10 Secret Ways Anorexia Manifests
People with anorexia have an obsessive desire to be thin that can lead to losing dangerous amounts of weight. Anorexia is an eating disorder that often begins around puberty, but it can begin at any age. People with this condition may have childhood trauma, emotional challenges or self-esteem issues that can make them vulnerable to developing anorexia, but it can also be related to hormones and genetics.
Secrecy is a hallmark of anorexia. So how do you know if someone is struggling with this potentially life-threatening disorder? We asked experts to share the top 10 signs of anorexia:
1. Sudden Weight Loss or Interest in Dieting
While weight loss that seems sudden and unexplained is one of the classic signs of anorexia, it’s not always conscious or intentional. “A lot of eating disorders are accidental, in the sense that someone will lose weight, get recognition for it, then continue those behaviors to an obsessive level,” says Shannon, a woman in eating disorder recovery whose mission is to helps others. “If someone has made a drastic change in their life and seems to be heavily focused on their weight loss that can be a red flag.”
2. Always Having an Excuse to Not Eat
“Excuses may include saying they already ate, they aren’t hungry or they don’t like the food,” says Catherine Silver, LCSW, a psychotherapist who specializes in eating disorders and body image issues. They may disappear from the dinner table or simply refuse to join the family for meals. If they stay at the table, they barely eat and play with their food.
3. Overeating “Safe” Food
Anorexia is characterized by restriction of food intake but that doesn’t mean only skipping meals. “They might be restricting certain types of foods such as sugar, fats and carbs,” says Silver, “but will eat other types ― and sometimes even large amounts ― of ‘safe’ foods.” They may also drink excessive amounts of water or fluids to curb hunger. “This can be particularly confusing for people who suspect their loved one has an eating disorder,” says Silver. “They know something isn’t right but they still see the person eating.”
4. Hiding or Disguising Food
People with anorexia may hide food to make it appear like it has been eaten. This may mean stashing a roll in their pocket or removing food from the plate when no one is looking. If there’s a family dog, they will feed it to the animal under the table. If hiding food is hard to pull off they may “spread food out on a plate to make it appear like more was consumed,” says Silver. Another sign of anorexia is overuse or inappropriate use of condiments, such as pouring on extra gravy or ketchup to make the plate seem fuller.
5. Strict Food Rules
Disordered eating also often involves a long list of foods to be avoided for various reasons. “This may be based on the calorie count, carb content or exercise needed to burn all the fat in the food,” says Julie Stefanski, MEd, RDN, CSSD, LDN, CDE, a nutritionist who works with patients with eating disorders. The rules of what they can and can’t eat are often accompanied by rigidity about when, where and how they can eat, such as never eating in front of others, never letting food touch their mouth after a certain time of day, or eating food in a particular order, adds Silver.
6. Overinformed About Nutrition Facts
Extensive knowledge of nutrition facts is not always a good thing. “It may be a sign that too much focus is being placed on restrictive eating,” says Stefanski. This type of hyper-focus can be easy to hide in today’s diet-obsessed culture, she says, but it is a red flag if someone who is losing weight and has other signs of anorexia suddenly becomes a nutrition expert.
7. Anxiety About Food
People with eating disorders often suffer from low self-esteem, poor body image, depressed mood, irritability and general anxiety to begin with, so feeling panicked about food or getting agitated around meal times can be very disturbing to them ― and it may be disconcerting to loved ones. “Someone who is struggling with anorexia will experience anxiety about ― or in the presence of ― food, which is related to their fear of eating certain foods or gaining weight,” says Sarah Farris, LCPC, a specialist in fitness nutrition. Food can be perceived as dangerous.
8. Wearing Jackets or Layers Indoors
Although some people with anorexia wear a big jacket or extra layers to hide their bodies, they are also prone to becoming very cold. “I used to wear a winter jacket 24/7,” says Shannon. “My school was required to turn up the heat in my classrooms to accommodate my extremely low body fat.”
9. Sudden Introversion or Withdrawing
People with anorexia often want to hide. Low self-esteem may even lead them to feel they deserve to disappear and not exist in the world. “This is visually seen through thinness, but can also be seen prior to emaciation through sudden shyness,” says Shannon. “When one of my cousins also developed an eating disorder, she started by hiding behind people, being really quiet in speech and almost folding in on herself in an attempt to hide.” This is often followed by withdrawal from friends and social circles. “Eating disorders are isolating diseases that cause those suffering to pull away from the people closest to them,” she explains.
10. Physical and Health Changes
In addition to obvious things such as weight loss and feeling chilly all the time, Silver points out that signs of anorexia can include the following health issues: dizziness; fatigue or tiring easily (while doing activities that weren’t previously tiring like walking short distances); dry skin; osteoporosis or osteopenia; hair loss; brittle nails; and irregular period or loss of one’s period. In severe cases, lanugo (when fine hairs or peach fuzz grows on other parts of the body such as the face, stomach or chest) develops.
The good news is that people can recover from anorexia with proper medical, psychological and nutritional support and residential eating disorder rehab if needed. It’s a process, but the healing may begin when someone notices the signs of anorexia and takes action to help the person they love.
Choose a better life. Choose recovery.