If you do a quick online search for “signs of an eating disorder,” you’ll get back countless websites listing warning signs and common symptoms, but these lists aren’t comprehensive. And while some eating disorder signs are pretty intuitive and might raise eyebrows on their own—like, say, significant changes in body weight and extreme dieting—there are many more subtle signs of an eating disorder, which often go unnoticed.

“While my daughter’s anorexia was diagnosed fairly quickly, it would have happened even faster if I was aware that a newfound obsession with interacting with food in a non-eating way was a sign of an eating disorder,” says J.D. Ouellette, Equip’s Director of Lived Experience. “I’ve always cooked and baked a lot, so looking up and making new recipes seemed normal to me. What wasn’t normal was the scale of it all: Food Network 24/7, Pinterest for recipes, organizing all our family recipes, cooking and baking amazing, delicious food… but not eating any of it.”

This behavior that Ouellette observed is just one of many less obvious eating disorder behaviors. Raising awareness around these symptoms is extremely important, as a huge number of eating disorders go undiagnosed: in one study, just 10% of college students reporting symptoms got a diagnosis. What’s more, many of the eating disorders that do get diagnosed could have been caught earlier if loved ones had known the less conspicuous warning signs, which matters because early intervention significantly increases the likelihood of recovery.

Read on to learn 11 subtle signs of an eating disorder you might not be aware of, and what to do if you’re concerned about yourself or a loved one.

Why do some eating disorder signs go unnoticed?

It can be tricky to spot an eating disorder for a number of reasons. Firstly, many eating disorder behaviors are done in secret, and the person struggling often goes to great lengths to hide their eating disorder. But even some red flags that happen in public go unnoticed—or we notice, but don’t think it’s anything to be concerned about. There are a few potential reasons for this:

The influence of diet culture

Our inability to see certain disordered behaviors can, in many ways, be chalked up to the fact that a lot of these behaviors are praised in our society, which is steeped in diet culture. “So many signs of eating disorders are socially normal and even applauded,” says Ouellette. “Working out twice a day, seven days a week? Go you! Restricting calories and categories of food? Wish I had your self-discipline! Lost a few pounds? Living the dream!”

Jessie Menzel, Equip’s VP of Clinical Programs, agrees, explaining that society has normalized behaviors that could be red flags, “things like changing one’s diet to be ‘healthier,’ deciding to become a vegetarian, trying to eat fewer sweets, starting to skip meals, or even forgetting to eat.”

Medical misconceptions

Eating disorder warning signs might also be ignored because trusted figures dismiss them. “Parents are often directly assured ‘nothing is wrong’ by their medical provider,” says Menzel. She explains that concerned parents might hear things like, “picky eating is normal,” “they’ll grow out of it,” or “it’s a good thing that they’re trying to eat healthier.” These providers are not ill-intentioned—this kind of response is a natural result of the fact that most healthcare providers receive very little training on eating disorders, and may have a very narrow idea of what an eating disorder might look like.

Myths about appearance

Another reason signs of an eating disorder might get missed is because someone doesn’t fit society’s stereotype of who gets an eating disorder. “I think the most common reason eating disorder signs tend to go unnoticed is that someone doesn’t ‘look’ the part of someone with an eating disorder,” says Menzel. “Whether it be because they aren’t white or wealthy or because their body is larger or because they aren’t a cis girl or woman. There are entire groups of people who we think ‘can’t’ get eating disorders, and therefore, we don’t ask.”

The truth is that eating disorders affect people equally across age, gender, race, class, and body size, and—despite what the media has told us for decades—you just can’t tell if someone has an eating disorder by looking at them.

Hidden signs of eating disorders that are often missed

For a thorough look at the more straightforward symptoms of eating disorders, our eating disorder screener is a great resource. Here we’ve outlined some of the less intuitive, often missed, and less obvious signs of eating disorders. This list isn’t exhaustive, and eating disorders manifest differently in every person, but it’s a good place to start.

1. Cooking and baking food without eating it

In addition to the behaviors Ouellete shared above, one particular memory stands out to her: her daughter prepared 50 cellophane gift bags for school Valentine’s Day, each filled with candy and immaculately decorated heart-shaped cookies—but she didn’t eat a single bite herself. At the time, this stood out to Ouellette as confusing, but she didn’t flag it as related to an eating disorder. However, preparing food without eating it is actually a fairly common eating disorder behavior.

2. Not eating around others

Ouellette remembers thinking that her daughter’s desire to eat anywhere but home was just typical teenage behavior, but eventually realized that it was a ruse not to eat at all. Someone with an eating disorder might also want to eat alone because of the shame they feel around eating. This could be true for all types of eating disorders, not just those associated with binge eating.

3. Encouraging other people to eat high calories foods they’re not eating

People with eating disorders might try to satisfy their own hunger by watching others eat the foods they won’t allow themselves. (In fact, research has shown that so-called “mukbang videos,” live-streamed videos where viewers watch someone eat, are associated with disordered eating.)

Free eating disorder screenerIf you’re worried you or a loved one may have an eating disorder, you can take a screener here.

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4. Refusing tiny bites of food

Eating disorder thinking tends to put a high value on precision, especially when it comes to food. Because of this, those struggling may refuse things with trivial caloric content, like a piece of gum or a small bite of a dish. This can also go the other way: they may refuse to share food because they have exactly accounted for what is on their plate, no more and no less.

5. Excessive interest in what other people are eating

Similar to cooking for others and watching others eat high-calorie foods, this sign likely emerges out of the fact that eating disorders cause people to become obsessed with food. Those who are struggling might show an abnormal interest in the food of others, asking questions about what they ate that day, what something tastes like (without accepting a bite of it), etc.

6. Rigidity around food

Just as a person with an eating disorder might refuse tiny amounts of food because of their precise accounting, they may also become incredibly upset if the food they receive is “wrong” or “off” in any way. That might mean that a parent buys a different brand of crackers from the store, or a server at a restaurant puts dressing on the salad rather than on the side.

7. Changes in personality

Ouellette remembers thinking that the change in her teen daughter’s attitude was “developmentally appropriate teen moodiness.” And in some cases, that might be true—which is why it can be extra tricky to identify eating disorders in teenagers—but significant personality changes can also be a red flag. Malnourishment combined with uncontrollable eating disorder thoughts make it impossible for a person’s mind to function normally, and their behaviors and mood will reflect that.

8. Regressing into childlike behaviors

It’s not uncommon for people with eating disorders to become more childlike in some ways. For Ouellette, that meant her daughter suddenly calling her “Mommy” instead of “Mom” at age 17. This is usually a coping strategy to manage the overwhelming stress, anxiety, and emotions caused by the eating disorder.

9. Keeping to a rigid schedule

This might have to do with food schedule, or simply the schedule in general. Ouellette remembers her daughter developing “extreme punctuality, to the point where 30 seconds early or late was distressing.” (As a person in recovery from anorexia, I remember breaking down crying if dinner slipped to 6:05 rather than 6 p.m. sharp).

10. Insomnia or sleep problems

Hunger keeps the brain alert, so those who are restricting their food intake might have difficulty sleeping through the night (plus eating disorders can mess with melatonin, a hormone that helps us regulate our circadian rhythms). If your loved one is suddenly experiencing chronic sleeplessness or feeling tired all the time, disrupted eating patterns might be behind it.

11. Isolating from friends and family

While there are certainly legitimate and even positive reasons that someone might decline an invitation, frequently opting out of social gatherings could mean that a person is prioritizing their eating disorder behaviors over the relationships in their life, or going out of their way to avoid social events that involve food. Social isolation isn’t just a potential red flag, it can also worsen the eating disorder, since these illnesses thrive in secrecy.

None of these signs on their own definitively means that someone has an eating disorder, and someone can have an eating disorder without exhibiting any of these signs. But by being aware of the less obvious signs of eating disorders and remaining alert to anything that seems amiss, you’ll ensure you’re doing all that you can to catch a potential problem early on. Says Menzel, “anytime you notice a shift in a loved one’s eating—no matter the reason—it warrants paying close attention and asking questions.”

How to address early warning signs of an eating disorder

If you’re concerned about a loved one (or yourself), don’t ignore it. Eating disorders don’t go away on their own, and get worse when left unaddressed. As intimidating as it might be, it’s important to take the first step toward getting the help you or your loved one need. The guidance below can help you get started.

Talking with loved ones

If you’ve noticed some of the subtle eating disorder signs outlined above, or other worrisome behaviors, your first move should be to talk with your loved one. Don’t assume that they have an eating disorder—instead, come to them with genuine curiosity, while also expressing your concerns.

Here are some tips to keep in mind:

• Wait until the time is right. Don’t ambush them with the conversation, or try to bring up your concerns when they’re busy or stressed. It’s also important not to talk to them too close to a mealtime. Find a quiet, private time to talk, and ask them, “Is now a good time for us to talk for a few minutes?”
• Use “I” statements rather than “you” statements. For instance, saying “I’ve noticed that you’ve stopped eating breakfast in the morning. Can you tell me a bit about why you’ve made that change?” instead of “You don’t eat breakfast anymore.”
• Offer specific examples. Bringing up specific things you’ve noticed will likely make your conversation more productive, as it’s easy for someone to dismiss more general, vague concerns.
• Be curious, not judgmental. No matter what you’re feeling—anger, fear, confusion, frustration—avoid being accusatory, angry, or judgmental when you speak. Your job isn’t to convince your loved one to change their behaviors, but rather to create a safe space so that they are open to receiving treatment.
• Expect resistance. People with eating disorders often don’t realize they’re sick, or don’t want to get better, so you will likely experience denial or pushback. This is normal. Do your best to remain firm, calm, and supportive.
• Don’t push too hard. Don’t expect a transformation or revelation from one conversation. It may be that you need to have several conversations over a few days before you make any progress. But remember, even if your loved one will not admit they have a problem or that they need help, you can still help them get treatment. Many people begin treatment without wanting to, and still achieve full, lasting recovery.

Seeking professional help

Recovering from an eating disorder requires professional help. It’s important to work with trained eating disorder specialists, who understand all the different ways that eating disorders can show up and how to effectively treat them. If you’re unsure whether you or your loved one have an eating disorder, they can also provide a professional assessment.

Here is some guidance on getting professional eating disorder treatment:

• Taking an online screener can be a good, low-lift first step for determining if you should reach out for help. Our free, 5-minute eating disorder assessment will let you know if you should be concerned (if you’re worried about ARFID, use our ARFID screener).
• Make sure you work with a multidisciplinary treatment team. Eating disorders affect multiple facets of a person’s life, and it’s important to have providers who can address all of them. An effective eating disorder treatment team should include (at minimum) a licensed therapist, a registered dietitian, and a medical provider. It might also include a psychiatrist, mentors, or other providers.
• Consider all the different treatment options available. There are in-person treatment programs, as well as virtual programs like Equip. There are also different levels of care, which essentially means how much time per day or week is spent in treatment (learn more about different levels of care in eating disorder treatment). Equip is an effective treatment approach for all levels of care, as long as a patient is medically stable.
• Try free resources. If you’re not yet ready to dive into treatment, there are many free and low-commitment resources you can explore in the meantime. Some great organizations to check out are F.E.A.S.T., Project HEAL, ANAD, and the National Alliance for Eating Disorders.

Free eating disorder screenerIf you’re worried you or a loved one may have an eating disorder, you can take a screener here.

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The importance of early intervention

We said it before but we’ll say it again: eating disorders don’t go away on their own. In fact, over time they only tend to become more severe and more entrenched. So if you’re noticing subtle signs of an eating disorder in someone you love (or yourself), it’s important to get help as soon as you can.

There are a lot of reasons to intervene early, not the least of which is that the earlier someone gets care, the more of their life they get to spend enjoying a full, free existence, rather than the small, constrained life that the eating disorder allows. Early intervention also has several research-backed benefits.

Improved treatment outcomes

Getting help early is associated with better treatment outcomes. Research shows that early intervention improves a person’s chance of achieving lasting recovery, and there’s evidence that intervening and improving symptoms early lowers a person’s risk of struggling with an eating disorder-long term. Additionally, one meta analysis that looked at 130 different studies found that early intervention programs significantly reduce eating disorder risk factors and encourage help-seeking behaviors.

Reduced long-term health complications

Eating disorders can take a significant toll on a person’s physical health. And the longer someone struggles with an eating disorder, the greater the risk that they’ll experience some of the short- and long-term health complications of an eating disorder.

Early intervention helps stop the progression of the eating disorder, which also helps prevent the many health consequences they can lead to, which include cardiovascular issues, metabolic imbalances, bone health concerns, and many more. It also helps prevent other comorbid psychological concerns, like anxiety and depression.

The Equip takeaway on subtle signs of eating disorders

It’s important to understand that eating disorders aren’t always obvious. In fact, they often aren’t—that’s part of the reason why only about 20% of people with eating disorders get treatment. Knowing the subtle signs to watch for, like the ones described in this article, can help ensure that your loved one (or you) get the help you need.

If you’re worried about a loved one, don’t ignore your concerns. Eating disorders only worsen over time, and it’s better to be safe than sorry. Approach your concerns with empathy, curiosity, and kindness. If an eating disorder is present, these next steps can help you get the support necessary to achieve lasting recovery:

• Take an eating disorder assessment created by specialists.
• Explore the free resources from organizations like F.E.A.S.T., Project HEAL, ANAD, and the National Alliance for Eating Disorders.
• Reach out to eating disorder treatment providers or programs to find the right treatment for you or your loved one. If you’re interested in Equip treatment, you can schedule a consultation with an Equip team member, email us at info@equip.health, or call us at (855) 685-2018.