Many people worry about their weight, what they eat, and how they look. This is especially true for teenagers and young adults, who face extra pressure to fit in and look attractive at a time when their bodies are changing.

In the early stages, it can be challenging to tell the difference between an eating disorder and normal self-consciousness, weight concerns, or dieting. As eating disorders progress, the red flags become easier to spot. But a person with an eating disorder will often go to great lengths to hide the problem, so it’s important to know the warning signs.

Restricting food or dieting

The most obvious warning signs of eating disorders involve restrictive eating behaviors. A friend or family member with an eating disorder may frequently skip meals or make excuses to avoid eating—he or she had a big meal earlier, isn’t hungry, or has an upset stomach. The person may also claim to be disgusted by foods that used to be favorites.

When your loved one does eat, he or she may take tiny servings, eat only specific low-calorie foods, or obsessively count calories, read food labels, and weigh portions. In an effort to curb appetite, your friend or family member may also take diet pills, prescription stimulants like Adderall or Ritalin, or even illegal drugs such as speed.

Bingeing

Some people with eating disorders eat normally around others, only to binge in secret—usually late at night or in a private spot where they won’t be discovered or disturbed. Warning signs of bingeing include piles of empty food packages and wrappers, cupboards and refrigerators that have been cleaned out, and hidden stashes of high-calorie foods such as desserts and junk food.

Purging

People with eating disorders often go to extreme measures to work off calories from a binge or even a normal snack or meal. They may purge by throwing up, fasting, exercising vigorously, or using diuretics and laxatives.

Common warning signs of purging include disappearing right after a meal or making frequent trips to the bathroom. If your friend or family member is vomiting, he or she may run the water to muffle the sound and use mouthwash, breath mints, or perfume to disguise the smell.

Distorted body image and altered appearance

A loved one’s appearance can also offer clues to an underlying problem. Significant weight loss, rapid weight gain, and constantly fluctuating weight are all possible warning signs. A person with an eating disorder may also wear baggy clothes or multiple layers in an attempt to hide dramatic weight loss.

Other warning signs include a distorted self-image or an obsessive preoccupation with weight. A relative complains about being fat despite a dramatically shrinking frame, for example, or a friend spends hours in front of the mirror, inspecting and criticizing her body.

Common eating disorder warning signs
•  Preoccupation with body or weight
• Obsession with calories, food, or nutrition
• Constant dieting, even when thin
• Rapid, unexplained weight loss or weight gain
• Taking laxatives or diet pills
• Compulsive exercising
• Making excuses to get out of eating
• Avoiding social situations that involve food
• Going to the bathroom right after meals
• Eating alone, at night, or in secret
• Hoarding high-calorie food