By William Marsh, Southwest Behavioral & Health Services
While eating disorders are commonly known for warning signs such as frequent dieting, noticeable undereating, overeating, and more, they can also be present in hidden ways.
Though these overlooked signs do not equal an eating disorder, spotting the lesser-known signs and talking about them to reduce stigma and offer support can significantly change someone’s life.
Here are some examples:
Eating rituals
Cutting or tearing food into small pieces, using excessive condiments, not allowing food to touch on the plate, and arranging food into groups are all signs of eating rituals that may be worth exploring.
In many cases, these tactics may be used by those with eating disorders to distract others from noticing how little food they are consuming during a meal.
While these behaviors may provide temporary comfort and relief for individuals who engage in them, they can reinforce disordered eating by successfully going undetected or increasing anxiety, leading to alternative hidden behaviors.
Extreme exercising
Like most everything, exercise is great, in moderation. While exercise habits may appear healthy, in excess, they can be signs of an eating disorder. Some forms of purging involve excessive exercising or sweating, despite physical and mental limitations.
Exercise may also be used to replace eating a meal, such as during a lunch hour. Some individuals may face guilt from missing a workout or abandoning other parts of their lives, such as family, friends, and responsibilities to meet weight loss goals, look a particular way, or make up for binge eating.
Food concoctions
We hear about odd food pairings during pregnancies, but they may be a sign of binge eating among those not pregnant. Food pairings such as sugar on scrambled eggs or pickles with chocolate are concoctions.
These concoctions are often eaten secretively due to fear of embarrassment or judgment from others. You may find hidden plates or remnants of the foods in their room or other locations in their living space.
Feeling cold
While we all feel cold at times, those who have eating disorders can have trouble maintaining body temperature and may frequently complain of coldness due to malnutrition or a lack of body fat, which helps the body withstand cold.
Body image insecurity
Hearing someone make frequent self-deprecating comments about their appearance may be a sign to explore. Those with poor or false perceptions of their physique, weight or attractiveness may be susceptible to disordered eating and exercising habits.
Direct challenges to their perceptions may be the first response; however, consider talking to them about where their perception comes from and if they’re open to believing something different or seeking professional help.
Changes in physical appearance
Our bodies require nutrients to maintain healthy skin, strong nails, and thick hair. Someone malnourished may lack the necessary building blocks to have a visibly healthy appearance.
Physical signs include eroded teeth, thin or fine powdery hair, dry and yellowed skin, nails, sunken cheeks or eye sockets, swollen jawline, or disturbed menstruation or libido.
Symptoms of eating disorders are not always apparent, and identifying warning signs in yourself or others and obtaining help can save lives.
Editor’s note: William Marsh is a clinical director and a primary supervisor for the APA-accredited clinical psychology internship program at Southwest Behavioral & Health Services. Visit sbhservices.org.
