Eating Disorder Symptoms

By Dr Ananya Mandal, MD

Symptoms and complications related to the various eating disorders vary according to the severity of the eating disorders.

Specific symptoms of bulimia without anorexia

This is a more secretive disorder. These patients may be underweight but they are not always anorexic. Symptoms may be very subtle and often go unnoticed.

Behavioral symptoms

  • Sudden episodes of eating large amounts of food or buying large quantities that seem to disappear
  • Evidence of use of laxatives, diet pills, emetics (drugs that induce vomiting), or diuretics (medications that reduce fluids)
  • Using the bathroom right after meals on a regular basis. Long periods of time in the bathroom
  • Eats in private
  • Eats a restrictive diet
  • Binge episodes are usually on high-fat, high-carbohydrate and high-sugar “junk” foods
  • Behavioral problems like shoplifting, binge spending, alcohol or drug use and/or sexual promiscuity
  • Decline in work and school attendance
  • Short lasting relationships
  • Perfectionist behaviors
  • Excessive exercising

Cognitive and mental symptoms

  • Preoccupation with food
  • Difficulty in concentrating, decision making, rigid thinking
  • Fear about intimacy in personal relationships
  • Anxiety, depression, anger, irritable, defiant or stubborn with or without mood swings
  • Feelings of worthlessness, inadequacy, loneliness and low self esteem
  • Fear of weight gain

Physical symptoms

  • Broad fluctuations of weight
  • Evidence of red eyes due to broken eye blood vessels during the strain of vomiting
  • Erosion of the tooth enamel, cavities in the teeth and gum diseases from excessive acid due to forced vomiting
  • Cuts and calluses across the tops of fingers due to self-induced vomiting. This is known as the Russel’s sign.
  • Dehydration, fainting spells, dizziness, hand tremors or blurred vision
  • Dry mouth
  • Pouch-like appearance to the corners of the mouth due to swollen salivary glands
  • Rashes and pimples
  • Loss of, or irregular, menstrual periods

Symptoms specific of anorexia

The major symptom of anorexia is severe weight loss.

Behavioral symptoms

  • Severe dieting by restrictive dieting or binge-eating and purging
  • Usually maintain calorie diaries and records of all that they eat. Weigh and measures food
  • Excessive exercising along with severely restrictive dieting
  • Refusal to eat in front of others
  • Ritualistic eating, including cutting food into small pieces or avoiding certain foods
  • Reactivity and hypersensitivity to cold
  • Excessive heavy clothing to prevent from being cold and from the thinness being apparent
  • Shop for groceries and prepare food for others, but avoids eating
  • There may be hoarding of food
  • Social withdrawal
  • Unrealistic perfectionist behaviors

Physical symptoms

  • Weight loss
  • Long periods without menstrual periods among women. Delay in onset of menses in young girls
  • Hair loss from scalp
  • Yellowish skin. This is especially evident on palms of the hands and soles of the feet due to eating too many vitamin A-rich vegetables such as carrots
  • Dry skin covered with fine hair
  • Swollen feet and hands
  • Bloating after eating and digestive problems

Mental symptoms

  • Confused or slowed thinking and poor memory or judgment
  • Conversations and projects revolving around food and weight loss
  • Indecisive or, conversely, rigid “black-and-white” thinking
  • Beliefs regarding thinness equating to happiness
  • Severe self control
  • Anxious, depressed, angry, stubborn or display mood swings.
  • Feelings of inadequacy, worthlessness, anxiety and loneliness and low self-esteem
  • Incapability to adjust to changes of routines
  • Severe fear of weight gain
  • Refusal to believe anything is wrong and denial for need for help. May become sulky, angry or defensive when concern is expressed

Reviewed by , BA Hons (Cantab)

Last Updated: Dec 3, 2012

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