Eating disorders are complex medical and psychiatric illnesses that are more common than we once believed. Newer studies point to rates of 5.2% among girls ages 12-20 for anorexia, bulimia, or binge eating disorder. When researchers included nonspecific eating disorder symptoms, that number rose to 13.2% (Stice et al., 2010). It is thought that approximately 20 million females and 10 million males in the US alone will have a clinically significant eating disorder at some point in their lifetime. Importantly, eating disorders can lead to a host of physical, emotional, and social difficulties that have a lasting and sometimes even life-threatening impact.

In order to achieve recovery, professional help from therapists, psychiatrists, and nutritionists is often needed. Many times however, people suffering from eating disorders are hesitant to enter treatment, which is where friends and family come in. Support and encouragement from loved ones to seek professional help can make a huge difference, but how do we know when to step in?

Many of us have heard of, and might easily notice some of the classic signs of an eating disorder, including significant weight loss or weight gain, frequent negative comments about one’s body weight/shape or size, eating very little or nothing at all at meals, over-exercising, or pre-occupation with losing weight. But noticing that a loved one is struggling can be harder that you think. We often assume that someone must be overweight in order to have an eating disorder, but many people of “average” or higher weight suffer just as much. The problem is that individuals with eating disorder symptoms often feel intense shame, leading them to become very adept at hiding their feelings and behaviors. This secrecy can make it difficult for us to notice that our child, friend, or family member is suffering. Here are some indicators (beyond the one’s that many of us typically look for) that may be a sign of trouble:

Frequently checking in the mirror for perceived flaws

Not eating in public or with others

Disappearance of large amounts of food in short periods of time (lots of empty wrapper and containers)

Consistently making excuses to avoid mealtimes or situations involving food

Unusual swelling of the cheeks or jaw area

Preoccupation with food

Hoarding or hiding food

Disappearing after eating (often to the bathroom)

Unusual food rituals (cutting food into small pieces, chewing each bit an unusually large number of times, eating very slowly)

Frequent fad diets (cutting out entire food groups, no sugar, no carbs, no dairy, veganism/vegetarianism)

Obsessive interest in cooking shows or collecting recipes

Avoiding certain foods

Withdrawal from usual friends and social activities

Making excuses for not eating

Cooking elaborate meals for others, but refusing to eat themselves

Eating strange combinations of foods

Wearing bulky, large clothing or layers to hide weight loss or body

Flat mood or lack of emotion


Sleep problems

Feeling cold all the time

Difficulty concentrating

Stomach aches or other non-specific gastrointestinal complaints

Dental problems, such as enamel erosion, cavities, and tooth sensitivity

Mood swings

Hyperactivity or restlessness (unable to sit down)

Rigidity in behaviors and routines – extreme anxiety if these are interrupted

Excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury

If you notice these symptoms in your child, family member, or friend, it’s a good idea to start a conversation and encourage them to seek professional help.

For more information, visit some of the websites below:

Stice E, Mar CN, Shaw H, and Jaconis M. (2010). An 8-year longitudinal study of the natural history of threshold, subthreshold, and par al ea ng disorders from a community sample of adolescents. Journal of Abnormal Psychology, 118(3):587-97.