7 Signs It's Time to Seek Help for Your Eating Disorder

Takeaway: If you or a loved one is struggling with an eating disorder, it’s important to seek treatment and get the care you need. But how do you know if you have eating disorder behaviors? In this blog post, we’ll discuss the signs and symptoms of eating disorders and offer suggestions for when and how to seek help. With early intervention and the right support, eating disorder recovery is possible.

It’s not always easy to know when you’re dealing with an eating disorder, let alone which type. We’ll review some of the most common eating disorders to help you make sense of it all and better understand some of the warning signs.

Types of Eating Disorders

There are several different types of eating disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5). You’ll notice that each type of eating disorder has its own unique symptoms. However, they are all psychological, medical, and nutritional disorders characterized by persistent disturbances in healthy eating behaviors that cause significant distress or impairment.

Anorexia nervosa is an eating disorder characterized by an intense fear of weight gain. In order to avoid gaining weight, individuals with anorexia nervosa rely on extreme dieting methods which significantly restrict what and/or how much they eat. They may not recognize the seriousness of their low weight, inaccurately perceive and/or significantly link their self-evaluation with their body size, shape, or body weight alone. While most individuals with Anorexia nervosa are underweight, the National Eating Disorders Association (NEDA) notes that individuals in average-sized or larger body types also suffer from this illness.

Anorexia nervosa

Bulimia nervosa is an eating disorder characterized by cycles of binge eating and compensatory behaviors. Binge eating includes eating a large amount of food in a distinct time period. The amount of food eaten is significantly larger than what most individuals would eat under similar circumstances. Compensatory behaviors, also known as purging, are used to prevent weight gain and may include self-induced vomiting, laxative abuse, or excessive exercise. Individuals with Bulimia nervosa often describe themselves as feeling out of control around food.

If you’re reading this, chances are you’re concerned about yourself or a loved one’s eating patterns. With all the varying information out there about the “healthier” ways to eat, it can be tricky to recognize disordered eating behaviors. Even if you recognize it as disordered, what do you do? You’re probably thinking, “Now what?”, “Where do people go when they have an eating disorder?”, and “Should I talk to my doctor if I think I have unhealthy eating behaviors?” The good news is that you’re on the right track by reading this. In this post, we’ll review some of the signs and symptoms of eating disorders and share suggestions for when and how to seek professional help.

Understanding Eating Disorders

Bulimia nervosa

Binge-eating disorder

Binge-eating disorder is similar to Bulimia nervosa in that individuals engage in recurrent episodes of binge eating. Unlike Bulimia nervosa, those with Binge-eating disorder do not engage in compensatory behaviors. 

Avoidant/restrictive food intake disorder (ARFID)

ARFID differs from the other eating disorders we’ve covered in that body image and weight do not play a role. Individuals with ARFID fail to meet nutritional requirements through oral food intake due to a lack of interest in eating, fear of choking or becoming ill, an aversion to food groups due to the sensory qualities of food, or another factor. It should be noted that it is not related to the lack of availability of food.

Other specified feeding or eating disorder (OSFED)

OSFED includes all other feeding or eating disorders that cause significant distress or impairment but do not meet the strict diagnostic criteria for another disorder. While there are misconceptions about OSFED and some perceive it as less serious than other diagnoses, NEDA states it “is a serious, life-threatening, and treatable eating disorder.”

Risk factors for Eating Disorders

There are many factors that contribute to a person’s likelihood of developing an eating disorder. The most well-accepted theory that explains the development of eating disorders is referred to as the Biopsychosocial model. It suggests that eating disorders occur when a variety of biological, psychological, and social and environmental factors all come together to create a perfect storm. Let’s break down each set of factors.

Biology

It’s estimated that genetics contribute up to 50% to 80% of an individual’s risk of developing an eating disorder (Schaumberg K, Welch E, Breithaupt L, et al., 2017). Like many mental illnesses however, it appears there is a genetic predisposition to the development of eating disorders as we often see a family history in people currently affected by them. While twin studies have not yet identified which genes are responsible, there is an undeniable genetic contribution.

Psychology

Psychological factors include things like a person’s natural sensitivity to stress, temperament, and personality. We tend to see some similar traits in people with eating disorders. For example, it’s common for someone with anorexia nervosa to display rigid thinking and perfectionistic traits. Other psychological factors include the ability to manage impulses, regulate emotions, and cope with difficult situations.

Social

Social factors include the direct and indirect messages people receive about food, bodies, themselves, the world, and everything in between. Often, individuals with eating disorders grew up in a food- and body-conscious household, experienced bullying related to their body shape or weight, or experienced a significant life event, such as a loss, trauma, or transition. Take a moment to reflect on all the messages you receive about food, bodies, and appearance on a daily basis. Perhaps you overheard a colleague describe himself as being “good” because he ordered a salad for lunch. While standing in the check-out line at the grocery store, you likely stood in front of several magazines with tips and tricks for getting the perfect summer body. Many of these messages may seem normal when you’re exposed to them over and over.

Getting support for your Eating Disorder

Eating disorders are serious, life-threatening, and take a significant toll on a person's emotional and physical health. They rank as the second most lethal serious mental illness or health condition, with opioid overdose as number one (Arcelus, Jon et al., 2011). According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), 28.8 million Americans will struggle with an eating disorder at some point throughout their life. However, this statistic might actually be higher. Research suggests that certain populations are significantly less likely to be screened for eating disorders, which prevents some people from receiving the diagnosis and treatment they need.

When to seek help for eating disorders: “7” signs it’s time

Whether you’re considering treatment for an eating disorder for the first time or you’ve been in treatment before, recognizing when to seek help can be tricky. Here are 7 signs that it’s time to speak up.

1. Behavior changes

Eating disorders often start when people make well-intentioned changes to become healthier. A person may be following their doctor’s advice to lose weight and exercise more. What may start out as eating smaller portions can spiral into skipping meals altogether. Skipping meals will increase hunger and cravings, and over time a person may end up engaging in a cycle of skipping meals and overeating. Be aware of new behaviors related to eating or your body, such as eating more or less than usual, avoiding certain foods, counting calories, excessively exercising, self-inducing vomiting after eating, misusing laxatives, or weighing yourself more frequently. These may indicate the need to seek help.

2. Thinking changes

In addition to behavioral changes, you’re likely to notice cognitive changes. Behaviors and thoughts are closely linked, with thoughts often preceding behaviors. Individuals affected by eating disorders often have recurring thoughts about food, eating, and bodies. It’s likely a warning sign if you find yourself spending more time thinking about food, obsessing over what or when to eat, comparing your body to others, or thinking negative thoughts about your body. Keeping track of calories in your mind or calculating how many minutes you need to spend at the gym to compensate for what you ate are also examples of thinking changes.

3. Rules

We all have rules for ourselves that we follow consciously or unconsciously. Most people brush their teeth twice a day and put garbage in a trashcan. We accept these rules as normal and helpful. However, when rules become overly rigid or specific, it can be cause for concern. People affected by eating disorders may have rules about how many calories they are allowed to eat each day, what times they are allowed to eat, or how long they have to exercise.

4. Physical changes

Most people envision someone who is emaciated when they think of eating disorders. While this is one presentation, eating disorders come in all shapes and sizes. Weight loss and weight gain can be a warning sign. In children and adolescents, maintaining weight while growing in height can be concerning. 

5. Medical concerns

Eating disorders come with a long list of medical complications and concerns. They affect every organ system in the body. Gastrointestinal symptoms are common, including bloating, nausea, constipation, and abdominal pain. Cardiovascular symptoms are likely, including low blood pressure, electrolyte imbalances, and chest pain. Endocrine problems are prevalent for both men and women. Without the energy needed to make hormones, individuals are more at risk for bone loss. Women may have irregular menstrual cycles or stop having them altogether. Neurological symptoms are common, including difficulty concentrating, difficulty falling and staying asleep, and dizziness and fainting. Other symptoms can include hair loss, feeling cold, anemia, low energy, and kidney problems just to name a few. It’s important to keep in mind that laboratory tests can be normal even when the eating disorder is severe.

6. Psychological changes

We mentioned earlier that eating disorder behaviors, and thoughts are closely linked. In fact, behaviors, thoughts, and emotions are all closely linked. You may notice changes in your self-esteem, a decrease in interest for things you used to enjoy, avoidance of social situations, or irritability. Additionally, you may notice other mental health problems, like depression, anxiety, trauma, or substance use. If your eating is impacting your mental health (or vise versa), it may be time to seek help.

7. Family members have expressed concern

Sometimes it can be hard to recognize changes within ourselves. We can become so wrapped up in ourselves that we don’t recognize what’s happening. If someone has expressed concern to you, listen up. They are viewing the situation from a different perspective and may see what you’re missing. 

How to seek help for Eating Disorders

Seeking treatment for an eating disorder can be overwhelming. You may not know where to start or which treatment options are the best fit for you. This is where we can help! Our team of expert clinicians, including both mental health professionals and registered dietitians, have extensive education and training in treating eating disorders of all kinds. When you reach out, our Care Coordination team will ask questions to help determine how we can support you. If we are not the right fit, our team will offer suggestions for finding the right treatment team.