Early Warning Signs of Disordered Eating: What to Look For
Early Warning Signs of Disordered Eating: What to Look For in Yourself or a Loved One
Eating disorders don't appear overnight. They typically develop gradually, starting with patterns that might seem harmless or even socially acceptable—a new diet, cutting out certain foods, or "getting healthier." But for some people, these eating behaviors can escalate into something much more serious.
Recognizing the early warning signs of disordered eating can make a significant difference. The sooner concerning eating behaviors are identified and addressed, the better the chances for recovery. Whether you're worried about yourself or someone you care about, understanding what to watch for is the first step toward getting help.
This guide will help you identify early signs of disordered eating, understand when behaviors have moved beyond "normal" concerns about food and weight, and know when it's time to seek treatment from a mental health professional.
What Is Disordered Eating?
Disordered eating refers to food- and diet-related behaviors that don't meet the full diagnostic criteria for recognized eating disorders but still negatively affect your physical health, mental health, and overall well-being. These eating behaviors exist on a spectrum, with disordered eating being less severe than full eating disorders, but still concerning.
The key distinction: Disordered eating involves troubling eating patterns around food, eating, and body image that cause distress or interfere with daily life, but may not yet be frequent or severe enough to qualify as an eating disorder like anorexia nervosa, bulimia nervosa, or binge eating disorder.
Why this matters: Disordered eating is a major risk factor for developing a full eating disorder. Research shows these disordered eating behaviors can escalate over time, especially if left unaddressed. Early intervention can prevent progression to more serious mental health conditions.
Understanding the Spectrum: Disordered Eating vs. Eating Disorders
Eating disorders are serious mental health conditions characterized by severe and persistent disturbances in eating behaviors and associated distressing thoughts and emotions. Eating disorders are serious illnesses that require comprehensive medical and psychological intervention as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
The main difference between disordered eating and eating disorders lies in:
Severity: How extreme the behaviors are
Frequency: How often the behaviors occur
Impact: How much they interfere with physical and mental health, relationships, work, and day-to-day functioning
Someone with disordered eating might skip meals occasionally, feel guilt after eating certain foods, or go through periods of restrictive eating to lose weight. Someone with an eating disorder experiences these patterns more intensely, more frequently, and with greater physical and psychological consequences.
It's important to understand that eating disorders can be life-threatening if not treated, while disordered eating—though serious—typically poses less immediate danger to physical health.
Common Early Warning Signs of Disordered Eating
Changes in Eating Patterns
Skipping meals regularly: Missing breakfast "to save calories," routinely skipping lunch because you're "too busy," or frequently eating much less than usual. While occasionally missing a meal due to a hectic schedule is normal, consistent skipping meals to control weight or shape is concerning.
Rigid food rules: Eliminating entire food groups without medical necessity, labeling foods as "good" or "bad," refusing to eat unless food is prepared a certain way, or requiring specific portion sizes or arrangements. These eating patterns become increasingly inflexible over time and can significantly reduce food intake.
Restrictive eating: Dramatically cutting calories, following increasingly strict diets, or constantly trying new restrictive eating plans to lose weight. A pattern of starting and abandoning diets is also a red flag, as dieting behavior is a significant predictor of whether someone will develop an eating disorder.
Preoccupation with "healthy eating": While wanting to eat nutritious foods is positive, becoming obsessed with food quality, purity, or nutritional value to the point where it causes anxiety or limits social activities can signal a problem. This intense focus on healthy eating habits can actually become unhealthy.
Behaviors Around Food
Eating in secret or alone: Avoiding eating with family or friends, hiding food, or feeling ashamed about what or how much food eaten. Eating habits that shift toward increased isolation are concerning disordered eating behaviors.
Using food to cope with emotions: Consistently turning to food (or restricting food intake) as the primary way to manage stress, sadness, anxiety, or other difficult emotions. While occasional emotional eating is normal, relying on food or food restriction as your main coping mechanism is a warning sign.
Compensatory behaviors: Exercising excessively after eating, feeling you must "earn" food through exercise, using laxatives or diuretics for weight loss, or inducing vomiting. These weight control behaviors are serious warning signs that require immediate attention from a healthcare professional.
Rituals around eating: Eating very slowly, cutting food into tiny pieces, chewing food a certain number of times, or requiring specific utensils or dishes. While some food preferences are normal, increasingly rigid food rituals that cause distress if disrupted are concerning.
Preoccupation with Weight and Body Image
Frequent weighing: Weighing yourself multiple times per day, feeling anxious if you can't weigh yourself, or having your mood significantly affected by your body weight.
Body checking: Constantly checking your appearance in mirrors, pinching body parts to assess fat, comparing your body shape to others, or frequently asking for reassurance about how you look. This preoccupation with body image can consume significant mental energy.
Distorted body image: Perceiving yourself as larger than you are, focusing exclusively on perceived flaws, or expressing intense fear of gaining weight even when at a healthy body weight.
Self-worth tied to appearance: Basing your value as a person primarily on your body shape, weight, or ability to control food intake. This unhealthy relationship between self-esteem and appearance is a significant risk factor for developing eating disorders.
Physical Warning Signs
While early disordered eating may not yet cause severe medical complications, some physical changes can appear:
Changes in energy levels: Feeling unusually tired, weak, or having difficulty concentrating. These can result from insufficient food intake or nutritional deficiencies.
Gastrointestinal problems: Constipation, bloating, or stomach pain that may be related to changes in eating patterns.
Feeling cold frequently: Being more sensitive to cold temperatures than others, which can indicate reduced caloric intake.
Changes in menstrual cycles: Irregular periods or loss of menstrual periods in women, which can occur with restrictive eating.
Hair and skin changes: Dry skin, brittle hair, or hair loss may develop with prolonged nutritional deficiencies.
In our work with Baltimore-area clients, we've noticed that people often don't recognize these patterns in themselves until someone else points them out. Many come to therapy for anxiety or depression, and through our conversations, we uncover concerning eating behaviors that have developed gradually. What started as a desire to "eat healthier" has evolved into rigid rules that control their lives. Early recognition is crucial because these patterns are much easier to address before they become deeply entrenched.
Social and Emotional Warning Signs
Social withdrawal: Avoiding social situations that involve food, making excuses to skip meals with friends or family, or feeling anxious about eating in public.
Mood changes: Increased irritability, anxiety, or depression, particularly around mealtimes or when food choices are limited. These mental health symptoms often accompany disordered eating.
Defensiveness about eating: Getting upset when others express concern about your eating habits, becoming secretive about food, or insisting there's "no problem" despite observable changes.
All-or-nothing thinking: Viewing eating as either "perfect" or "ruined" with no middle ground. Having one "bad" food leads to giving up entirely and binge eating, followed by restriction or other compensatory behaviors.
Risk Factors: Who Is Most Vulnerable?
While anyone can develop disordered eating or eating disorders, certain factors increase the risk:
Biological factors: Family history of eating disorders or other mental health conditions, particularly if a parent or sibling has struggled with disordered eating.
Psychological factors: Perfectionism, difficulty managing emotions, low self-esteem, history of trauma or childhood adversity, or co-occurring mental health conditions like depression, anxiety, or obsessive-compulsive disorder.
Social and environmental factors: Cultural pressures regarding body image, participation in sports or activities that emphasize appearance or weight (such as dance, gymnastics, wrestling, or modeling), social media exposure to idealized bodies, experiencing weight-based teasing or bullying.
Life transitions: Starting college, going through puberty, experiencing relationship changes, or other significant life stressors can trigger or worsen disordered eating patterns.
Eating disorders affect people of all ages, genders, ethnicities, and backgrounds. They often start in the teen and young adult years, but they can develop at any age.
When Should You Seek Help?
It can be hard to know when eating behaviors have crossed the line from "normal" concern about health to something that requires professional help. Here are clear signs it's time to seek treatment from a mental health professional or healthcare provider:
Seek help if you or a loved one:
Think about food, weight, or body shape most of the day
Feel distressed, anxious, or guilty around eating
Avoid social situations because of food or body image concerns
Experience physical symptoms like fatigue, dizziness, or digestive problems
Notice that eating behaviors are interfering with work, school, or relationships
Engage in any compensatory behaviors (purging, excessive exercise, laxative use)
Have lost a significant amount of weight or have frequent weight fluctuations
Feel your eating patterns are out of your control
Don't wait until behaviors meet full criteria for an eating disorder. Early intervention is key. The sooner someone is treated, the more likely recovery is.
From a clinical perspective, one of the most harmful myths we encounter is the idea that you need to be "sick enough" to deserve help. We regularly work with clients who delayed treatment because they didn't think their eating behaviors were severe enough. The truth is, if your relationship with food is causing you distress or interfering with your life, that's enough reason to seek support. You don't need to wait until you're in medical crisis.
What Eating Disorders Look Like When Fully Developed
Understanding the most common eating disorders can help you recognize when disordered eating has progressed to something more serious:
Anorexia Nervosa
Anorexia nervosa is characterized by:
Restriction of food intake leading to significantly low body weight
Intense fear of gaining weight or becoming "fat," even when underweight
Distorted body image or failure to recognize the seriousness of low body weight
This can involve self-starvation, excessive exercise, or in some cases, episodes of binge eating followed by purging. Anorexia nervosa is one of the most life-threatening mental health conditions.
Bulimia Nervosa
Recurrent episodes of binge eating (eating a larger amount of food than most people would in a similar time period with a sense of loss of control)
Repeated compensatory behaviors to prevent weight gain (self-induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise)
Self-worth overly influenced by body shape and weight
Binge Eating Disorder
Binge eating disorder involves:
Recurrent episodes of binge eating with a sense of loss of control
Marked distress about binge eating episodes
Associated features like eating faster than normal, eating until uncomfortably full, eating alone due to embarrassment, or feeling disgusted afterward
Unlike bulimia nervosa, no regular compensatory behaviors
Binge eating disorder is actually the most common eating disorder in the United States, affecting more people than anorexia nervosa and bulimia nervosa combined.
Avoidant/Restrictive Food Intake Disorder (ARFID)
Avoidant restrictive food intake disorder (ARFID) involves avoidance of food due to lack of interest, sensory characteristics, or concern about consequences of eating, leading to nutritional deficiency or weight loss, but without body image disturbance. This restrictive food intake disorder is more common in children but can affect adults as well. This condition is also called food intake disorder ARFID.
We often have clients ask whether their behaviors "count" as disordered eating or if they've crossed into a full eating disorder. From our perspective, this distinction matters less than addressing the distress and interference these behaviors are causing. Whether you meet diagnostic criteria or not, if food and body image concerns are taking up significant mental space and affecting your quality of life, that's what matters. Treatment can help at any point on the spectrum—you don't need a formal diagnosis to benefit from support.
Health Consequences of Untreated Eating Issues
Both disordered eating and full eating disorders can lead to serious complications. Eating disorders affect nearly every organ system, causing damage to both physical and mental health:
Physical health complications:
Nutritional deficiencies leading to anemia, weakened bones, and impaired immune function
Electrolyte imbalances that can affect heart rhythm and muscle function
Cardiovascular problems including low heart rate, low blood pressure, and irregular heartbeat
Gastrointestinal problems like constipation, bloating, and delayed stomach emptying
Hormonal disruptions affecting menstruation, fertility, bone health, and growth
Dental problems from frequent vomiting (in bulimia nervosa)
Mental health complications: Eating disorders commonly co-occur with other mental health conditions including depression, anxiety, obsessive-compulsive disorder, and substance use disorders. Suicide risk is significantly elevated among individuals with eating disorders.
Social consequences:
Isolation from friends and family
Difficulty maintaining relationships
Impaired work or academic performance
Reduced quality of life and well-being
These are serious illnesses that can be life-threatening if not treated effectively. Eating disorders have among the highest mortality rates of any mental disorders.
How to Start a Conversation with Someone You're Worried About
If you're concerned about a loved one's eating behaviors, approach the conversation with care:
Choose the right time and place: Have the conversation privately when you won't be rushed or interrupted. Avoid discussing it during meals.
Express specific concerns: Instead of saying "you have an eating disorder," describe specific eating disorder behaviors you've observed: "I've noticed you've been skipping lunch every day" or "I'm worried because you seem anxious around food lately."
Use "I" statements: "I'm concerned about you" or "I care about you and want to help" rather than accusatory statements.
Listen without judgment: They may deny there's a problem or become defensive. Listen to their perspective and avoid arguing.
Offer support: Let them know you're there for them and willing to help them find professional support if they're ready.
Be prepared for resistance: They may not be ready to acknowledge the problem or seek help immediately. That's okay—planting the seed of concern can still be valuable.
Treatment Options and Where to Find Help
The good news is that eating disorders are treatable, and with proper treatment, individuals can return to healthier eating habits and improve their relationship with food and their bodies.
Treatment typically involves:
Psychotherapy: Cognitive behavioral therapy (CBT) has strong evidence for treating bulimia nervosa and binge eating disorder. For young people with anorexia nervosa, family-based treatment is often the first-line approach.
Proper medical care: Regular monitoring with a healthcare provider to address physical health complications and ensure appropriate medical care throughout recovery.
Nutritional counseling: Working with a dietitian who specializes in eating disorders to develop healthy eating habits and normalize eating patterns.
Medication: In some cases, medications may be helpful as part of a treatment plan, particularly for co-occurring other mental health conditions like depression or anxiety.
Where to start:
Talk to your primary care provider and ask for a referral to an eating disorder specialist
Contact a mental health professional with experience in eating disorders
Reach out to eating disorder organizations for resources and treatment referrals
If you're in the Baltimore area and concerned about your relationship with food or body image, the therapists at the Baltimore Therapy Group can help. We provide comprehensive assessment and treatment for disordered eating and eating disorders. Schedule an appointment to discuss your concerns.
Moving Forward with Hope
Recognizing early warning signs of disordered eating is not about being perfect with food or never having concerns about your body. It's about noticing when those concerns start controlling your life, causing significant distress, or putting your physical and mental health at risk.
If you see yourself or someone you love in these descriptions, please know:
You're not alone—eating disorders affect millions of people
You don't have to wait until you're "sick enough" to get help
Early intervention significantly improves outcomes
Recovery is possible with the right support
The relationship between food, our bodies, and our emotional health is complex. If eating behaviors are causing you distress or interfering with your life, reaching out for professional support is a sign of strength, not weakness.
Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding a mental health condition. If you are in crisis or experiencing thoughts of self-harm, please call 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room.