Eating disorders are not occasional concerns about weight or health—they are serious medical conditions that affect a person’s relationship with food. Warning signs can include dry skin, negative body image, and excessive exercise. These conditions can be life-threatening and impact both mental and physical health. With proper treatment, recovery is possible, making early recognition of symptoms essential.

What Is an Eating Disorder?

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), eating disorders are categorized under Feeding and Eating Disorders. They are marked by persistent disruptions in eating behaviors that negatively impact well-being. Individuals may become fixated on losing weight, controlling food intake, or obsessing over body shape and size.

Anyone can be affected, regardless of age, gender, race, or body type. While most commonly beginning in adolescence, eating disorders can also appear in childhood or adulthood.

Eating Disorder vs. Disordered Eating

Disordered eating refers to irregular eating patterns—such as eating from boredom or cutting out food groups unnecessarily. Although disordered eating can evolve into a full-blown eating disorder, not everyone who experiences it will develop a diagnosable condition.

Common Eating Disorders

Anorexia Nervosa

Characterized by restricted food intake, an intense fear of weight gain, and a distorted body image. People may not acknowledge the seriousness of their low weight.

Avoidant or Restrictive Food Intake Disorder (ARFID)

More than just picky eating, ARFID involves severe food avoidance leading to nutritional deficiencies.

Binge Eating Disorder (BED)

Involves consuming large amounts of food in a short time without engaging in purging behaviors. The person feels a lack of control but does not attempt to compensate through vomiting or excessive exercise.

Bulimia Nervosa

Similar to BED, but includes periods of restrictive eating followed by purging behaviors such as vomiting or misuse of laxatives.

Pica

Involves cravings for and eating non-food substances like chalk or soap.

Rumination Disorder

Consists of regurgitating food after swallowing, followed by re-chewing, re-swallowing, or spitting it out.

Other Eating Disorders

Other conditions fall under the OSFED category (Other Specified Feeding and Eating Disorders), including:

  • Atypical Anorexia Nervosa: Symptoms of anorexia with a body weight in a typical range.

  • Night Eating Syndrome: Excessive eating after evening meals or waking up at night to eat.

  • Purging Disorder: Purging without binge eating.

  • Subthreshold Disorders: Individuals who show symptoms of bulimia or BED but do not meet full diagnostic criteria.

Compulsive Exercise is another related behavior, marked by emotional dependence on exercise, though it is not formally recognized in the DSM.

Signs and Symptoms of Eating Disorders

Physical Signs

Symptoms vary by disorder, but can include:

  • Dry, blotchy skin due to dehydration

  • Calluses on knuckles (Russell’s sign)

  • Feeling cold often due to low body fat

  • Fine, downy hair growth on the body (lanugo)

Emotional Signs

  • Discomfort or anxiety when eating around others

  • Persistent negative thoughts about body image or size

Behavioral Signs

  • Preparing meals for others without eating themselves

  • Watching videos of others eating large amounts of food

  • Engaging in food rituals, such as cutting food into small pieces

  • Excessive exercise, even when injured or ill

  • Obsessively focusing on “healthy” or “safe” foods (linked to orthorexia)

  • Creating strange food combinations or recipes as a result of cravings

How to Support Someone With an Eating Disorder

Reach Out to Your Loved One

Start by educating yourself about eating disorders. Approach your loved one privately and share specific behaviors you’ve noticed. Helpful tips include:

  • Avoid oversimplified advice like “just eat”

  • Reassure them that seeking help is not shameful

  • Use “I” statements to reduce defensiveness

  • Prepare for negative or dismissive responses

Help them connect their condition to broader impacts like depression or isolation, and gently remind them of life goals that recovery can help them achieve.

Encourage Them to Get Help

Support your loved one by encouraging them to seek therapy and medical care. Offer help in locating providers and setting up appointments. If they resist or if there’s an emergency, it may be necessary to involve a third party. Keep checking in without making your relationship solely about the disorder.

Resources for People With Eating Disorders

Contact the National Eating Disorders Association (NEDA) Helpline at 1-800-931-2237. NEDA offers online chat support, treatment directories, and crisis help via texting “NEDA” to 741741. The Suicide & Crisis Lifeline is also available by dialing 988.

A Quick Review

Eating disorders can severely affect mental and physical health. Recognizing early signs allows for timely intervention. Friends and family support plays a key role in recovery. If you or someone you know may be struggling, reach out to NEDA or a qualified healthcare provider for guidance and support.