During adolescence, young people often experience sudden variations in height and weight. A girl or boy who puts on weight before having a growth spurt in height may look heavier, while a student who grows taller but not heavier may appear rather thin.
The points outlined below are not necessarily definitive signs or symptoms of an eating disorder — only an expert can make that diagnosis. Although many individuals with eating disorders are perfectionistic and appear to be “perfect” students, it’s not a universal trait. Also be aware that perfectionism can be expressed by what looks like apathy — if a student can’t reach the impossibly high standards they set for themselves, they may opt not to try. Perfectionistic individuals might feel that disappointing themselves or others would be too upsetting, so they opt to avoid the possibility instead.
Eating disorders are marked by a variety of emotional, physical, and behavioral changes. While some of the behaviors may appear to be little more than teenage dieting and body dissatisfaction, taken together they can indicate a serious, life-threatening eating disorder. If a student consistently shows one or more of the signs or symptoms listed below, it is cause for concern.
- Changes in attitude/performance
- Expresses body image complaints/concerns: being too fat even though normal or thin; unable to accept compliments; mood affected by thoughts about appearance; constantly compares self to others; self-disparaging; refers to self as fat, gross, ugly; overestimates body size; strives to create a “perfect” image; seeks constant outside reassurance about looks
- Incessant talk about food, weight, shape, exercise, cooking, etc.
- Displays rigid or obsessive thinking about food, eating, exercise: labels foods as good/ bad; on/off limits for no actual reason; appears uncomfortable or unwilling to share food; inflexible about diet without reason
- Appears sad/depressed/anxious/ashamed/ embarrassed/expresses feelings of worthlessness
- Emotions are flat or absent
- Intolerance for imperfections in academics, eating, social life, etc.
- Is target of body or weight bullying currently or in the past
- Spends increasing amounts of time alone; pulls back from friends
- Is obsessed with maintaining unhealthy eating habits to enhance performance in sports, dance, acting, or modeling
- Overvalues self-sufficiency; reluctant to ask for help • Unable or unwilling to acknowledge recent changes
- Sudden weight loss, gain, or fluctuation in short time
- Complaints of abdominal pain
- Feeling full or “bloated”
- Feeling faint, cold, or tired
- Dark circles under the eyes or bloodshot eyes/ burst capillaries around eyes
- Calluses on the knuckles from self-induced vomiting
- Dry hair or skin, dehydration, blue hands/feet
- Lanugo hair (fine body hair)
- Fainting or dizziness upon standing; frequent fatigue
- Thinning, dry hair
- Diets or chaotic food intake; pretends to eat, then throws away food; skips meals
- Creates rigid dietary rules or observes strict diet without medical or religious reason
- Exercises for long periods and with obsessional attitude; exercises excessively every day (can’t miss a day)
- Constantly talks about food; unwilling to share food; hoards food; refuses to eat food prepared by others or without knowing exact ingredients
- Difficulty sitting still: hovers over chair instead of sitting, constantly jiggles legs, gets up from desk at every opportunity, offers to run errands
- Makes frequent trips to the bathroom
- Makes lists of foods and calories eaten
- Wears very baggy clothes to hide a very thin body (anorexia) or weight gain (binge eating disorder) or to hide a “normal” body because of concerns about body shape/size
- Avoids cafeteria, works through lunch, eats alone
- Shows some type of compulsive behavior (e.g., compulsive hand washing; hoarding; repetitive movements/speech; need for constant reassurance)
- Denies difficulty with food or body image despite evidence that it is an area of concern