Recognizing an Eating Disorder

By Rebecca F. Ward, LCSW, MSW & Angela E. Thomas


In my profession, there are few diagnoses that have a mortality risk. Eating disorders are one of them.

Eating disorders affect up to 30 million people of all ages and genders in the United States. Theses disorders, such as anorexia, bulimia and binge eating, are associated with extreme emotions, attitudes and behaviors that surround weight and food issues, according to NEDA, the National Eating Disorders Association. Eating disorders have serious consequences; these include but aren’t limited to: muscle loss and weakness; severe dehydration, which could result in kidney failure; abnormally slow heart rate and low blood pressure; electrolyte imbalances; tooth decay; and more. Binge eating specifically can lead to high blood pressure and cholesterol levels, gall bladder disease and more.

A 2010 study found it’s common for eating disorders to occur with other issues, such as alcohol and substance abuse disorders, depression and obsessive-compulsive disorder.

While eating disorders were once primarily associated with teenage girls, they are now also associated with young adults and younger children. “By age 6, girls especially start to express concerns about their weight or shape, and 40 to 60 percent of elementary school girls — ages 6 to 12 — are concerned about their weight or becoming too fat.” Dieting and the drive to be thin is affecting young girls — 46 percent of 9- to 11-year-olds “sometimes” diet — and the behavior is sometimes driven by their families — 82 percent of their families are “sometimes” on diets.

Further, 10 to 15 percent of individuals with anorexia or bulimia are male, according to figures from the National Association of Anorexia Nervosa and Associated Disorders.

Signs of eating disorders

Often the signs of an eating disorder are obvious: noticeable weight loss; eating very little food at meals; tooth enamel decay; dry skin; and retreating to the bathroom after meals. But what about people who suffer from eating disorders and it’s not so obvious? They look fine and seem to be healthy. For instance, bulimics often maintain normal weight due to the purging associated with the disorder. So, how can you tell if a friend or family member has an eating disorder? What are the symptoms to look for?

Poor body image is a marker for possible eating issues. When you hear someone talk a lot about his or her body in negative terms, take note. He or she may often say things like, “I just hate my hips. They’re huge.” And, “I look fat no matter what I wear” or “I think I look bloated and miserable.”

Excessive exercising is another possible sign. Many who have eating disorders use exercising, rather than purging, as a way to get rid the food they’ve eaten. These folks will run miles a day, spend hours working out and allow almost nothing to interfere with their routines.

Eating in public is another no-no for many with eating disorders. They often think others are critically watching their eating behaviors. Also, if they cannot control the ingredients in the food they’re eating, they often obsess about fat and carb content. And, if forced to eat out, they will frequently move food around or cut it up on their plates to make it look as if they’re eating, when in truth they may have only taken a few bites. 

A preoccupation with safe foods, called orthorexia, is often a precursor to anorexia. While not an official diagnosis, those with orthorexia are highly concerned with the quality of food, only eating what they know to be healthy and free of “bad things,” such as fat, calories and sugar. People with anorexia focus more on quantity, though they, too, generally have very limited diets and eat the same “safe foods,” over and over.

While women are much more likely than men to develop eating disorders, each case is serious. Mortality rates for anorexia nervosa, for instance, are about 4 percent and almost that high for bulimia nervosa. These rates are not particularly reliable, however, because those who suffer and die from eating disorders may ultimately die of heart or organ failure, malnutrition or suicide.

Get Help

If you think you have an eating disorder or if you think one of your friends, colleagues or a family member might be afflicted, please seek treatment. Start a dialogue. As discussed, eating disorders can be deadly and should not be ignored. Luckily, there are good treatments, and people do recover.

Kristin Agar, a LCSW and certified interventionist, and several of her colleagues have formed the Eating Disorder Coalition of Arkansas (EDCA), a weekly support group run by professionals. Their focus is education, research and resources.

“We have a great need to treat people with food disorders,” Agar said. “Anorexia has the No. 1 mortality rate of all the psychiatric disorders.”

For more information about the EDCA, log on to or call 501.664.0091. You’ll also find the organization on Facebook at

*Source: National Association of Anorexia Nervosa and Associated Disorders,; National Eating Disorders Association,