5 Common Overlooked Signs of Eating Disorders
It’s common to miss the warning signs of an eating disorder because the behaviors are so normalized and often encouraged in the diet culture you live in.
Many parents, friends, and loved ones of those struggling with eating disorders blame themselves for missing the signs. Not only this, many people are overwhelmed and saddened with how long they went without getting help and support with their eating disorder. While all of these emotions are valid and normal, the truth is:
Eating disorders are incredibly conniving and deceitful.
Eating disorders do an extremely good job of going unnoticed and the diet culture that you live in rewards disordered behaviors that are part of an eating disorder. In fact, eating disorders strive to go unnoticed for as long as possible. Not only is it difficult to see and know if others are struggling with disordered eating, but it may be difficult to tell if you’re personally struggling with disordered eating or an eating disorder.
While you may feel quick to blame yourself for not seeing the signs, it is important to remember that even healthcare providers have a difficult time diagnosing eating disorders.
What is an eating disorder?
The Mayo Clinic defines an eating disorder as “a serious condition related to persistent eating behaviors that negatively impact your health, your emotions and your ability to function in important areas of life.” There are several different kinds of eating disorders, the most commonly diagnosed being anorexia nervosa, binge eating disorder, and bulimia nervosa. While each type of eating disorder has its own characteristics and behaviors, there are signs that are common across most eating disorders. Eating disorders come in all body sizes, body shapes and don’t discriminate across race and ethnicities. You cannot tell by looking at someone if they have an eating disorder, this is why it’s important to know and understand the signs and symptoms of eating disorders in order to help others (or yourself) in getting help.
Here are five commonly missed signs of an eating disorder that may help you identify if you or a loved one needs help:
1. Frequent constipation, abdominal pain, or bloating.
Digestive upset can be a result of various underlying conditions and they often get misdiagnosed. Even healthcare workers misattribute digestive symptoms to other conditions and as a result will often prescribe restrictive diets to “resolve” digestive problems that only get worse over time because of the restrictive diet. It’s unfortunately very rare that doctors, dietitians or other healthcare providers will have the knowledge and understanding that disordered eating can lead to lots of digestive issues.
One of the main reasons why restricting your food intake, i.e. when you diet or cut out food/food groups, causes constipation, abdominal pain and bloating, is because when you restrict food, you’re depriving your body of the fuel it needs to survive. Because your body is weak and not receiving enough fuel, it attempts to conserve as much energy as possible. As a result, your body makes sure to not waste any more energy than it needs to, and slows digestion and stops functioning normally.
In addition to constipation, abdominal pain, or bloating after eating, if you feel uncomfortably full after eating just a small amount of food, or full even hours after a meal, you may be experiencing what is known as gastroporesis.
What is gastroparesis?
Gastroparesis, in the simplest of terms, is when the stomach slows down its emptying. Normally, food is held in the stomach for two hours before it moves on through the rest of the digestive tract. When gastroporesis happens it causes food to remain in the stomach much longer than 2 hours. If you are experiencing gastroparesis, you may feel extreme discomfort, prolonged periods of fullness, abdominal pain, bloating, or constipation because your stomach is not emptying food at the speed it normally does.
You may find yourself eating less in order to avoid this discomfort and pain, which only worsens the gastroporesis symptoms. This creates a viscious cycle, leaving you in despair and stuck in cycles of disordered eating and stuck in the eating disorder.
Overall, although these ill-digestive symptoms can be a result of other conditions, abdominal pain, bloating, and constipation are commonly seen across the spectrum of eating disorders and should be something that is assessed.
2. Feelings of guilt or shame related to eating.
It’s very common for people suffering from eating disorders to experience feelings of guilt and/or shame about the foods they eat, the quantity of foods consumed, and timing of meals/snacks.
What is the difference between guilt and shame?
Shame is related to your character. When feeling shame, you may believe that you are a bad person or there’s something wrong with you. You may feel that you aren’t your “ideal” self, or that there is a gap between who you currently are and who you wish to be. Guilt on the otherhand is related to actions. You feel guilt as a result of your actions that you perceive as not ok, ie you’ve done something wrong.
Guilt says, “I’ve done something wrong.” Shame says, “There’s something wrong with me.”
With eating disorders, a combination of both of these feelings is often present which tends to feel horrible for the person suffering.
Examples of feeling guilt when stuck in an eating disorder are:
Eating foods you perceive as “bad”, not “clean”, or “unhealthy”
Finding yourself in a constant binge-purge cycle, bingeing and then purging out of guilt
Skiping or missing a workout
Not eating “enough” vegetables or fruits
Examples of shame experienced in the eating disorder are:
Feeling like you’re unable to attain the body type you desire, no matter what you do and therefore their must be something wrong with you.
Lying to friends and family about your disordered eating behaviors because you fear how they will think of you or judge you.
Feeling like it’s only you who feels out of control with food and binge eats because there’s something wrong with you.
Guilt and shame perpetuate negative self-talk and secrecy, and keep you in a ruthless, self-hate cycle which keeps the eating disorder going. While guilt and shame around food and bodies can be experienced by those without eating disorders, it’s worth paying attention to this sign in combination with others to assess if you or someone you know has an eating disorder.
3. Preoccupation with weight or body shape which results in body checking.
It is common for those suffering from eating disorders to have an intense preoccupation with weight, body size, and body shape. This is largely due to diet-culture and fatphobia leading you, and so many others, to pursue thinness at any cost to your physical or mental wellbeing. It has taught you to equate thinness with feelings of self-worth, health, desirability, success, and beauty.
As a result, you may feel anxious about the number on the scale, constantly find yourself looking in mirrors or reflections to see how your body looks, and pinching or squeezing areas of your body that you wish looked different. These behaviors are called body-checking.
What is body-checking?
Body-checking is the act of checking your body, in thought or action, to see if you are “ok”. Body-checking can look like:
Squeezing or pinching areas of your body in search for fat, bone, or muscle
Checking your appearance in mirrors, windows, reflections, pictures and videos
Constantly comparing your body to those around you
Asking others frequently if you look “ok”
Constantly weighing yourself or measuring parts of your body
Intentionally trying on too small clothes
Why is body-checking harmful?
Body-checking is a vicious cycle, one that you may be familiar with from experience. You feel anxious or stressed about your body image/weight/size, so you turn towards these body-checking behaviors as an attempt for some relief. When you do this, your awareness of your body appearance heightens. The feeling of anxiety only becomes worse, causing you to feel even more stressed than you felt to begin with. Body-checking tends to lead to you feeling worse about your body, not better. And, the body checking behaviors fuel the eating disorder and perpetuate disordered eating behaviors, such as bingeing, purging, restricting, and overexercising.
4. Avoidance of social situations involving food.
Social situations with food are an opportunity for humans to experience community and connection. Food brings people together. However, for someone with an eating disorder, social events involving food can lead to lots of feelings of fears and anxiety. In fact, a common regret of those in recovery from eating disorders is all the food experiences they missed out on because of their fears at the time.
When you’re stuck in an eating disorder, social situations with food may lead you to feeling:
Fearful of others paying attention to the types of food you eat
Fearful of others judging how much/how little you eat
Stressed about your body image or the appearance of your body
Anxious about eating food in front of other people
Healing from an eating disorder means that vacations, birthday parties, graduations, anniversaries, clubs, and sporting events no longer will be filled with fear and anxiety. Know that no matter how much fear and anxiety you have right now in social eating situations, it can and often does get better over time with help and support with eating disorder recovery.
5. Irregular menstrual cycles and/or absence of a menstrual period no matter your body size.
Not all people who suffer from eating disorders menstruate, and a large portion of those suffering do menstruate. If you have the biological ability to have a period, your menstrual cycle can be indicative of how your body is doing. Periods can tell us a lot about your hormones and your health.
It’s important to note that while the absence of a menstrual cycle is a common unknown sign of eating disorders, many people who have eating disorders don’t experience the absence of, or irregularities with, their cycle.
And, if you’re restricting food, excessively exercising or both, you may experience irregular menstrual cycles or lose your period all together. This medical term is called amenorrhea.
Amenorrhea happens when your body does not have enough fat/weight to resume normal hormone functioning. Hormones stop producing at the same rate, and as a result, your period stops.
But periods are kind of annoying, what’s the big deal?
Periods are often very inconvenient, expensive, and draining for those that have a menstrual cycle. While this is true, your menstrual cycle is crucial to your health, and untreated amenorrhea can have serious consequences for your well-being.
Complications of amenorrhea include: Fertility issues such as unpredictable ovulation, inability to become pregnant, unplanned pregnancies, and dangers to the fetus during pregnancy; bone loss such as thinning bones and increased risk of osteoporosis; early menopause; and increased risk of cardiovascular disease. Bringing back your period can resolve most of the side effects of amenorrhea, and the sooner you can get your period back to a normal cycle by getting support for nutrition counseling the better.
In summary, in our culture eating disorders often go unnoticed because so many of the signs and symptoms of eating disorders are normalized and celebrated especially if you are not in a very thin body. If you or anyone you know is suffering from any of these signs and symptoms, please know that you or they deserve help.
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You don’t have to navigate healing from an eating disorder on your own. Our registered dietitian nutritionists at Bravespace Nutrition specialize in eating disorders, disordered eating and body image concerns. There is never a “right” time to reach out and you don’t need to be sick, have abnormal labs, have lost your period, or be in a small body to get nutrition help and support. Reach out to our caring, weight-inclusive dietitians today to schedule a discovery call!