you suggest eating out at a restaurant?
• Have they suddenly become a vegetarian or vegan?
• Do you see them reading food labels more often and choosing foods with lower calories or fat content?
• Have they cut out foods that they used to love?
• Have they stopped eating dinner with the family?
• Have they started eating in secret or hoarding foods?
• Have they started cooking or baking for others without taking part in enjoying what they have made?

2. Changes in exercise

You may think that the changes your child has made in terms of physical activity are healthy ones. Yet, while these changes may not be an indication that anything is wrong, it is possible they may be signs of something deeper.

Here are some questions to ask yourself about your loved one’s exercise habits:

• Do they compulsively exercise after eating (meaning do they feel compelled to exercise regardless of time, fullness, energy levels, etc.)? Do they get emotional or agitated when they are unable to exercise after a meal or that day?
• Do they spend hours at the gym, when before they disliked sports/physical activity?
• Do they have a rigid workout schedule that is maintained regardless of injury or fatigue?
• Have they made comments about exercising (like needing to “burn off calories,” “earn a meal,” or proclaiming “no days off”)?

3. Changes in attitude or sleeping habits

• Does your loved one, who used to be an early riser, now sleep all day when they’re at home? Or are they having insomnia at night?
• Are they more moody or irritable than before?

4. Changes in physical appearance

• Has your loved one lost a significant amount of weight? Regardless of if they started a “normal” or higher weight, has there been a significant or rapid change?
• Do you notice that their hair seems dry, brittle, thinning, or breaking off? Has their skin broken out?
• Do they complain of being cold all the time?
• Have their clothing choices changed to wearing baggy clothes or clothing considered inappropriate for the weather?

5. Changes in other medical symptoms

• Do they complain of being full after just a small amount of food?
• Have they stopped menstruating?
• Have they had an increase in anxiety or obsessive behaviors?

How to get help:

Eating disorders are mental health illnesses, like anxiety or depression, that require treatment.

Remember to be understanding of the fact that if your loved one is dealing with disordered eating, this is not something that they are choosing for themselves or can stop doing at a moment’s notice.

Your valid expressions of concern may be met with defensiveness.

The most crucial step in getting help for someone who may be struggling with disordered eating is to visit a Registered Dietitian or therapist to determine what the problem is.

The National Eating Disorders Association (NEDA) has a toolkit on their website that will help you find a Registered Dietitian in your area. T

hey also provide an online screening for Eating Disorders.

This is not as comprehensive as what you would get from a face-to- face screening, but it may alert you to areas of concern before deciding to schedule an appointment.

Here is a list of some Resources:

• NEDA Parent Toolkit
• FEAST Website
• Eating Disorder Hope Resource Page

At our practice, we use the EAT-26 screening tool that you can access here. A score above 20 indicates that an eating disorder may be present. If you are concerned about your own eating patterns, or that of a loved one, our team has multiple dietitians that specialize in disordered eating that can help. You can reach our office to schedule an appointment at 301-474-2499 or by email at [email protected] for more information about How to Tell if Someone has an Eating Disorder.