Eating Disorder Warning Signs and What To Do


Healthy Living – February 28, 2017
Mark R. Allen, MD – Acadia Hospital
This week is National Eating Disorders Awareness Week!  Per NEDA, “the goal is to shine the spotlight on eating disorders and put life-saving resources into the hands of those in need.”  This year’s theme is “It’s Time to Talk About It,” and the hope is to encourage people to get screened.

Eating Disorder Stats:
  • 40-60% of normal-weight adolescents view themselves as “overweight”
  • Nearly 60% of teens regularly diet to lose weight
  • >50% of teens report that they exercise in order to improve their shape or lose weight
  • Majority of teens acknowledge being preoccupied with how much they eat
  • Roughly 70% of girls report that their body shape is important to their self-esteem
  • Up to 10% of American teens have an eating disorder
Warning Signs & Symptoms of an Eating Disorder:
  • Change in attitudes or behaviors related to food, size/shape, and weight
  • Withdrawal from usual social activities, avoiding being with others
  • Developing odd eating habits, such as chewing each bite for extensive periods of time or cutting food into very small pieces
  • Perfectionistic about appearance (shape and weight)
  • Negative self-image or self-esteem tied to appearance
  • Hoarding and hiding food
  • Skipping meals, fasting for 24 hours, or eating in secret
  • Unhealthy, excessive exercise habits (even when ill or injured)
  • Disappearing after eating (often to the bathroom)
  • Dangerous dieting or “clean eating”
  • Obsessing over food labels for nutritional content
  • Large quantities of food disappearing in small amount of time
  • Gastrointestinal distress (constipation, acid reflux)
  • Being physically and emotionally uncomfortable after eating because of anxiety about the calories ingested
  • Losing weight to the bottom of the healthy range for age and size
Anorexia Nervosa-specific warning signs:
  • Excessive weight loss
  • If female, lacking a menstrual cycle
  • Lanugo (fine hair) on the face, arms, torso
  • Wearing baggy clothing
  • Appearing pale or dizzy
  • Fainting
Bulimia Nervosa-specific Warning Signs:
  • Fluctuating weight
  • Missing food around the house or secret eating
  • Cuts or scrapes on the back of the hand from purging
  • Tooth decay from vomiting
  • Using bathroom after meals
  • Taking diet pills
  • Abusing laxatives, emetics, or enemas
  • Demonstrating self-disparaging talk related to food intake
  • Having swollen glands, puffy cheeks, or broken blood vessels under the eyes
How to Help a Loved One:
  • Express your concerns in a loving, compassionate way, but do not wait too long
  • Educate yourself about eating disorders so you can recognize signs and symptoms
  • Set aside time to have a private conversation and be prepared for it to be difficult
  • Remind them that you care about them and that you want them to be happy and healthy
  • Give love and attention to their needs, not yours
  • Don’t give advice about weight loss, exercise, or appearance
  • Avoid placing shame or guilt
  • Don’t oversimplify (“if you just start to accept yourself…” or “if you just started eating normally… everything would be fine”
  • Use “I” statements – e.g. “I’m concerned because you do not eat breakfast or lunch” or “It makes me afraid to hear you vomiting”
  • Set boundaries to preserve your own emotional well-being
  • Suggest that they seek professional help from a physician, dietician, or therapist (someone who knows about eating disorders)
For more information about eating disorders and to complete a free 3-minute eating disorder screening, please go to  For more information about the Acadia Hospital Outpatient Eating Disorders program, please call 207-973-6048, or go to