Recognizing Signs, Support Recommendations, and Correcting Stereotypes

Signs of Disordered Eating Not To Ignore:

Recognizing an eating disorder is not always easy for many reasons. An example that explains this phenomenon is that people who struggle with disordered eating or eating disorders often are taking steps to hide the behaviors they may be engaging in from others around them. Another example, is that many individuals are in denial of their eating disorder and may not be ready to accept their conditions, meaning they “explain away” their pathology or symptoms in a way that is rationalized as “normal”. There is also no certain way an individual struggling with an eating disorder should “look,” as we like to remind folks that only 6% of individuals struggling with an ED are deemed as medically underweight. Remember: Eating disorders can affect individuals of any age, gender, ethnicity, and body type, occurring at any point in someone's life. Some signs of eating disorders can include physical, emotional, and behavioral changes. Take a look below at some of the signs and differences you may say in someone who is struggling with their relationship with food or body.

Emotional Signs

• Intense worry/fear of weight gain

• Poor body image

• Mood swings

• Irritability

• Guilt

• Shame

Physical Signs 

• Rapid weight loss/gain

• Frequently cold or feeling cold when others are not

• Dry skin

• Thinning hair

• Muscle weaknesses

• Fatigue

• Yellowing skin

• Menstrual irregularities

• Dental issues (ex. cavities , tooth sensitivity)

• Gastrointestinal (GI) distress or changes

• Difficult concentrating

• Frequent Weight Changes

• Scrapes/Cuts on Hands (Self induced vomiting)

• Heart Palpitations

• Bradycardia

• Hypotension

• Vision Changes

• Orthostatic Changes

Behavioral Signs

• Body checking (mirrors, measurements)

• Tracking intake/exercise

• Overexercising

• Eating habits impacting day to day life

• Skipping meals/avoiding meal time with others

• Eating rituals (ex: taking tiny bites)

• Refusing to eat certain foods (may be seen as picky eater)

• Hiding food

• Hoarding food

• Throwing away food: Excessively, or inability to

• Changing outfits multiple times

• Asking about perceived body changes from opinions of others

How To Talk To Someone About Their Eating Disorder:

Talking to someone about their eating disorder is not easy, as you may often fear you could do more damage than good. We’re here to remind you: These disorders are deadly; Speaking up and not speaking perfectly is better than not saying anything at all.

The first step is to try to educate yourself as much as possible. Additionally, make sure you choose the right time to talk to your loved one when you have this conversation. The best timing may be to choose a private setting, in a space where the loved one feels comfortable. Be honest and respectful when you express your concerns, and acknowledge outright that you may not have all of the “right words” to say. Express your willingness to learn, and accept the feedback that is given to you by your loved one. It is okay to tell them that you may not understand what they are experiencing, but that you are here to offer support in any way you can. Support them in the decision to engage with therapy and nutrition support, with a therapist and dietitian who specialize in Eating Disorders. Most importantly, listen to your loved one, ask AGAIN how they are doing, offer them a space to express their experiences and relationship with food, and make it known you are there when they need you. Try to avoid offering solutions or over-relating, and mainly focus on how you can support them towards recovery. Taking the first steps of admitting they have a problem and engaging in therapy may be difficult and scary for individuals struggling with an eating disorder, so offer to support them in finding an outpatient therapist and team to help take this task off their plate. Decisions around therapists and dietitians can feel overwhelming, so sharing in this effort can be helpful. Most individuals struggling with disordered eating often feel shame or guilt, a sense of not being “sick enough”, or feeling that they’re undeserving of care. Keep this in mind when you gently express your concerns to your loved one with an eating disorder, and acknowledge the thoughts in their mind you may be up against. Be the pillar of reality reminding them they are worthy of help, and capable of recovery. Remember- We externalize eating disorders. Your loved one is still in there, we just have to help them resurface and triumph.

For more information on how to support your loved one struggling with an eating disorder, you may contact Maria Ortiz, LMHC, CEDS regarding her virtual Loved Ones Psychoeducation Group at mortiz@breakfreetherapyservices.com for upcoming dates and availability.

Common Eating Disorder Stigmas  

·       “Having an eating disorder is a choice”

 EDs are not a choice: They are a diagnosable disorder affecting all systems of the human body.

·       “Eating disorders affect only girls”

EDs impact all. Boys are more likely to not be as forthcoming about their symptoms, and are less likely to be screened.

·       “Eating disorders are a highschool thing”

EDs impact folks at all ages. They do not discriminate against age.

·       “Diets aren’t to blame”

This is the equivalent of saying, “Alcohol is not to blame.” For some, individuals may be able to have a glass of wine, and further regulate their intake and interactions with alcohol in an adaptive manner past this point. On the other hand, some individuals with a pre-disposition to addiction may struggle with this. The same goes for eating disorders. For some, engaging with dieting may be brief without many health consequences. For others, this may be a trigger or catalyst for an ED to begin or strengthen. Let’s also remember, a strong majority of diets end in return of the weight that was lost, meaning the goal is not met or maintained.

·       “Eating disorders are just a “phase”

EDs are not a phase of life. They are a life-threatening disorder that require specialized attention.

·       “People with EDs are seeking attention”

Yes, an ED may be functioning as a method of communication of their pain, or as an expression of needing help (i.e “attention”). This cannot be discredited as “attention-seeking behavior,” but rather needs to be addressed as a dangerous disorder that has very functional components.

·       “All people with EDs will present as obviously thin” 

Only 6% of individuals with an ED will be deemed as medically underweight. EDs occur across all body shapes and sizes.

We will go further into these in a future blog post, but for now, we wanted to combat some of the more common stereotypes or language we hear as specialists.  

Reminders Relating To Comorbidity:

While considering some of the signs of disordered eating, clinicians must take the clients other mental health conditions into consideration as well. For instance, co-occurring diagnoses have been found to be common with individuals struggling with an eating disorders, such as, Generalized Anxiety Disorder (Anxiety), Major Depressive Disorder (Depression), Post-Traumatic Stress Disorder (PTSD), Body Dysmorphic Disorder (Body Dysmorphia), Trauma-related Diagnoses, and Obsessive Compulsive Disorder (OCD). Seeking out a treatment team who is competent and experienced in the treatment of both Eating Disorders and the above diagnoses is imperative relating to prognosis and progression with recovery.

BreakFree Therapy Services offers support and resources available in the community in person or virtually for the state of Florida if you or anyone you know is struggling with an eating disorder. This blog is an extension of our efforts toward prevention, education, and therapeutic treatment.

About the Authors:  

Maria Ortiz is currently a Licensed Mental Health Counselor and Certified Eating Disorder Specialist (CEDS). She is also personally recovered from an eating disorder, meaning this work is not only her profession, but her true passion as well. She is persistent in her efforts to provide awareness, education, and therapeutic services regarding all things eating disorders. “The road to recovery can be one of the most challenging processes one may ever face, and I'm so grateful that my story led me to helping others find their hope again. It gets better!” – Maria Ortiz, MS, LMHC, CEDS

Jenesis Vasquez is currently a Licensed Mental Health Counselor and in the process of earning her Certified Eating Disorder Specialist Credential. She strives to provide a safe place for everyone, and her desire and purpose is to provide awareness that reduces stigma surrounding eating disorders and overall therapeutic care. “To create an environment where everyone feels accepted and learns their self-worth is not defined by their body shape and/or size is my goal, and I truly believe recovery is possible for my clients. I will ensure to provide an individualized treatment approach to best fit each unique individual.” – Jenesis Vasquez, MS, LMHC