An eating disorder is a serious mental health issue that can severely impact a young person’s health and can threaten his or her life. Fortunately, early detection can significantly improve a person’s ability to recover. But eating disorders, like many mental health issues, can be difficult to detect, especially when you’re not sure what signs to look for.

Here are some common signs of eating disorders in young people that can help you recognize when a young person in your life may be developing or living with an eating disorder.

Signs and Symptoms of Eating Disorders

Behavioral

1. Dieting behaviors (e.g. fasting, counting calories and avoidance of food groups or types).
2. Evidence of binge eating (e.g., disappearance or hoarding of food).
3. Evidence of deliberate vomiting or laxative use (e.g., taking trips to the bathroom during or immediately after meals).
4. Excessive, obsessive, or ritualistic exercise patterns (e.g., exercising when injured or in bad weather, feeling compelled to perform a certain number of repetitions of exercise or experiencing distress if unable to exercise).
5. Changes in food preference (e.g., refusing to eat certain fatty or “unhealthy” foods, cutting out whole food groups such as meat or dairy, a sudden concern with healthy eating or replacing meals with fluids).
6. Development of rigid patterns around food selection, preparation and eating (e.g. cutting food into small pieces and eating very slowly).
7. Avoidance of eating meals, especially in a social setting (e.g. skipping meals by claiming to have already eaten or have an intolerance or allergy to particular foods).
8. Lying about the amount or type of food consumed or evading questions about eating and weight.
9. Behaviors focus on food (e.g., planning, buying, preparing and cooking meals for others but not consuming meals themselves; interest in cookbooks, recipes and nutrition).
10. Behaviors focused on body shape and weight (e.g., interest in weight-loss websites, books, and magazines or images of thing people).
11. Development of repetitive or obsessive behaviors relating to body shape and weight (e.g., body checking such as pinching waist or wrists, repeated weight of self and excessive time spent looking in mirrors).
12. Social withdrawal or avoidance of previously enjoyed activities.

Physical

13. Weight loss or weight fluctuations.
14. Sensitivity to the cold.
15. Changes in or loss of periods.
16. Swelling around the cheeks or jaws, calluses on knuckles or dental discoloration from vomiting.
17. Fainting.

Psychological

18. Preoccupation with food, body shape and weight.
19. Extreme body dissatisfaction.
20. Distorted body image (e.g., frequently check their reflection in mirrors, windows and other reflective surfaces).
21. Sensitivity to comments or criticism about exercise, food, body shape or weight.
22. Heightened anxiety around meal times.
23. Depression, anxiety or irritability.
24. Low self-esteem (e.g., negative opinions of self; feelings of shame, guilt or self-loathing).
25. Rigid thinking (e.g., labeling of food as either bad or good).

Warning Signs Especially Common for Young People

26. Obsessively count calories or examine food labels for nutritional information
27. Avoid eating with friends or discard lunches
28. Spend a great deal of time online talking to people who promote or encourage disordered behaviors rather than spending time with friends in person

Need-to-Know

There are three main eating disorder classifications: anorexia, bulimia and eating disorder not otherwise specified (EDNOS), which includes binge-eating disorder. Bulimia is statistically more common than anorexia and many hide their symptoms and behaviors for years before seeking professional help. EDNOS is the most common form of eating disorder. EDNOS describes people with symptoms and behaviors that do not strictly align with anorexia or bulimia but whose attitude toward good weight or body shape seriously impacts their life. EDNOS is not less serious than anorexia or bulimia and can cause significant health problems.

Many assume that eating disorders affect only young, white, middle to upper-class women. In truth, eating disorders affect boys and young men as well as African American, Hispanic, Asian and Native American youths and young adults. Many also falsely believe that only people with a certain body type can have an eating disorder. It’s important to remember that eating disorders are a mental illness – they are not dependent on a person’s size, shape, race or gender.

For some it can be difficult to distinguish eating disorder behaviors from healthy self-care practices. A good question to ask is whether something feels mandatory or causes an undue amount of anxiety or stress.

The National Eating Disorders Association (NEDA) provides a host of helpful resources and information, including how to talk to a loved one about their eating disorder and an online screening tool.

If you or a loved one is living with an eating disorder and are looking for information or support, call the NEDA helpline at (800) 931-2237. You can also learn to recognize and respond to signs and symptoms of mental health challenges specific to young people by getting trained in Youth Mental Health First Aid. Register for a course today.