About three percent of teenagers and four percent of adults are affected by eating disorders, but most do not receive treatment, according to the National Institute of Mental Health.

Why? Because the people around them—health professionals and school personnel, as well as friends and families—often don’t recognize the signs.

There are many online resources that list the physical and emotional symptoms of various eating disorders. (I recommend going here, here or here.) Knowing these symptoms doesn’t go far in terms of early intervention, however. If someone is demonstrating the symptoms of a full-blown eating disorder, then the illness is already fairly advanced. (Author Harriet Brown likens it to a cancer that has already reached stage III, or worse.)

And the longer an eating disorder goes on, the more difficult it is to treat it, the higher the rate of relapse and the worse the physical and mental consequences.

The good news is that someone who struggles with disordered eating or body image issues is not fated to develop a full-blown eating disorder. There are signs along the way that, if caught and treated early, could make all the difference.

7 Signs of a Possible Eating Disorder:

Here are some of the more subtle signs that indicate someone may be struggling with eating or body image. The presence of one or more of these signs doesn’t necessarily mean that an eating disorder is looming, but it does represent a red flag calling for extra awareness.

1. Weight concerns - he or she:

a. Expresses concern about body shape or weight, or expresses a desire to lose weight or look different.
b. Talks excessively about food and healthy or “clean” eating.
c. Talks about dieting or is actively on a diet.

2. Exercise - he or she:

a. Increases an exercise regimen or physical activity without also increasing caloric intake.
b. Becomes anxious or upset if he or she cannot exercise.

3. Meal preparation - he or she:
a. Becomes unusually interested in cooking, but might not actually be eating the meals or treats he or she makes.
b. Makes one’s own “safer” meals instead of eating what the family is eating.

4. Control over food - he or she:
a. Becomes inordinately upset when unable to control a situation related to food—for instance, if dinner plans change or the restaurant isn’t serving the meal they planned to order.

5. Odd behaviors during and after meals - he or she:
a. Makes frequent excuses to use the bathroom after a meal.
b. Refuses to eat in anyone else’s presence.
c. Engages in strange rituals with food, such as cutting it into small pieces or eating things in a certain order.

6. Mood - he or she:
a. Appears more depressed, anxious, irritable or fatigued than normal.
b. A note about mood, particularly with teenagers: Almost all teenagers experience mood fluctuations during adolescence. However, depression and anxiety are notoriously comorbid with eating disorders. Sometimes these conditions predate an eating disorder, and sometimes they are caused by an eating disorder. It is always important to monitor a teen’s mental health, especially if you have concerns about their eating patterns.

7. Energy - he or she:
a. Seems lower in every sense of the word—less energy, less vivacious and less interested in the activities they once loved. Seems “down” all the time.
b. Alternatively, he or she has become super(wo)man, taking on all sorts of responsibilities and activities, giving 100 percent of oneself 100 percent of the time. This may or may not be accompanied by perfectionism.

Stress and Trauma

The environment could also provide clues that someone is struggling. Do you know of any stressors in this person’s life? Has the family undergone a change or tragedy? Has she or he experienced a personal trauma? Is he or she being bullied (especially about weight or body shape)? Are they inordinately anxious about school and grades?

If the answer is “yes” to any of the above, this is the time to be watchful. In people with a genetic predisposition to eating disorders, stress, anxiety and trauma make the perfect kindling to awaken an eating disorder (as well as other mental illnesses).

If you think your friend, daughter, son, partner, spouse, coworker or loved one is exhibiting some of these signs, don’t panic. Research eating disorders and body image issues on sites like NEDA and Proud2BMe. Talk to a trusted health professional, such as a physician, pediatrician or a therapist.

Most importantly, start the conversation. Gently express your concerns to him or her. Remind them that you are always available to talk. And let them know that you love them.

About the blogger: Joanna Kay is a New York City writer in recovery from anorexia nervosa. She has written for the National Eating Disorders Association (NEDA), HealthyPlace.com and other mental health sites. She is also the author of The Middle Ground, a blog that deals with issues facing people who are midway through eating disorder recovery. Find Joanna on Twitter and on her blog.