5 Early Signs of an Eating Disorder
Michelle Konstantinovsky
A woman in a white t-shirt and jeans holds a cup of coffee and looks at her phone

While eating disorders can manifest in a variety of ways, there are a number of common and widely recognized red flags: fixating on nutrition labels and calorie counts, severely restricting food intake, or visiting the bathroom immediately after meals, for example. But often, by the time these signs become obvious and impossible to ignore, the eating disorder has already taken root. Considering how complex these illnesses can be and how ingrained disordered habits can become over time, there really is no better tool to combat eating disorders than prevention. And one of the best preventative tools is knowing the early signs of an eating disorder.

“Eating disorders are notoriously tough to treat once they become entrenched,” says Equip’s Director of Lived Experience, JD Ouellette. “While anyone can recover at any age or length of illness, the earlier you act, the easier it is. Early action also lowers the risk of lifetime physical complications.” She drives this point home by noting that these are serious—and sometimes deadly—mental illnesses, with one American dying from an eating disorder every 52 minutes.

To put it bluntly, early intervention saves lives—however, those first signs of trouble can be tough to spot. This is true for a variety of reasons, including the fact that people struggling often hide their disordered behaviors, and that our diet culture-informed society tends to praise and normalize a number of different eating disorder symptoms.

“Early signs can be obvious or they can be subtle,” Oullette says. “Because the initial phases of a restrictive eating disorder are in line with what society values—’discipline,’ weight loss attempts— it’s common for these signs to be ignored, or even celebrated, particularly if someone has a body size that medicine and society deem too large.” This is particularly notable given that all eating disorders, in fact, contain an element of restriction.

Still, with a bit of education, it is possible to identify an eating disorder in its earliest stages. Here are five early signs of an eating disorder.

Early signs of an eating disorder to know about

1. A history of an eating disorder or disordered eating in the family

While this isn’t necessarily a visible sign, knowing someone’s family history can provide helpful context about their eating disorder risk. Eating disorders aren’t inheritable, but there is a genetic component to them. So if someone’s parent has an eating disorder, it doesn’t mean they will too, but it can make them more predisposed to developing one. Female relatives of people with anorexia have been shown to be 11 times more likely to develop the disease than relatives of people without anorexia. Rates of other specified feeding or eating disorder (OSFED) are elevated in first-degree relatives of people with anorexia and bulimia, and there’s research suggesting a genetic element in the development of binge eating disorder (BED) and bulimia as well.

2. Starting a diet or yo-yo dieting

In today’s society, it can be hard to tell the difference between the early stages of an eating disorder and diet culture habits that, while disordered, don’t signify an underlying issue (think: intermittent fasting, extreme exercise regimens, cutting out entire food groups, etc.). But showing interest in any kind of dieting behavior—no matter how “normal” or common—can be a red flag. It can also be the first step on a slippery slope toward an eating disorder.

Disordered eating is more common than not in 2024,” Oullette says. “We've been told for a long time now that our eating should be rules-based rather than listening-to-our-bodies based, and our movement should be compensatory, paying for the food we've eaten.” While dieting is sadly normal, she notes that it might be tipping into dangerous territory if a person becomes distressed when they can’t follow their eating or exercise regimen, they become defensive when their diet is questioned or loved ones bring up concerns, or their diet negatively affects their mood and ability to engage in normal life.

3. Fear of social situations that involve food

One early sign of an eating disorder is a fear of eating around others. This anxiety over social situations involving food can result from a number of things, including a desire to isolate, a fear of “losing control” around “unsafe” or unfamiliar foods, distress over straying from a rigid routine, or worry over being “caught” restricting or bingeing. Many people with eating disorders also feel shame about eating, and simply don’t want others to see them eat.

“Do they skip meals, rarely eat in public, or only pick at food when eating with others?” asks Lara Effland, LICSW, Equip’s Director of Adult Programs. “If yes, it’s a sign that they’re struggling with eating.” Effland adds that progressively worsening pickiness around foods and an insistence on eating the same thing every day—both of which can make it difficult or anxiety-producing to eat with others—can be signs of trouble as well.

4. New and uncommon eating or exercise behaviors

Rigidity and rituals are both common among people on the brink of an eating disorder, and this can rear its head in a variety of ways. Ouellette points out that inflexibility around exercise is a telltale sign: for instance, if someone adopts a new or increased exercise routine that they’re unwilling to take a break from for any reason, even injury or illness.

Unusual food behaviors can also pop up. Some examples Ouellette cites are drinking an excessive amount of noncaloric beverages (sugar-free energy drinks, coffee, tea, diet sodas), cutting food into tiny pieces or taking very small bites, or only eating using very small utensils. But any uncommon and rigidly enforced habits around food or exercise are potential cause for concern.

5. A strong urge to keep moving (and checking) the body

Body checking, defined as any behavior that involves the use of external markers to get information about the size and shape of one’s body, is common among those who are starting to develop an eating disorder. “This can include pinching, measuring, or spending a lot of time in mirrors evaluating your body,” Oullette says. Chronic use of a scale can also be considered a form of body checking, as can feeling one’s body for protruding bones or muscles.

In addition to compulsive body monitoring, people slipping into a troubled relationship with food and their bodies might also feel compelled to keep moving in an effort to burn calories or release anxiety. “Standing, jiggling legs, or being unable to be still are signs,” Oullette says.

Why it's essential to get help, even without a clinical diagnosis

Eating disorders are treatable and with the right support, full recovery is possible for everyone struggling, regardless of how long they’ve been living with their illness. But once an eating disorder has fully taken hold, it can take a lot of time, heartbreak, and sacrifice to heal; halting the disorder in its tracks by staying vigilant and looking out for early warning signs is the key to successful prevention and easier recovery.

“If there’s one thing I could change about our healthcare system, it would be for us to focus more on prevention than intervention,” Effland says. “I’ve had patients who were turned away from treatment because they were ‘not sick enough.’ This is the wrong message to send to people who are brave enough to ask for help.”

Effland and other professionals who diagnose and treat eating disorders every day believe prevention is the key to reducing the number of people affected by eating disorders. “If you’re experiencing any level of suffering related to food, shape, or weight, it’s worth seeking support from someone who is educated in eating disorders,” she says. “Even if you’re uncertain about what level of care you or your loved one need, starting a conversation with a trained professional is a wonderful place to explore your options. Without support, disordered habits can quickly progress, and they only get more complex. They won’t go away on their own, and it’s tough to recover without help.”

If you’ve noticed any early signs of an eating disorder in yourself or a loved one, it’s important to get help promptly. Talk to your medical provider or schedule a consultation with someone on our team to get a professional assessment.

Early intervention saves livesIf you're worried about yourself or a loved one, don't ignore it.
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References
  1. Bulik, Cynthia M., Lauren Blake, and Jehannine Austin. 2019. “Genetics of Eating Disorders.” Psychiatric Clinics of North America 42 (1): 59–73. https://doi.org/10.1016/j.psc.2018.10.007.
  2. Thornton, Laura M et al. “The heritability of eating disorders: methods and current findings.” Current topics in behavioral neurosciences vol. 6 (2011): 141-56. doi:10.1007/7854_2010_91
  3. “Report: Economic Costs of Eating Disorders.” 2020. STRIPED. June 11, 2020. https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.
Michelle Konstantinovsky
Equip Contributing Editor
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