Signs your friend may have an eating disorder

You’ve seen the images of what a “stereotypical” person with an eating disorder is supposed to look like. The subjects are usually young, white, affluent, emaciated females. But those pictures do not reflect the whole story, as eating disorders can affect people of all ages, genders, races, body types and socioeconomic groups.

According to the National Alliance on Mental Illness, eating disorders are a group of related conditions surrounding a preoccupation with food and weight that cause serious emotional and physical problems. Common eating disorders include anorexia, bulimia, binge eating disorder (BED), orthorexia and avoidant-restrictive food intake disorder (ARFID).

While symptoms of an eating disorder usually appear in adolescence, you might worry about some of the behaviors you’ve noticed in your adult friends. Is their desire to “eat clean,” cut carbs or skip dessert driven by a goal to live a healthy lifestyle with common sense nutritional habits? Or are these behaviors signs your friend might be living with an eating disorder?

Signs of an eating disorder

Eating disorder symptoms are common among people of all ages. It's important to watch not only for obvious weight loss — or gain — but also for signs such as:

• Preoccupation with weight, food, calories, carbohydrates, fat grams and dieting

• Refusal to eat certain foods, such as carbohydrates, meat, dairy or sugary foods — any foods they deem not healthy, pure or clean

• Discomfort eating around other people

• Food rituals, such as mashing, excessive chewing and pushing food around the plate

• Skipping meals, making excuses to avoid meals or eating very small meals

• Excessive consumption of water

• An excessive, rigid exercise regime — despite weather, fatigue, illness or injury

• Frequent checking in the mirror — or touching and squeezing areas of the body — for perceived flaws

• Evidence of binge eating — disappearance of large amounts of food or excessive empty wrappers and containers — or hoarding food

• Complaints of stomach cramps or other nonspecific gastrointestinal complaints

• Menstrual irregularities — missing periods or only having a period if on hormonal contraceptives

• Dizziness or fainting

• Cuts and calluses across the top of knuckles, frequent trips to the bathroom after meals, or smells and signs of vomit — all potential signs of induced vomiting, known as purging

It’s also important to pay attention to how your loved one talks about themselves, says Linda Santangelo, PhD, lead clinical psychologist with the Sharp Mesa Vista Hospital Eating Disorders Program. Extreme concern about their body size and shape; expressing negative thoughts; or exhibiting feelings of guilt, anxiety or depression after eating can be a sign they are struggling.

“Friends and family members can play an important role in helping a loved one with an eating disorder,” says Dr. Santangelo. “Knowing what to watch for and having a willingness to help them seek treatment and recover can make the difference between someone fully recovering and someone experiencing serious health complications.”

Differences between eating disorders in teens and in adults

Though eating disorder symptoms are similar across age groups, the National Eating Disorders Association (NEDA) reports eating disorder triggers in adults usually differ from those in adolescents. In adults, an eating disorder is more likely to be triggered — or activated — by life-altering events. This can include marriage, pregnancy, divorce, death of a loved one, menopause and other milestones.

What’s more, recovery from an eating disorder may be more difficult for adults than youths. Along with the general challenges related to aging and illness recovery, adults may feel ashamed or embarrassed to have what many consider a “teenagers’ disorder” and avoid seeking treatment. They also may find it difficult to make time for treatment because of their responsibilities at home and work.

How you can help a friend or loved one

If you have a friend or loved one who is showing signs of having an eating disorder, take some time to learn about the issue before talking with them, suggests Dr. Santangelo. NEDA offers information about eating disorders and how to talk with someone you’re concerned about.

It's important to be calm, caring, honest and prepared for a defensive reaction when initiating a discussion. Remove stigma, shame and judgment from the conversation and offer firm support in encouraging them to seek help. Additional tips from NEDA include:

• Use “I” statements, such as “I’ve noticed you aren’t joining us when we go out for lunch or dinner anymore,” or “I am worried about how often you work out.”

• Avoid overly simplistic solutions, such as “Just stop,” or “Just eat,” which can make them feel frustrated, defensive and misunderstood.

• Encourage them to seek professional help and offer to help them find a doctor, therapist or program.

“Eating disorders are treatable in people of all ages — especially with prompt, early and specialized intervention,” Dr. Santangelo says. “With loved ones’ support, proper nutrition, healthy eating behaviors, therapy and medication, as needed, sufferers can regain self-awareness and attain a life of health and wellness.”

Learn more about specialized eating disorders treatment at Sharp Mesa Vista Hospital.