Signs of Eating Disorders

In our image-obsessed culture, it can be easy for teens (and adults, for that matter) to be critical of their bodies. Normal concerns about body image can cross the line and become eating disorders when a person starts to do things that are physically and emotionally dangerous — things that could have long-term health consequences.

Some people go on starvation diets and can become anorexic. Others go on eating binges and then purge their bodies of the food they've just eaten through forced vomiting, compulsive exercise, taking laxatives, or a combination of these (known as bulimia).

Although eating disorders like anorexia and bulimia are far more common in girls, guys can get them, too. So how do you know if a friend has an eating disorder? It can be hard to tell — after all, someone who's lost a lot of weight or feels constantly tired may have another type of health condition. But some of the signs that a friend may have an eating disorder include:

• Your friend has an obsession with weight and food (more than general comments about how many calories he or she eats in a day). It might seem like your friend talks about food, weight and being thin and nothing else.
• Your friend knows exactly how many calories and fat grams are in everything that he or she eats — and is constantly pointing this out.
• Your friend feels the need to exercise all the time, even when sick or exhausted.
• Your friend avoids hanging out with you and other friends during meals. For example, he or she avoids the school cafeteria at lunch or the coffee shop or diner where you usually meet on weekends.
• Your friend starts to wear big or baggy clothes. Lots of people wear baggy clothes as a fashion statement, but someone who wears baggy clothes to hide their shape might have other issues.
• Your friend goes on dramatic or very restrictive diets, cuts food into tiny pieces, moves food around on the plate instead of eating it, and is very precise about how food is arranged on the plate.
• Your friend seems to compete with others about how little they eat. If a friend proudly tells you she only had a diet soda for breakfast and half an apple for lunch, it's a red flag that she could be developing an eating disorder.
• Your friend goes to the bathroom a lot, especially right after meals, or you've heard your friend vomiting after eating.
• Despite losing a lot of weight, your friend always talks about how fat he or she is.
• Your friend appears to be gaining a lot of weight even though you never see him or her eat (people with bulimia often only eat diet food in front of their friends).
• Your friend is very defensive or sensitive about his or her weight loss or eating habits.
• Your friend buys or takes laxatives, steroids, or diet pills.
• Your friend has a tendency to faint, bruises easily, is very pale, or starts complaining of being cold more than usual (cold intolerance can be a symptom of being underweight).

What to Do

If a friend has these symptoms and you're concerned, the first thing to do might be to talk to your friend, privately, about what you've noticed. Tell your friend that you're worried. Be as gentle as possible, and try to really listen to and be supportive of your friend and what he or she is going through.

It's normal for people with eating disorder to feel guarded and private about their eating problems. Try not to get angry or frustrated. Remind your friend that you care.

People with eating disorders often have trouble admitting — even to themselves — that they have a problem. Trying to help someone who doesn't think he or she needs help can be hard. Many people feel successful and in control when they become thin, but those with eating disorders can become seriously ill and even die. If your friend is willing to seek help, offer to go with him or her to see a counselor or a medical expert.

If your concerns increase and your friend still seems to be in denial, talk to your parents, the school guidance counselor or nurse, or even your friend's parents. This isn't easy to do because it can feel like betraying a friend. But it's often necessary to get a friend the help he or she needs.

Eating disorders can be caused by — and lead to — complicated physical and psychological illnesses. You can support your friend by learning as much as you can about eating disorders. Your friend's body image and behavior may be a symptom of something else that's going on. Many organizations, books, websites, hotlines, or other resources are devoted to helping people who are battling eating disorders.

Being a supportive friend also means learning how to behave around someone with an eating disorder. Here are some ways to support a friend who is battling an eating problem:

• Try your best not to talk about food, weight, diets, or body shape (yours, your friend's, or even a popular celebrity's).
• Try not to be too watchful of your friend's eating habits, food amounts, and choices.
• Try not to make statements like, "If you'd just eat (or stop working out so much), you'll get better."
• Focus on your friend's strengths — that he or she has a great smile, is helpful and friendly, or good at math or art.
• Try to avoid focusing on how your friend looks physically.

Most important, remind your friend that you're there no matter what. You want to help him or her get healthy again. Sometimes you'd be surprised how asking simple questions such as "what can I do to help?" or "what would make you feel better?" can lead to a great conversation about how you can help your friend heal.

Reviewed by: Michelle New, PhD
Date reviewed: November 2007

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