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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 • • • • • • • • • • • • • • • • • • • • • • • • • • • 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 expression Page  | 15