NEDA TOOLKIT for Coaches and Trainers
General physical signs of eating disorders
General Signs
• Avoiding eating with others
• Hoarding and hiding food; eating in secret
• Unusual food rituals (cutting food into small pieces,
chewing each bite an unusually large number
of times, eating very slowly, consuming unusual
combinations of foods)
• Cutting out entire food groups (no sugar, no carbs,
no dairy, vegetarianism/veganism)
• Large changes in weight, both up and down
• Excessive exercising; exercising even when ill or
injured, or for the sole purpose of burning calories
• Stomach cramps, other non-specific
gastrointestinal complaints (constipation, acid
reflux, etc.)
• Menstrual irregularities—missing periods or only
having a period while on hormonal contraceptives
(this is not considered a “true” period)
• Difficulties concentrating
• Abnormal laboratory findings (anemia, low thyroid
and hormone levels, low potassium)
• Sleep problems
Signs of binge eating disorder
• Evidence of binge eating (eating in a discrete period
of time an amount of food that is much larger
than most individuals would eat under similar
circumstances), including the disappearance of
large amounts of food in short periods of time or
lots of empty wrappers and containers indicating
consumption of large amounts of food; feeling a
lack of control over the ability to stop eating
• Developing food rituals (e.g., eating only a
particular food or food group [e.g., condiments],
excessive chewing, not allowing foods to touch)
• Stealing or hoarding food in strange places
• Hiding body with baggy clothes
• Creating lifestyle schedules or rituals to make time
for binge sessions
• Skipping meals or taking small portions of food at
regular meals
• Periods of uncontrolled, impulsive or continuous
eating beyond the point of feeling comfortably full
• Does not purge
• Engaging in sporadic fasting or repetitive dieting
• Body weight varies from normal to mild, moderate
or severe obesity
Signs of anorexia nervosa and other restrictive
eating disorders
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• Marked weight loss
Little concern over extreme weight loss
Dressing in layers to hide weight loss or stay warm
Preoccupation with weight, food, calories, fat
grams and dieting
Refusing to eat certain foods, progressing to
restrictions against whole categories of food (e.g.,
no carbohydrates)
Eating tiny portions or refusing to eat
Making frequent comments about feeling “fat” or
overweight despite weight loss
Complaining of constipation, abdominal pain, cold
intolerance, lethargy and excess energy
Denying feeling hungry
Developing food rituals (e.g., eating foods in certain
orders, excessive chewing, rearranging food on a
plate) Cooking meals for others without eating
Consistently making excuses to avoid mealtimes or
situations involving food
Maintaining an excessive, rigid exercise regimen
despite weather, fatigue, illness, or injury; the need
to “burn off ” calories taken in
Hyperactivity and restlessness (inability to sit
down, etc.)
Withdrawing from usual friends and activities and
becoming more isolated, withdrawn, and secretive
Behaving concerned about eating in public
Limited social spontaneity
Resisting maintaining a body weight appropriate for
their age, height and build
Intense fear of weight gain or being “fat,” even
though underweight
Disturbed experience of body weight or shape,
undue influence of weight or shape on self-
evaluation, or denial of the seriousness of low body
weight Losing menstrual period (applicable to post-
puberty females)
Thinning of hair on head, dry and brittle hair
Muscle weakness
Cold, mottled hands and feet or swelling of feet
Impaired immune functioning; poor wound healing
Displays feelings of ineffectiveness and need for
control Overly restrained initiative and emotional
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