We'd like them to be easy to diagnose, but eating disorders are often much more complicated than that. Any given person may suffer from more than one at a time, and one list of symptoms doesn't necessarily equal the same verdict for everyone. It's important to keep in mind that many of the signals are less obvious than we might think. Not everyone suffering is skin and bones, haggard, and clearly starving. Because there are so many stereotypes around mental illnesses that deal with food, people who wrestle with them will do everything they can to keep it under wraps.
Having battled binge eating disorder (BED) since my teenage years, I know how tough it can be to hold onto countless habits that are secret and imperceptible to the outside human eye. Some of them seemed unrelated, but looking back after going through recovery, I can now see how they were all connected. Psychologist Ted Weltzin told Huffington Post that it's getting harder to precisely diagnose eating disorders, partly because the signals are so hidden, and he's training medical students to get better at recognizing the signs and knowing how to respond.
Remember that none of the following indications are meant to be a concrete diagnosis; if you feel like you might be struggling with any kind of mental illness, know that there's no reason for you to face it without a solid support. Talk to your closest friends and family, and schedule an appointment with a trusted doctor so you can talk about it in a safe space.
Here are eight subtle signs that you might be suffering from an eating disorder.
1. You Dread Eating In Front Of People
Cynthia Bulik, Ph.D., an eating disorder specialist at the University of North Carolina, Chapel Hill, says the anticipation of eating with a bunch of friends can be extremely anxiety-provoking for someone dealing with anorexia, BED, or any other related illness. The mere thought of people's eyes on you as you work your way through a whole plate of spaghetti can spark deeply-rooted stress, so you let it occupy your mind until it drives you crazy. You might be convinced that others will harshly judge you for the amount you do or don't consume.
This particular symptom is one that is invisible to everyone else. You know in your heart whether this is you, even if your partner and bestie has no idea this fear exists. I used to do my best to avoid girls' nights out and first dates that involved a proper dinner; I instead made up some wild excuse about how I wasn't able to meet for a meal, but that I was up for cocktails later. The dinners I couldn't weasel out of nearly gave me a panic attack.
Dr. Bulik says anxiety about any kind of eating, solo or with a group, is a sign that you should reach out for help. If you don't feel like going out to brunch on Sunday, that's perfectly OK — don't force yourself to go just to please someone else. But if you are facing serious stress over it, don't hesitate to speak to a medical professional.
2. You Think About Food All The Time
Ask yourself how often your next meal takes up your brain space. Are you constantly planning what you'll have for dinner or obsessing over the next snack you'll allow yourself? The more we think about food, the more we give it power over us; if this sounds vaguely familiar, you should consider getting help. People suffering from an eating disorder often think of their next meal based on how "skinny" or "fat" they think they look, and of course these perceptions are probably morphed compared to what others see.
I used to stress for hours in the morning about what I would eat later that night, pinching my stomach to decide if I could have anything more than sauteed spinach and a boiled egg. Just because an individual doesn't talk about food all the time doesn't necessarily mean it isn't a topic that haunts them. If this is you, don't be embarrassed to tell someone about it; the hardest part can be merely admitting that your brain is constantly bombarded with unhealthy thoughts about food.
3. You're Always Cooking Elaborate Meals For Others
People who refuse to eat normally themselves often eat vicariously through those around them, and that might look like a huge dinner party they host at their house, complete with a 4-course meal they create from scratch. It also might be a way of trying to convince others that they don't have an issue with food — why would they if they're such a good cook and have worked so hard to make artisanal roast lamb for a group of 10?
In the Minnesota Starving Experiment conducted in the 1940s, the people who struggled with semi-starvation and lost 25 percent or more of their body fat became obsessed with cooking. They boasted large libraries of cookbooks in their kitchen, had recipes lying around everywhere, yet they themselves didn't eat many calories in a day. This behavior has since been identified strongly in individuals with anorexia, although it certainly occurs amongst those who suffer from other kinds of eating disorders.
I was an expert at having people over to my apartment to make them mind-blowing food. I would plan the menus in advance and spend nearly two days slaving away in the kitchen to prepare a meal for all my friends. I did Mexican nights, a breakfast for dinner theme — all to convince others that I had a good relationship with food, when I was actually drowning in my own disease.
4. You're Constantly Cold
Our relationship with food shows up in more places than the kitchen. If a person is constantly cold, tossing on sweaters when the weather is quite mild, or shivering when everyone else seems to feel perfectly fine, this might be a sign of malnutrition. A body with a healthy amount of fat — yes, we need fat — stores energy and helps us handle lower temperatures that might come our way. When the fat levels are not where they should be, whether it's from not eating enough or extreme yo-yo dieting, we have trouble staying warm enough.
If you think you might be harboring an eating disorder, and you usually find yourself wrapped in an extra layer, you should seriously consider speaking to someone. The last thing you want is to do is unnecessarily suffer.
5. You Spend A Lot Of Time Looking At Your Stomach In Mirrors
They may not like what they see, but many people with an eating disorder spend a lot of time staring at themselves in the mirror, sizing up each and every detail about their body. Body dysmorphic disorder is often tied to diseases like bulimia and anorexia, so there is a lot of time spent obsessing over what they perceive their body to look like. But a person won't advertise their unhealthy relationship with mirrors; in fact, they almost always will check themselves out when nobody else is around.
During the worst period of my binge eating days, I used to lift up my shirt in front of every mirror in my apartment and inspect how much "fat" had accumulated. This was a habit that was never witnessed by anyone else, no boyfriends or family members, but it was directly connected to my mental illness. There was a lot of anxiety and negative feedback associated with the act as well — comments to myself like "You're so fat" and "You need to lose more weight." These are very common among people who have a similar disorder to BED.
6. You Have Weird Eating Rituals
Do you find yourself cutting up your plate of lasagna into strangely small morsels? Or only taking two bites at a time before you put your fork down and stare at your food for a while? Dr. Bulik says that bizarre eating habits are generally tactics that are incorporated to stop the person from eating too much, and these obsessive actions point to a destructive relationship with food. Weird rituals range across the whole spectrum — you might have a stash of snacks in your nightstand drawer that you only dig into when nobody else is around.
Sometimes eating disorders overlap with other mental illnesses that don't relate to food, and this sign may also point to a struggle with obsessive compulsive disorder (OCD). That's why it's important to see a doctor, because they can help you identify what the major problems are and give you a treatment regimen that addresses all the issues that are decreasing the quality of your life — not just your food habits.
7. Your Skin Is Extra Dry
Dehydrated skin that is blotchy or discolored means the person isn't getting the nutrition they need. It could be a result of purging or lack of eating properly, and it's an electrolyte imbalance. Other physical signs that may accompany flaky skin include sunken cheeks, bags under eyes, and dry mouth. The body is good at giving you signs that it's not being taken care of; don't ignore them!
If you notice a close friend who is carting around these physical symptoms, speak up from a place of caring. When the disorder gets out of hand, it will definitely show up on their bodies, and they deserve to get some help. I wish someone had said something to me when my facial features spoke a story of struggling with an eating disorder — my skin was constantly up and down, broken out in acne one week and dried up the next.
8. You Panic If You Can't Exercise
This was me to the T. I worked out compulsively — sometimes seven or eight times a week — for several reasons: I wanted to show others that I was "healthy," I was trying to make up for all the food I was binge eating late at night, and I obsessed over my body image. Excessive exercising is a telltale sign that you have an unhealthy relationship with your body and probably with food as well. If there is any acute anxiety — palms sweating, mind racing, sudden sweating — in response to you missing out on a workout, there might be an underlying problem.
Disordered eating and overexercising go hand-in-hand, and the person in question might talk about working out all the time too, like the new gym they joined or the 5K they just ran over the weekend. While staying active is obviously a great thing, it needs to be done in a conscious, balanced way. The second you start intensely worrying about whether you've exercised enough this week, especially in relation to what you're eating, is when you should think about asking for help.
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