National Eating Disorders Association

Those struggling with an eating disorder may have some, but not all, of the following physical signs and symptoms. Presence of any of the signs that your loved one may be struggling is cause for serious concern and you should encourage them to seek professional help.

  • Noticeable fluctuations in weight, both up and down
  • 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, low blood cell counts, slow heart rate)
  • Dizziness
  • Fainting/syncope
  • Feeling cold all the time
  • Sleep problems
  • Cuts and calluses across the top of finger joints (a result of inducing vomiting)
  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity
  • Dry skin
  • Dry and brittle nails
  • Swelling around area of salivary glands
  • Fine hair on body
  • Thinning of hair on head, dry and brittle hair (lanugo)
  • Cavities, or discoloration of teeth, from vomiting
  • Muscle weakness
  • Yellow skin (in context of eating large amounts of carrots)
  • Cold, mottled hands and feet or swelling of feet
  • Poor wound healing
  • Impaired immune functioning

Signs of Anorexia Nervosa

  • Dramatic weight loss
  • Dresses in layers to hide weight loss or stay warm
  • Is preoccupied with weight, food, calories, fat grams, and dieting
  • Refuses to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
  • Makes frequent comments about feeling “fat” or overweight despite weight loss
  • Complains of constipation, abdominal pain, cold intolerance, lethargy, and excess energy
  • Denies feeling hungry
  • Develops food rituals (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate)
  • Cooks meals for others without eating
  • Consistently makes excuses to avoid mealtimes or situations involving food
  • Maintains an excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury, the need to “burn off ” calories taken in
  • Withdraws from usual friends and activities and becomes more isolated, withdrawn, and secretive
  • Seems concerned about eating in public
  • Has limited social spontaneity
  • Resists maintaining a body weight appropriate for their age, height, and build
  • Has intense fear of weight gain or being “fat,” even though underweight
  • Has 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
  • Postpuberty female loses menstrual period
  • Feels ineffective
  • Has strong need for control
  • Shows inflexible thinking
  • Has overly restrained initiative and emotional expression

Signs of Bulimia Nervosa

  • In general, behaviors and attitudes indicate that weight loss, dieting, and control of food are becoming primary concerns
  • Evidence of binge eating, including 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
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
  • Appears uncomfortable eating around others
  • Develops food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)
  • Skips meals or takes small portions of food at regular meals
  • Steals or hoards food in strange places
  • Drinks excessive amounts of water
  • Uses excessive amounts of mouthwash, mints, and gum
  • Hides body with baggy clothes
  • Maintains excessive, rigid exercise regimen– despite weather, fatigue, illness, or injury, the need to “burn off ” calories
  • Shows unusual swelling of the cheeks or jaw area
  • Has calluses on the back of the hands and knuckles from self- induced vomiting
  • Teeth are discolored, stained
  • Creates lifestyle schedules or rituals to make time for binge-and-purge sessions
  • Withdraws from usual friends and activities
  • Looks bloated from fluid retention
  • Frequently diets
  • Shows extreme concern with body weight and shape
  • Has secret recurring episodes 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); feels lack of control over ability to stop eating
  • Purges after a binge (e.g. self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, fasting)
  • Body weight is typically within the normal weight range; may be overweight

Signs of Binge Eating Disorder

  • Evidence of binge eating, including 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
  • Develops food rituals (e.g., eats only a particular food or food group [e.g., condiments], excessive chewing, doesn’t allow foods to touch)
  • Steals or hoards food in strange places
  • Hides body with baggy clothes
  • Creates lifestyle schedules or rituals to make time for binge sessions
  • Skips meals or takes small portions of food at regular meals
  • Has periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full
  • Does not purge
  • Engages in sporadic fasting or repetitive dieting
  • Body weight varies from normal to mild, moderate, or severe obesity

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