Notice if the person eats large quantities of food even when they are not hungry. Observe if your friend complains of a stomach ache or having eaten too much on a regular basis. This can be a sign of binge-eating. See if the person self-medicates with food. People with eating issues may often use food as a way to feel better. Does your friend want to eat unhealthy when they are feeling sad or angry? Notice if your friend never wants to eat around other people, or eats secretively. Does your friend hide food that they are eating so that others won’t see? There may be a problem if your friend repeatedly makes excuses for not eating such as saying, “I’m not hungry,” very often. Look for food hoarding. Individuals with eating disorders may hoard food out of embarrassment. They may stash food in a secret place to use for future binging.
Binge eating involves: eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances, and a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating). To be classified as binge-eating, the person will experience at least 3 of the following: eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not feeling physically hungry, eating alone because of feeling embarrassed by how much one is eating, or feeling disgusted with oneself, depressed, or very guilty afterward. [1] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source Binge eating also causes emotional distress, and occurs at least once per week.
Purging is one type of compensatory behavior that is used to deal with the effects of a binge. [2] X Trustworthy Source Johns Hopkins Medicine Official resource database of the world-leading Johns Hopkins Hospital Go to source This means the person purposely vomits in order to release the food out of their system. Notice if your friend goes to the bathroom repeatedly during or right after a meal. Listen for sounds of throwing up, using mouthwash, or brushing of the teeth (which will often occur after a purge). Other compensatory behaviors include taking laxatives, diet pills, or diuretics as well as fasting or exercising excessively (several times or many hours per day).
People with eating disorders may experience a sense of lack of control over their eating. [3] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source Notice if your friend says things like, “I just can’t help myself. I don’t think I can control what I eat. ” On the flip-side, the person may show extreme care and control over their eating. Observe if there is a noticeable preoccupation with weight, calories, or food. Also look for food rituals such as needing to eat a certain way or a certain type of food regularly.
Does your friend often feel guilty after they eat? They may verbalize their guilt by saying things like, “Ugh, I wish I hadn’t eaten that. ” Identify self-esteem issues such as feelings of worthlessness or inferiority.
This may mean that the person is very fearful of gaining weight. Notice if your friend says they are overweight or fat, when they clearly are not. Denial of low weight can be a symptom of Anorexia.
Some specific health-related symptoms include: Pale or yellow skin tone. Thin, dull, and dry hair, skin, and nails. Intolerance for cold. Recurrent fatigue or feeling of lethargy. Fainting. Looking very frail or underweight (abnormally thin arms, legs, or face). Gaining weight, being significantly overweight, or obese.
Realize that the person does not have to self-induce vomiting to meet the criteria for this disorder. [5] X Trustworthy Source Johns Hopkins Medicine Official resource database of the world-leading Johns Hopkins Hospital Go to source
Anorexia nervosa primarily affects adolescent girls and young women (although can also be present in older women and men). [8] X Trustworthy Source National Institute of Mental Health Informational website from U. S. government focused on the understanding and treatment of mental illness. Go to source People with anorexia severely restrict their calorie intake. Low body weight means the person is underweight in terms of their height, age, and sex. This can be calculated by using the Body Mass Index (BMI). Even though the individual is not overweight they will be very fearful of gaining weight or becoming fat. Look for body image issues such as concern with weight, body shape, or body type. Someone with anorexia will have a disturbance in body-image, meaning they could be in denial about the seriousness of their low weight, or believe that they are overweight. There are two subtypes of anorexia - restricting type (not eating enough food), and binge-eating/purging type.
Binge eating is eating significantly more food than normal in a short period of time. Normal is defined in terms of what most people would eat under normal circumstances. People who binge will feel out of control, like they cannot stop themselves from binging. Someone with binge eating disorder may eat too quickly, even when they are not hungry. After binging, the individual may feel guilty, embarrassed, or disgusted. Some individuals may binge eat only when alone in order to conceal the issue from others.
Pica is when someone eats non-nutritive substances (objects, not food-related) for a period of at least one month. [9] X Trustworthy Source National Eating Disorders Association Nonprofit organization dedicated to supporting individuals and communities affected by eating disorders Go to source The eating of non-nutritive substances is inappropriate to the developmental level of the individual (you would not diagnose a young child for eating crayons). The eating behavior is not part of a culturally supported or socially normative practice (such as eating something non-harmful as part of a religious practice). Pica often occurs along with other mental health disorders. [10] X Trustworthy Source National Eating Disorders Association Nonprofit organization dedicated to supporting individuals and communities affected by eating disorders Go to source However, pica may be severe enough to require specific clinical attention and treatment planning.
Rumination disorder is not due to a medical issue (such as a stomach flu that causes you to vomit).
This eating disorder includes one or more of the following: significant loss of weight, nutritional deficiency, dependence on enteral feeding or oral nutritional supplements, and marked interference with psychosocial functioning. This diagnosis cannot be made if the person does not have enough food available to eat (such as being homeless or having low income). The person will not have a body image disturbance. Some individuals who are vegan or vegetarian may meet this diagnosis if they do not have adequate nutrition.
For example, a person may not meet the full criteria for binge eating disorder because they binge at a lower frequency (such as once every few weeks), or has been doing it for less than 3 months. This still means there is a problem, however, and that it might turn into a full binge eating disorder. Another example is if the person meets most of the criteria for anorexia nervosa, but is within the normal weight range for their height. Remember that just because your friend doesn’t meet the full criteria for anorexia or bulimia, this doesn’t mean there is not a problem. Seek out help from a professional for a proper diagnosis.
You can begin by saying something like, “I care about you very much and I’m concerned about your eating habits and that they might be hurting you. Have you every thought about getting help?” Be careful not to diagnose your friend by saying, “I think you have bulimia”
Offer your assistance by saying something like, “I can help you find someone to talk to if you’d like me to. " You can search the American Psychological Association (APA) database for therapists in your area. [15] X Research source Tell your friend to contact their insurance company to find out more information about services and possible therapists.
When you notice your friend eating in a healthy way, tell them, “I noticed you are eating a normal amount lately. Good job!”
