11 Subtle Signs of an Eating Disorder that Are Easy to Miss
A quick online search for “signs of an eating disorder” delivers you countless websites listing warning signs and common symptoms, but these lists aren’t comprehensive. And while many signs of an eating disorder are pretty intuitive and might raise eyebrows on their own—like, say, significant changes in body weight and extreme dieting—many others are less obvious, and often go unnoticed.
“While my daughter’s anorexia was diagnosed fairly quickly, it would have happened even faster if I was aware that a newfound obsession with interacting with food in a non-eating way was a sign of an eating disorder,” says J.D. Ouellette, Director of Lived Experience at the virtual eating disorder treatment provider Equip . “I’ve always cooked and baked a lot, so looking up and making new recipes seemed normal to me. What wasn’t normal was the scale of it all: Food Network 24/7, Pinterest for recipes, organizing all our family recipes, cooking and baking amazing, delicious food…but not eating any of it.”
This behavior that Ouellette observed is just one of many subtler signs of eating disorders. Raising awareness around these symptoms is extremely important, as a huge number of eating disorders go undiagnosed—in one study, just 10% of college students reporting symptoms got a diagnosis. What’s more, many of the eating disorders that do get diagnosed could have been caught earlier if family members had known the less conspicuous warning signs of an eating disorder. This matters because early intervention significantly increases the likelihood of recovery.
Why do some signs of eating disorders go unnoticed?
Our inability to see certain disordered behaviors can, in many ways, be chalked up to the reality that many of these behaviors are praised in our society, steeped as it is in diet culture. “So many signs of eating disorders are socially normal and even applauded,” says Ouellette. “Working out twice a day, seven days a week? Go you! Restricting calories and categories of food? Wish I had your self-discipline! Lost a few pounds? Living the dream!” Jessie Menzel, Equip’s Senior Director of Program Development, agrees, explaining that society has normalized behaviors that could be red flags, “things like changing one’s diet to be ‘healthier,’ deciding to become a vegetarian, trying to eat fewer sweets, starting to skip meals, or even forgetting to eat.”
Warning signs of an eating disorder might also be ignored because trusted figures dismiss them. “Parents are often directly assured ‘nothing is wrong’ by their medical provider,” says Menzel, explaining that parents might hear things like, “picky eating is normal,” “they’ll grow out of it,” or “it’s a good thing that they’re trying to eat healthier.”
Signs of an eating disorder might also get missed because someone doesn’t fit society’s stereotype of who gets an eating disorder. “I think the most common reason eating disorder signs tend to go unnoticed is that someone doesn’t ‘look’ the part of someone with an eating disorder,” says Menzel. “Whether it be because they aren’t white or wealthy or because their body is larger or because they aren’t a cis girl or woman. There are entire groups of people who we think ‘can’t’ get eating disorders, and therefore, we don’t ask.” The truth is that eating disorders affect people equally across age, gender, race, class, and body size, and—despite what the media has told us for decades—you just can’t tell if someone has an eating disorder by looking at them.
Subtle signs of eating disorders that are often missed
For a thorough look at the more straightforward symptoms of eating disorders, this eating disorder screener is a great resource. Here we’ve outlined some of the less intuitive, less obvious, and often missed signs of eating disorders. This list isn’t exhaustive, and eating disorders manifest differently in every person, but it’s a good place to start.
1. Cooking and baking food without eating it.
In addition to the behaviors Ouellete shared above, one particular memory stands out to her: her daughter prepared 50 cellophane gift bags for school Valentine’s Day, each filled with candy and immaculately decorated heart-shaped cookies—but she didn’t eat a single bite herself. At the time, this stood out to Ouellette as confusing, but she didn’t flag it as related to an eating disorder. However, preparing food without eating it is actually a fairly common eating disorder behavior.
2. Not eating around others.
Ouellette remembers thinking that her daughter’s desire to eat anywhere but home was just typical teenage behavior, but eventually realized that it was a ruse not to eat at all. Someone with an eating disorder might also want to eat alone because of the shame they feel around eating. This could be true for all types of eating disorders, not just those associated with binge eating.
3. Encouraging other people to eat high calories foods they’re not eating.
People with eating disorders might try to satisfy their own hunger by watching others eat the foods they won’t allow themselves. (In fact, research has shown that so-called “mukbang videos,” live-streamed videos where viewers watch someone eat, are associated with disordered eating.)
4. Refusing tiny bites of food.
Eating disorder thinking tends to put a high value on precision, especially when it comes to food. Because of this, those struggling may refuse things with trivial caloric content that they’d normally accept, like a piece of gum or a small bite of a dish. This can also go the other way: they may refuse to share food because they have exactly accounted for what is on their plate, no more and no less.
5. Excessive interest in what other people are eating.
Similar to cooking for others and watching others eat high-calorie foods, this sign likely emerges out of the fact that eating disorders cause people to become preoccupied with food. Those who are struggling might show an abnormal interest in the food of others, asking questions about what they ate that day, what something tastes like (without accepting a bite of it), etc.
6. Rigidity around food.
Just as a person with an eating disorder might refuse tiny amounts of food because of their precise accounting, they may also become incredibly upset if the food they receive is “wrong” or “off” in any way. That might mean that a parent buys a different brand of crackers from the store, or a server at a restaurant puts dressing on the salad rather than on the side.
7. Changes in personality.
Ouellette remembers thinking that the change in her teen daughter’s attitude was “developmentally appropriate teen moodiness.” And in some cases, that might be true, but significant personality changes can also be red flags.
8. Regressing into childlike behaviors.
It’s not uncommon for people with eating disorders to become more childlike in some ways. For Ouellette, that meant her daughter suddenly calling her “Mommy” instead of “Mom” at age 17.
9. Rigidity around schedule.
This might have to do with food schedule, or simply the schedule in general. Ouellette remembers her daughter developing “extreme punctuality, to the point where 30 seconds early or late was distressing.” (As a person in recovery from anorexia, I remember breaking down crying if dinner slipped to 6:05 rather than 6 p.m. sharp).
10. Insomnia.
Hunger keeps the brain alert, so those who are restricting their food intake might have difficulty sleeping through the night (plus eating disorders can mess with melatonin, a hormone that helps us regulate our circadian rhythms). If you or your loved one are suddenly experiencing chronic sleeplessness or feeling tired all the time, disrupted eating patterns might be behind it.
11. Isolating from friends.
While it can be easy to frame declining a social event in a positive light (self-care, for instance), frequently opting out of invitations could mean that someone is prioritizing their eating disorder behaviors over the relationships in their life, or going out of their way to avoid social events that involve food.
None of these signs on their own definitively means that someone has an eating disorder, and someone can have an eating disorder without exhibiting any of these signs. But by being aware of them and remaining alert to anything that seems amiss, you’ll ensure you’re doing all that you can to catch a potential eating disorder early on. Says Menzel, “anytime you notice a shift in someone’s eating—no matter the reason—it warrants paying close attention and asking questions.”
This article originally appeared on equip.health.
Equip is the leading provider of virtual, evidence-based eating disorder treatment in the U.S. Built with a combination of clinical expertise and lived experience, Equip’s model delivers eating disorder care that empowers families to help their loved ones achieve lasting recovery. Who we treat: Patients ages 6-24 and older adults if they are living with caregivers. Eating disorders never exist alone so Equip treats co-existing conditions like anxiety, OCD, trauma, and depression simultaneously How we treat: 100% virtual care with a 5-person provider team that is stays with you throughout treatment, and scales care up and down as needed. Every team includes a therapist, psychiatrist, family mentor, peer mentor, and dietitian.