Eating disorders are complex conditions that are difficult to address, but it’s absolutely vital to do so. Sometimes that means recognizing ― and stepping up ― if a loved one is at risk or is currently dealing with one.
An estimated 30 million Americans live with an eating disorder, which is the most fatal mental health condition. There’s also a common misconception that the illnesses only affect young, thin women. Data actually shows nearly 10 million men in the United States will experience an eating disorder at some point in their lives. A recent survey also found more than half of young LGBTQ people have an eating disorder.
While some symptoms of an eating disorder may be more visible to the naked eye, many others are often hidden in plain sight.
“Often the signs of an eating disorder at first are very subtle or sometimes appear to be healthy in nature,” said Susan Albers, a licensed clinical psychologist at the Cleveland Clinic and author of Eating Mindfully for Teens: A Workbook to Help You Make Healthy Choices, End Emotional Eating, and Feel Great.
It’s important to know what to look for in those who might be at risk for an eating disorder. Below are a few subtle signs someone you love might be dealing with a condition and a few ways you can help, according to experts.
1. They’re constantly talking about dieting
The discussion around changing eating habits is incredibly pervasive. Look at any lifestyle magazine or website and you’ll likely find dieting tips and advice. However, an obsession with it is a different story. If someone you love is constantly ruminating over food or drastically yo-yoing with their dieting habits, it might be cause for concern.
“An eating disorder is not always obvious given that it is often a secretive disorder,” said Dena Cabrera, executive clinical director for Rosewood Centers for Eating Disorders. “Also, talk about diets, body image, and weight are often a common part of everyday conversation. Therefore it is a little more difficult to detect.”
2. They’re cutting out entire food groups
Eliminating foods from a diet isn’t always cause for alarm, especially when it’s prescribed by a doctor. But if there’s no apparent health, religious or moral reason behind the change, it might be a sign something more serious is at play, according to Albers.
3. Their fitness or eating habits are out of the ordinary
“Changes in mood or behaviors surrounding food or exercise can be signs of concern,” said Lauren Smolar, the director of programs at the National Eating Disorders Association.
This could mean a switch in activity level (like overexercising, for example), excessively counting calories, frequently visiting the bathroom after eating, fasting or binge eating. This also might come with a noticeable weight fluctuation, Smolar said.
Mood changes associated with eating may also be a red flag, Cabrera added. This could include expressing feelings of disgust, shame or guilt after eating, or a sense of perfectionism associated with eating and exercising.
4. Their physical appearance is shifting
There are other outward physical effects of eating disorders aside from weight changes. The conditions can cause nail brittleness, skin rashes, tooth erosion and hair thinning, according to Kristin Wilson, vice president of clinical outreach at the Newport Academy, a Connecticut-based center for teens experiencing mental health issues. A person living with an eating disorder might also bruise easily and get cold easily.
5. They’re taking laxatives somewhat often
Someone living with an eating disorder might overuse laxatives or diuretics, according to Cabrera, as a way to get rid of food that may have been consumed during a binge episode. Someone with disordered eating could also overuse diet pills, she added.
6. They’re constantly turning down food-centric social gatherings
“Avoiding social interactions such as birthday parties or going out to dinner with friends is a significant red flag,” Albers said.
Since there’s such an intense focus on food or body image, many people living with the condition will withdraw from situations ― likely ones that once brought them joy ― where that mindset might be tested.
“An eating disorder that progresses can cause a lot of emotional distress and consume someone’s life,” Albers continued. “I’ve seen it cause a lot of pain in their relationships, missing opportunities to enjoy life and [taking] away the energy that they could be putting into other things that make them happy.”
7. They’re showing signs of other mental health issues
It’s not unheard of for eating disorders to occur in conjunction with other illnesses like depression or anxiety, both of which have physical and mental symptoms on their own. The impact of untreated eating disorders can be deadly, Albers stressed, which is why it’s crucial for someone living with an eating disorder to get professional support.
“They can have serious medical and emotional consequences,” Albers said. “Identifying and classifying an eating disorder early is helpful.”
How To Help
The first step to getting someone help is addressing what’s going on. Don’t ignore any glaring signs that show someone is dealing with an eating disorder.
“It’s often tempting to look the other way, avoid it or assume that the person is on a diet,” Albers said. “You can make some gentle inquires such as, ‘I’ve noted that you’ve changed your eating habits, what’s prompted the change?’”
The best way to support someone who may be experiencing an eating disorder is by talking with them, but when and how you do it matters.
“It is important to find a time to have a conversation away from the normal routine and outside of a meal time,” said Bonnie Brennan, senior clinical director of the Eating Recovery Center in Denver. “Approach them with love and compassion, let them know that you care about them and that you notice that there is something they may be struggling with.”
And, most importantly, you should stress to anyone who might be dealing with an eating disorder that recovery isn’t just possible, it’s probable.
“It is never too early to seek care. You don’t have to wait until you need the hospital to get treatment, and it is never too late to seek care, even if you have been in your eating disorder for a long time,” Brennan said. “Recovery happens every day.”
If you're struggling with an eating disorder, call the National Eating Disorder Association hotline at 1-800-931-2237.