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Eating Disorders: Lesser Known Signs and Symptoms

Eating disorder pictureEating disorders such as anorexia nervosa and bulimia nervosa can cause serious damage to the body.  Dangers include malnutrition, dehydration, vitamin deficiency, electrolyte imbalance and significant risk for heart attack.  Frequent purging can cause tears in the esophagus or gastrointestinal tract which can result in death.  These are only a few examples of the havoc eating disorders can wreak on the body.

The following is a brief description of the criteria individuals need to meet in order to be diagnosed with one of these eating disorders:

Anorexia Nervosa:

  • Restriction of caloric intake resulting in body weight which is lower than expected (based on age, sex, individual growth trend and physical health)
  • Fear of weight gain and behaviors which inhibit weight gain despite low body weight
  • Distorted perception of one’s weight or body shape; weight and body shape have a significant impact on one’s self-evaluation
  • Two forms of anorexia: restricting type or binge/purge type

Bulimia Nervosa:

  • Recurrent episodes of binge eating (eating much more in a two hour period than most people would) and feeling a lack of control over eating during the episode
  • Recurrent behaviors which compensate for the food intake (self-induced vomiting, laxative misuse, diet pills, excessive exercise, or fasting)
  • Weight and body shape have a significant impact on one’s self-evaluation

There are warning signs that signal concern before the behaviors turn into a full-fledged diagnosis, but they can often be mistaken for normal dieting behavior (common among women and adolescent girls in our culture).  These warning signs do not necessarily indicate the presence of an eating disorder; however, when multiple signs are noticed together, it could suggest a need to have someone evaluated by a professional.  Earlier treatment is correlated with better outcome.  Here are some lesser known signs that those who treat eating disorders commonly see:

  • “I’m a vegetarian.”  It is not uncommon for individuals who experience eating disorders or eating disordered behavior to cut out certain food groups.  This aids in the restriction of food intake if the individual has a list of things they no longer allow themselves to eat.  It is not uncommon for individuals with eating disorders to suddenly become vegetarian or vegan.
  • “I’m allergic to gluten.”  This is similar to the previous warning sign.  Often times, the patient might claim to have sudden food allergies, perhaps to wheat, gluten or other food groups.  While it could be true that the individual has a food allergy, it also could be a way to cut out entire food groups to help with the restriction process.  It is important for anyone in treatment to have a food allergy verified by a physician.
  • “I already ate/I’m not hungry.”  Often times eating disorder behaviors feel very shameful and therefore occur in secret.  If someone avoids eating in front of others, avoids situations where food might be present, or seems to be making excuses not to eat at normal mealtimes, these could be potential warning signs
  • “I was just trying to be healthy.”  It is not uncommon for eating disorders to develop without the awareness of parents or even the identified patient.  Sometimes what starts as trying to eat in a more healthy fashion or an interest in “clean eating” or an intense interest in fitness can develop into harmful behaviors and can result in an unhealthy weight.
  • Other behaviors that could signal potential problems include:
    • Firm food rules
    • Obsession with a particular food
    • Ritualistic behaviors with food
    • Frequently checking one’s weight
    • Fear of eating certain foods

The most effective treatment of eating disorders involves a multidisciplinary team, including a therapist, a dietitian, a physician and possibly a psychiatrist to treat any other co-occurring disorders.  For more information on what to do if you or someone you love is exhibiting signs of an eating disorder, go to http://www.nationaleatingdisorders.org/.


Colleen Damino By Colleen Damino, PsyD 4 at MSP

Colleen is a fourth year PsyD student at MSP. In her current internship placement, she sees a number of presenting concerns, but     receives specialized training in the treatment of eating disorders. She also has a passion for working with LGBT-related issues and is currently researching “The Experience of Religious Rejection Based on Sexual Orientation.”