Advice on eating disorder(s) - the signs to look out for and things to do and say (or not).

In a number of recent discussions with teachers and parents, I have been asked for advice on possible signs of eating disorder(s) - an area in which I specialist.

I have therefore captured some of those signs to look out for here, especially in school/at home. But, to be clear, these are possible signs of eating disorder(s) but can also be signs of “normal” teenage behaviour. 

They should be approached sensitivity and only used as a possible warning sign(s) to investigate (gently) further - not evidence to push a panic button.

I have also shared some tips on things to do/not do at school/at home to help in a part two of this post below.

Part one

Possible sign(s) of an eating disorder(s) to prompt further (gentle) investigation

Obvious changes in weight and/or appearance.

New or increased use of make-up to add colour to face, especially blusher, (which can be used to hide perceived problems with size of face, bone structure etc).

Wearing coats/hoodies/sweaters etc when the weather doesn’t warrant it (can be done to hide body).

Wearing loose clothes/extra layers when it doesn’t feel appropriate/seems unusual or new (can be done to hide body).

Being cold when the temperature is “normal” and wearing scarfs, gloves, hats, coats etc when it’s not cold (can be a sign of weight loss and being more exposed to the cold). 

Reluctance to do PE/sports, especially if previously had been happy to do it (can be result of increased self-consciousness about body). 

Increased interest and participation in exercise or sports, including walking, running, going to the gym etc (can be evidence of using exercise to “offset” a perception of eating too much/the need to lose weight). 

Increased (or new) use or a wearable and a focus on the metrics, including step counts, heart rate etc (can be evidence of increased and unhealthy fixation with “health” and own body). 

Change in eating patterns at school/home, for example skipping break time snack/lunch/dinner (or eating in own room) or being “busy” doing other stuff at that time (possibly to avoid eating/restricting food intake). 

Eating in room, or “later” when no-one else around (can be evidence of hiding food intake/lack of food intake). 

Leaving the table/going to bathroom/to room etc within 15 minutes of finishing eating (can be evidence of purging/making self sick). 

Noticeable checking of body shape and size, using fingers and/or hands to measure size of wrists, arms etc (can be evidence of increased awareness and discomfort of size of body).

Increased focus (and possible comments) on own appearance, perhaps demonstrated by looking at self in phone, spending extra time in mirror/toilets/bathroom etc (can be result of increased self-consciousness about body).

Increased distress, anxiety, stress etc on school work or other activities: a focus on doing everything right and getting upset if results, work etc not going to plan (increased perfectionism linked to eating disorders can manifest in lots of ways, including extra focus on other areas other be “perfect”, like school work).  

Social media use has shifted to see lots of “healthy” eating and/or gym and/or exercise content (all social media in children should be monitored as eating disorder content is everywhere and deeply dangerous and damaging). 

Part two

Suggested actions to support a young person/help avoid a possible eating disorder(s)

Avoid commenting on their weight or size (especially in a positive way, including saying something about how small, petite, tiny, slim etc they are -  e.g.. “I wish I was more like you”).

Avoid commenting on your own weight or size - positively or negatively.

Remove full length mirrors from their bedroom - if there is one in the house, put it in a communal area where its use can be seen.

Remove scales from the house. 

Avoid any talk of diets or the refusal of any food because “I am being good” or “I need to be good”.

Don’t talk about foods as “good” or “bad”.

Exercise should be discussed as a good thing for health and wellbeing not linked to weight loss/looking good.

Avoid comments on eating, for example “you enjoyed that” or “I am surprised you finished that” etc - these can so easily be heard as “you are greedy, fat etc”

Be respectful of privacy and boundaries but be aware that many young people with eating disorder(s) are secretly exercising in their bedroom - doing star jumps, sit-ups etc. 

Avoid lots of questions and challenges about eating and food - instead try to be open to discussions about how the person is feeling about themselves and the world.

Be aware of the person leaving the table/going to bathroom/to room etc within 15 minutes of finishing eating - this can be evidence of purging/making self sick. Something to keep an eye on.  

Be curious about their social media feeds - ask them what they are viewing - look out of for increased focus on “healthy” eating, gym and exercise content and ask them about it: “that looks cool,  who is that/what do you like about it etc?”. 

Be curious all the time but without asking lots and lots of closed questions - be open and appear chilled and non-judgmental.

Eating disorder(s) are always about feelings and not food - spend more time on feelings than food when talking with them.  

If you are worried seek advice of a professional about what to do.