Five Red Flags

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Having worked with hundreds of eating disorder (ED) patients and their families, the question I am most often asked by the patients’ parents is “How did I miss the signs?” EDs by nature are a very secretive disease, and those who suffer with them are pros at hiding them.  Despite this, there are some red flags that might signal that your daughter/son/sister/brother/friend could be struggling with an ED.

1. She is obsessed with watching the Food Network and/or cooking shows, finding recipes online, and with baking and/or cooking for others, but rarely partakes in her own creations.

This is a subtle, but clear sign that something is up.  People with EDs are preoccupied with thoughts about food – where to get it, how to prepare it, and what they can/cannot eat.  Therefore, it is natural that they would turn to TV shows about food, cooking magazines/books, and finding online recipes to fuel this obsession.  Of course there is nothing wrong with doing these things per se, but the key is that a person with an ED rarely, if ever, will eat any of the foods she creates.  Instead, she will bake an elaborate cake and offer it to her family and friends to eat while she has none.  In this way, the individual can vicariously enjoy the food without having to eat any of it.

2. He used to eat dinner with the family every night, but now he always says he ate dinner out or at a friend’s house.

Parents want to be able to trust their son or daughter.  If your child tells you that he already ate, you, like most parents, would believe him. But if your child has always eaten dinner with the family and this new behavior becomes a daily occurrence, then something could be up.

3. She used to love going out to eat and to the movies with her friends.  Now it seems like she finds any excuse to avoid these activities.

As mentioned above, one of the cornerstones of EDs is secrecy.  Most teens with EDs are not open about their disorders with their friends, so it would become pretty clear to her friends that something was wrong if she went out to eat with them and did not order any food.  For most individuals with EDs, simply avoiding these situations is the easiest way to keep their ED under wraps.

4. He used to love a wide variety of food, but lately he seems to only eat a few different foods.

There are plenty of kids who are picky eaters.  The red flag arises in the case of a child that formerly was an omnivore who has now started to cut out certain foods/food groups in an obsessive manner.  Usually this elimination happens in the context of a diet (e.g. “I want to lose some weight to be better at running track,”), so he might begin by limiting carbohydrates and fats, but soon the list of unacceptable foods starts to grow.  This could translate to no longer eating fruit because it has “too many carbs,” eating salad without dressing as it has “too much fat,” etc.  If your child will only eat certain “safe” foods and balks at the idea of increasing food variety, you might have a problem on your hands.

5. She all of a sudden wants to be a vegan, but is unclear about why.

Veganism (the omission of any and all animal products from the diet) is not inherently indicative of an ED.  The question to ask would be why the individual wants to become a vegan.  Is it because, for example, she feels that eating animals and their products is cruel or bad for the environment?  Or could it be another way for her to eliminate foods from a previously varied diet?  By declaring oneself vegan, that means that meat, fish, poultry, eggs, dairy, and a slew of other food groups will be off the table.  In a way, veganism can be used by ED individuals as way to legitimize their restriction.  Of course, this is not always the case, and there are plenty of vegans who are not disordered, but figuring out the motive behind this decision is paramount.

Now, am I saying that if your child exhibits one of these red flags that he/she definitely has an ED?  Of course not.  But I think it is important for parents, siblings, and friends to be aware of these subtle signs and to take action if necessary by talking to a professional such as a doctor, therapist, or dietitian who specializes in EDs.  Forewarned is forearmed.

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