Do You Have An Eating Disorder? Diagnosis And Next Steps

Eating disorders are on the rise¹, and can potentially become life-threatening if left untreated.

There are several different kinds of eating disorders. While anorexia nervosa is perhaps the most widely known, it is not the only type, or even the most common.

If you, your child, or a loved one may have an eating disorder, there are steps you can take to get diagnosed and start the path to recovery.

What is an eating disorder?

An eating disorder is any pattern of disordered and unhealthy eating or weight loss that interferes with your physical health and functioning. It often causes malnutrition or nutrient deficiencies.

Eating disorders are serious conditions, but understanding what they are and how they affect you is the first step to recovery.

Types of eating disorders² include:

Anorexia nervosa

This type of eating disorder most commonly presents in teenagers and involves restricting the number of calories you consume. You may also exercise excessively and compulsively in order to lose weight. 

Bulimia nervosa

Consuming often large amounts of high-calorie food then purging (usually through self-induced vomiting, fasting, or excessive exercise) in an attempt to prevent your body from storing excess calories. 

Binge eating disorder

This is the most common eating disorder in the US. It involves consuming large amounts of food, often in secret, in a short period of time.

Learn more about binge eating disorder, including its warning signs, complications, and treatment options.

Avoidant restrictive food intake disorder (ARFID)³

ARFID involves extremely picky eating, in which the person consumes only very limited food, typically resulting in consuming too few calories. ARFID is often associated with autism.

It can be distinguished from anorexia in that it does not involve any concern or desire to lose weight. Instead, it is a sensory disorder, which requires a very different treatment approach.

Other specified feeding and eating disorder (OSFED)

This is a group of eating disorders where people show signs of an eating disorder, but their symptoms are not severe enough to warrant a specific diagnosis.

Orthorexia nervosa⁴

This type of eating disorder involves an obsession with a healthy diet. While orthorexia is not a formal diagnosis, it is a term that is commonly used to refer to people who cut out certain food groups (often fat or carbohydrates) for the sake of health and become distressed when “safe” foods are not available.

People with orthorexia may or may not have issues with body image. They often show concern for what those around them are eating, especially friends and family members. It is sometimes associated with OCD.

What are the warning signs of an eating disorder?

Each type of eating disorder has its own signs and symptoms, but general warning signs to watch out for include:

• Eating in secret or hiding stashes of food.

• Forcing yourself to vomit or taking diuretics or laxatives to "purge your system.”

• Significant weight loss (although people can have an eating disorder and be normal or even overweight).

• Obsession with weight, weight loss, and dieting.

• Excessive exercise, especially with no goal other than to lose weight.

• Using appetite suppressants, including nicotine.

• Consuming unusually small or large amounts of food.

• Avoiding certain or many foods because of fear of negative consequences (a sign of ARFID).

• Avoiding certain or many foods because of their texture, consistency, smell, or temperature (also a sign of ARFID).

• Preoccupation with body image, body size/shape, or a specific body part.

• Specific rituals associated with food or eating.

• Avoiding eating in a social context, preferring to eat alone.

• Changes in menstrual regularity.

• Fatigue.

• Fainting.

• Changes in skin and hair.

• Acid-related dental problems (a sign of bulimia).

As children and teenagers are particularly prone to developing eating disorders, it's important for parents to watch out for these warning signs.

Maintaining open communication with your children is vital, as is modeling healthy eating behaviors because eating disorders can be passed on to other family members.

How are eating disorders diagnosed?

There are no blood tests or other physical assessments to determine whether you have an eating disorder. Instead, doctors will evaluate your signs and symptoms together with certain statistics.

For example, a diagnosis of anorexia nervosa⁵ requires:

• Bodyweight is at least 15% below the expected level in children, or a body mass index (BMI) of 17.5 or lower in adults.

• Avoidance of high-calorie foods and at least one of:

  • Self-induced vomiting

  • Self-induced purging, excessive exercise

  • Use of appetite suppressants and/or diuretics.

  • Distorted body image.

  • Endocrine issues, which include menstrual cycle changes in girls and loss of libido in boys.

  • Delayed puberty in younger children.

An eating disorder is diagnosed by reference to specific criteria. However, you can still have an eating disorder even if you don’t meet the diagnostic criteria.

Eating disorders affect women more than men, which may be because women are often more targeted by unrealistic beauty standards and negative body image messaging from an early age.

However, eating disorders often go undiagnosed in boys and men due to the stigma and a mistaken belief that they only affect women.

What should you do if you suspect an eating disorder?

Disordered eating can have strong effects on your life, health, and relationships so it is important to seek help as early as possible. If you are concerned that you, your child, or a loved one may have an eating disorder, it is important to see a doctor.

If you think you have an eating disorder, don't try to deal with it on your own. Recognizing you have a problem is the first step towards recovery. It can be easy for disordered eating behaviors to become entrenched habits, and many people with an eating disorder do not recognize that they need help.

You may be afraid that you will gain weight if you get treatment. This is often the main barrier to seeking help. Your doctor and a mental health professional can work with you to resolve these sorts of beliefs to support your recovery.

You should consult your family doctor in the first instance, and they may then refer you to a specialist.

With children and teenagers who suffer from eating disorders, it is particularly important to provide them with support, even if they do not want it. The most effective treatment for eating disorders in adolescents is family-based therapy where the family works together as a unit on strategies to help their teen recover.

If you think a friend or family member has an eating disorder, you should try to very gently ask them about it, and encourage them to seek help. Left untreated, eating disorders can become life-threatening.

Once you or a loved one has a diagnosis, the next step is to start a treatment program that may include medication, counseling, and nutrition guidance to learn normal eating behaviors.

The lowdown

If you or a loved one has an eating disorder, it’s important to seek treatment sooner rather than later to prevent disordered behaviors from becoming entrenched and causing negative, or even life-threatening, consequences.

It is also important to recognize the differences between types of eating disorders and the different treatments they require.

Talk to your doctor about eating disorder screening. Your doctor may also refer you to a specialist for diagnosis and treatment.

The biggest obstacle to recovery is being resistant to seeking treatment, but if you notice any warning signs in yourself or a loved one, you should seek support as early as possible.