Spot the Signs
If you think someone you know has an eating disorder
Signs of a Potential Eating Disorder
- Expressions of concern about being fat or feeling fat, even though he or she is underweight
- Expressions of concern about being or becoming overweight that does not decrease as weight loss continues
- Depressed mood and expression of self-deprecating thoughts after eating
- Periods of extreme calorie restriction or fasting
- Avoiding situations in which the individual may be observed while eating, such as refusing to eat with the family at dinner or in social situations
- Evidence of excessive physical activity (especially in a thin person) that is not part of a training regimen (like training for a marathon) or is in excess of a training regimen
- Refusal to maintain even a minimal normal weight consistent with the individual’s age (if a child or adolescent) and/or height
- Secretive eating or stealing of food, repeated disappearance of food, empty food containers in a closet or bedroom
- Consumption of huge amounts of food not consistent with the individual’s weight
- Wide variations in weight over short periods of time
- Vomitus or odor of vomit in the toilet, sink, shower or trash can
- Preoccupation with the eating behavior of other people such as friends, relatives and peers
- Complaints of light-headedness or dizziness not explained by other medical causes
- A pattern of eating large quantities of food followed immediately by trips to the bathroom and resumption of eating shortly thereafter
- Evidence of using diet pills; for example, irritability fluctuating with lethargy over short periods of time
- Complaints or evidence of bloating or water retention that cannot be attributed to other medical causes, such as PMS
- Laxative or diet pill packages seen in private areas of the individual’s home (bedroom or bathroom drawers, closet, trash can, etc.)
- Certain changes in the individual’s physical appearance; for example, pouch-like area at or just under the angle of the jaw, sores at the corners of the mouth or on the tongue, thinning or loss of hair
- Known or reported family history of eating disorders or family dysfunction
What To Do If You Suspect an Eating Disorder
The person with the best rapport with the individual should arrange a private meeting with the indiviual. The tone of the meeting should be completely supportive. It should be expressed that the best interests of the individual are being considered.
Discuss what specific observations were made that aroused concern in as non-punitive a manner as possible. Let the individual express their thoughts and feelings. Try to determine if the individual feels that he or she is beyond the point of being able to voluntarily refrain from the problem behavior.
If the individual refuses to admit that a problem exists despite compelling evidence, or if it seems that the problem either has been long-standing or cannot readily be corrected, consult a clinician with expertise in treating eating disorders.
Many individuals with a pathogenic eating behavior have made repeated, unsuccessful attempts to correct it on their own. Let the individual know that outside help is often required and that this need should not be regarded as a personal failure or lack of effort. Arrange for regularly scheduled follow-up meetings, or if the individual is seeing a specialist, get advice on how you may continue to help.
Be aware that many individuals who resort to pathogenic weight control techniques have been told at various times that they had a weight problem. It is important to know what role, if any, past or present family members, friends, peers, coaches or trainers may have played in the development of this behavior. Let the individual know that you realize certain pressures may have played a role in the development of this behavior.
What Not To Do
- Do not question other people — such as friends, family members, or co-workers — instead of talking directly to the individual.
- If the individual is a minor, do not immediately discipline him or her if you find evidence that a problem exists.
- Tell the individual that you know what’s going on, but give no indication as to how or why you’ve become suspicious.
- Do not tell the individual to “straighten up,” or that you’ll be checking back from time to time.
- Do not decide that if the individual really wants to be OK, he or she will make it happen. Don’t assume that failure to improve shows a lack of desire or effort.
- Do not refuse to obtain professional assistance or insist on “keeping it in the family.”
References
Adapted from “Memory Jogger – Eating Disorders in Athletes: How to Identify Pathogenic Weight-Control Behavior,” The Physician and Sports Medicine.
