Written by Joan Zhang, clinical review by Sehrish Ali PhD, LPC, CEDS

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We’re all surrounded by the pervasive messages around body ideals and diet culture, so it’s no surprise many people struggle with disordered eating habits that may manifest as restrictive dieting or an unhealthy relationship with food. But when does disordered eating cross the line into eating disorder territory? 

The line may blur between disordered eating and eating disorders, but there are subtle eating disorder signs that, over time, can add up to life-threatening conditions that interfere with relationships, educational and career goals, hobbies, and day-to-day life.

If you’re wondering how to tell if you have an eating disorder, read on as we explore the most common signs and symptoms people with eating disorders tend to have. Most importantly, consider this a safe space for exploring questions you may have about eating disorders and, if you’re ready, seeking treatment and support. 

What are common eating disorders and their symptoms?

At some point in their lives, over 28 million Americans will grapple with an eating disorder. Although some eating disorders have historically been shown to be more common in women, often starting in adolescence or young adulthood, they can impact people of any age, gender, cultural background, and body size. Some of the common types that you may have heard of include anorexia nervosa, bulimia nervosa, and binge eating disorder. However, there are many others that we’ll walk through together.

People struggling with an eating disorder may have all-consuming concerns with body shape, weight, and food. The American Psychiatric Association (APA) notes that eating disorders often coexist with other mental health issues like anxiety or mood disorders. 

For those struggling with disordered eating habits, knowing what to look for is the first step to healing. Here’s a closer look at common eating disorders and their symptoms — which are either defined in the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or fall under other recognized categories of disordered eating. As a note, while the DSM-5 is the field’s standard diagnostic criteria, we want to acknowledge that it’s far from perfect and is limited in its ability to capture everyone’s experiences. In fact, the DSM is updated regularly and we see these criteria evolve with each edition. Even if you don’t resonate perfectly with all of the criteria, it can be helpful to discuss your experiences with a trusted friend or care provider.

Anorexia

People with anorexia nervosa tend to have an extreme fear of gaining weight, which may materialize as severe calorie restriction, excessive exercise, and a persistent pursuit of being thin. Symptoms may include significant weight loss, restrictive eating, calorie counting, and a distorted self-perception — for instance, viewing oneself as being overweight even when underweight. Importantly, people of all body sizes can experience Anorexia and there’s continued work that is being done to expand the healthcare field’s recognition and screening for Anorexia.

Bulimia

Bulimia nervosa involves repeated episodes of overeating followed by vomiting, laxative use, fasting, or excessive exercise.. Signs of bulimia often include secretive binge eating, weight fluctuations, frequent bathroom visits after meals, and dental erosion and throat sores resulting from frequent contact with gastric juices. While exercise is broadly thought of positively in society, oftentimes compensatory exercise may be present in individuals with Bulimia which involves utilizing exercise to compensate for the food that was consumed.

Avoidant/Restrictive Food Intake Disorder (ARFID)

People with avoidant/restrictive food intake disorder (ARFID), previously known as “feeding disorder of infancy and early childhood,” tend to avoid various foods due to disinterest or sensory aversions. Symptoms may include inadequate calorie and nutrient intake, disruptions in social eating, and weight loss or stunted growth. 

ARFID differs from typical picky eating and isn't related to food scarcity or cultural/religious practices. Also, individuals with ARFID do not necessarily fear weight gain or have body image issues, though this can sometimes still be present. 

Binge Eating Disorder

Binge eating disorder involves recurrent episodes of consuming large amounts of food in a short period while feeling a lack of control over eating behavior. Unlike bulimia, individuals with binge eating disorder do not engage in compensatory behaviors like vomiting or over-exercising. Symptoms include eating even when not hungry, eating alone due to embarrassment, and feeling guilty or ashamed after binge eating episodes.

Pica

The persistent consumption of non-food substances such as ice, dirt, hair, soap, paper, or chalk characterizes Pica. This disorder typically co-occurs with other conditions such as autism spectrum disorder, schizophrenia, or certain intellectual impairments. Over time, consuming such substances can lead to gastrointestinal complications, nutritional deficiencies, or poisoning.

Orthorexia

Orthorexia nervosa is an obsession with healthy eating, leading to rigid dietary restrictions and compulsive behaviors related to food quality and preparation. Unlike other eating disorders, orthorexia focuses more on the quality of food rather than quantity or weight. Symptoms include strict adherence to self-imposed dietary rules, obsession with ingredient lists, anxiety or guilt when deviating from those rules, and reluctance to eat out. 

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Diabulimia

Diabulimia describes the intentional misuse of insulin by individuals with type 1 diabetes. Symptoms include skipping insulin injections to induce hyperglycemia (high blood sugar) and subsequent weight loss, increased thirst, frequent urination, and blood sugar fluctuations. Diabulimia poses serious health risks, including diabetic ketoacidosis, organ failure, and nerve damage.

Other Specified Feeding or Eating Disorder (OSFED)

Other specified feeding or eating disorder (OSFED), formerly known as eating disorder not otherwise specified (EDNOS), is one of the most common types of eating disorders. OSFED encompasses a range of disordered eating patterns that do not meet the criteria for a specific eating disorder. Symptoms vary depending on the particular subtype of OSFED but may encompass behaviors seen in other eating disorders. Importantly, OSFED is not necessarily less severe and can often be trickier to identify and treat because of the diverse symptom presentations.

Examples of OSFEDs include: 

• “Atypical” anorexia nervosa, where weight is not significantly low despite exhibiting anorexia symptoms. There is important advocacy work being done to challenge the use of “Atypical” and we’ll dive deeper into the role of weight stigma and the use of this term in a future blog post.
• Subthreshold bulimia nervosa, whereby individuals may exhibit symptoms similar to bulimia nervosa but do not meet all DSM-5 diagnostic criteria
• Binge eating disorder, as defined above
• Purging disorder, or purging without binge eating
• Night eating syndrome

What behaviors and feelings are potential warning signs?

Here’s a list of questions to help identify potential warning signs of disordered eating behaviors and feelings:

• Do you get nervous eating certain foods out of fear that you may gain weight or that they’re “bad” for you, such as carbs and sugars?
• Do you engage in negative self-talk around your food consumption?
• Do you feel triggered and anxious every time you have to eat?
• Do you find that food comforts you and helps you cope, but you constantly feel physically uncomfortable and guilty afterward?
• Are you preoccupied with thoughts about food and your body image?
• Do you notice yourself doing anything “different” with your food than others?
• Do you intentionally restrict what you eat in a day?
• Do you cut out certain types of foods or entire food groups from your diet?
• Do you track what you eat via an app, in your mind, or on paper?
• Are you scared or anxious to eat in front of others?
• Do you engage in self-induced vomiting?
• Do you engage in excessive exercise as a means of controlling your weight?
• Do you use laxatives, diuretics, or diet pills to control your weight or eating habits?

While it’s not necessarily concerning to watch what you eat, it's crucial to be mindful of when behaviors begin interfering with your health and happiness. If you find yourself nodding at several of these questions or notice a pattern of disordered eating behaviors and feelings, it may be worthwhile to seek professional support. You don’t have to wait until you meet all of the criteria above, it’s important and even beneficial to get support earlier on through a supportive community or care team.

What are some physical symptoms? 

Physical symptoms of eating disorders may include:

• Rapid changes in weight up or down
• Dry skin and hair, brittle nails, and thinning hair 
• Stomach cramps, constipation, acid reflux, and other digestive symptoms
• Dizziness, fatigue, and light-headedness 
• Difficulty concentrating
• Difficulty sleeping or insomnia 
• Irregular or missed periods

What are some signs to look for in someone I’m concerned about?

Watch for the following signs if you’re concerned someone you know may have an eating disorder:

• Secrecy or lying about food or eating
• Mood disturbances
• Unexplained disappearance of large amounts of food in short periods of time
• Frequent comments about feeling fat or overweight or about a fear of gaining weight
• Personality changes around meal times or before and after exercise
• A rigid focus on counting or tracking calories
• Withdrawal from friends, social activities, and the community

When to know to seek help? 

If you're unsure whether your symptoms are concerning enough to seek help, remember this: wanting to understand your eating behaviors and feelings about food is a good enough reason to reach out. You don’t have to wait until your symptoms worsen to get answers. 

Here at Arise, we recognize that eating disorders are complex and don’t “look like” any one thing. They can affect anyone at any age and might not fit neatly under one category or definition. 

If you're struggling with issues related to food, body image, and mental health, know that you're not alone. Arise is here for you. We're a fully virtual eating disorder program created by individuals who have lived through these challenges ourselves. Together, we've developed a program that prioritizes meeting your unique needs. 

Take the first step today toward personalized, compassionate care — whether you're feeling just a little off or struggling with persistent eating challenges.

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