Eating disorder diagnoses
Not everyone struggling with an eating disorder has symptoms which fit neatly into one category. Sometimes it’s a combination of the disorders, symptoms present to a greater or lesser degree, or a completely unique struggle with feeding, food, exercising, or body image that impairs the health and well-being of an individual. All of these diagnoses pose serious emotional, psychological, and physical health risks.
Anorexia nervosa is characterized by self-starvation and excessive weight loss.
Bulimia nervosa is characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.
Binge eating disorder is characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures to counter the binge eating.
Other Specified Feeding or Eating Disorder (OSFED). Not everyone struggling with an eating disorder has symptoms which fit neatly into one category. Sometimes it’s a combination of the disorders, symptoms present to a greater or lesser degree, or a completely unique struggle with feeding, food, exercising, or body image that impairs the health and well-being of an individual.
Eating disorder signs and symptoms
- Dramatic weight gain or loss
- Frequently talking about food, weight, and shape
- Rapid or persistent decline or increase in food intake
- Excessive or compulsive exercise patterns
- Purging, restricting, binge eating, or compulsive eating
- Abuse of diet pills, laxatives, or diuretics
- Denial of food and eating problems, despite the concerns of others
- Eating in secret, hiding food, disrupting meals, feeling out of control with food
- Medical complications, such as menstrual irregularity, dizziness, fainting, bruising, dry skin, leg cramps, hair loss, brittle hair, osteoporosis, diarrhea, constipation, dental problems, obesity, diabetes, chest pain, heart disease, heartburn, shortness of breath, organ failure, and other serious symptoms
Tips for intervention
If you are worried about your friend’s eating behaviors or attitudes, it is important to express your concerns in a loving and supportive way. It is also helpful to discuss your worries early on, rather than waiting until your friend has endured many of the damaging physical and emotional effects of eating disorders. In a private and relaxed setting, talk to your friend in a calm and caring way about the specific things you have seen or felt that have caused you to worry.
What to Say—Step by Step
Set a time to talk. Set aside a time for a private, respectful meeting with your friend to discuss your concerns openly and honestly in a caring, supportive way. Make sure you will be some place away from distractions.
Communicate your concerns. Share your memories of specific times when you felt concerned about your friend’s eating or exercise behaviors. Explain that you think these things may indicate that there could be a problem that needs professional attention.
Ask your friend to explore these concerns with a counselor, doctor, nutritionist, or other health professional who is knowledgeable about eating disorders. If you feel comfortable doing so, offer to help your friend make an appointment or accompany your friend on their first visit.
Avoid conflicts or a battle of wills with your friend. If your friend refuses to acknowledge that there is a problem, or any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener.
Avoid placing shame, blame, or guilt on your friend regarding their actions or attitudes. Do not use accusatory “you” statements such as, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements. For example: “I’m concerned about you because you have not been eating eat breakfast or lunch.” Or, “I feel afraid to when I hear you vomiting.”
Avoid giving simple solutions. For example, “If you’d just eat, then everything would be fine!”
Express your continued support. Remind your friend that you care and want your friend to be healthy.
After talking with your friend, if you are still concerned with their health and safety, find a trusted adult or medical professional to talk to. This is probably a challenging time for both of you. It could be helpful for you, as well as your friend, to discuss your concerns and seek assistance and support from a professional.