Below are some of the behaviors a parent might be observing as a loved one develops an eating disorder. Some are related to food, and some are not. Some are present before an eating disorder comes into the picture, and some increase in intensity as the illness progresses.
Around food:
- Dieting
- Avoiding a widening range of foods
- Avoiding situations where communal eating is expected
- New interest in “healthy,” “clean,” “low-carb” or “vegetarian” diets
- Inflexibility about what or when or how much to eat
- Unnatural focus on what others are eating
- Rigidity on certain ingredients or utensils
- Need to know calorie content of all foods
- Unavailable for family meals
- New interest in cooking and recipes but avoiding eating the food
- Foods, especially carbohydrates, disappearing quickly from the house
- Secretive or ritualistic eating
- Avoiding food until certain hours
- Anger at others if pressed to eat something
- Self-criticism for eating or not exercising
- Fear of over-eating, or gaining weight from a particular meal or type of food
- Visiting the bathroom or showering right after meals
Around activity:
- Exercising intensely but without pleasure
- Needing to exercise to compensate for eating
Medically:
- Failure to gain weight or height according to growth curve
- Weight loss at any time during childhood or adolescence
- Fainting, weakness, dehydration
- Injuries from overexercise
Thinking:
- A conviction that one is too large
- Unnatural focus on the flaws of a particular body part or aspect of the body
- Repetitive requests for reassurance about appearance
- An inability to understand that they may be ill (anosognosia).
Socially:
- Social withdrawal
- Reports others are newly judgmental or “not connecting”
- Inability to describe emotions
If a loved one shows only a few of the symptoms of an eating disorder, or denies that anything is wrong, this is NOT a reason to put the issue aside.
FACT: Resistance to treatment is normal.
Denying and concealing symptoms are a common symptom of brain changes associated with eating disorders and resulting malnutrition.
FACT: Early intervention increases the effectiveness of treatment.
Early detection and assertive treatment are the best way to prevent chronic illness and death from an eating disorder. There is no “too early to be concerned.”
DEFINITION: Anosognosia / Anosognosic
Pertaining to an illness or disability in which the sufferer seems to be unaware of, or denies, the disability. Patients with anorexia nervosa are often “anosognosic” as they truly do not feel ill and they experience their own behaviors and thoughts as normal. This is not a choice or conscious denial, but rather a feature of brain dysfunction. Also see Egosyntonic and Denial.