It is estimated that 30 million people may suffer from an eating disorder at some point, and if these estimates are correct then that number is higher than depression. But what are the signs that someone you know may be struggling with an eating disorder? Baylor College of Medicine’s Dr. Asim Shah explains what to watch out for when it comes to anorexia, bulimia and binge eating.

“Eating disorders are serious conditions that are related to persistent eating behaviors, but they negatively impact your health, emotions and ability to function in important areas of life,” said Shah, professor and executive vice chair in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor. “More people die of an eating disorder than of any other psychiatric disorder.”  

The estimates of how many people have eating disorders may actually be low because many people who have an eating disorder don’t talk about it, he added.

Anorexia

Anorexia may be slightly easier to identify because families will usually observe weight loss in their loved one; however, the person with the disorder will feel like they are not losing weight. Their weight might be 80 pounds but still when they look in the mirror, they will feel that they are overweight and that they need to lose more weight.

Sometimes people with the disorder know that others will comment that they are losing weight so when they go out, they will try to hide it by wearing baggier clothes or they will put on layers of clothes. In addition, they may eat only a small meal, say they are never hungry or try to refrain from eating certain foods that are very starchy or contain high amounts of carbohydrates. Someone with anorexia also may want to isolate themselves in their room because they want to avoid social situations or they may exercise more than the normal amount to burn off calories. For females, they also can develop amenorrhea, which is a lack of menstruation periods. Other signs include feeling dizzy, not being able to concentrate, pale skin, poor sleep, dry skin, thinning hair, weak muscles and a weaker immune system.

Bulimia

For those who have bulimia, they are constantly dieting and hiding food. They may eat in secrecy and eat to the point of discomfort. After a period of eating, they self-induce vomiting, usually by putting their hands down their throat, so you may actually see marks on the back of their hands. Using laxatives excessively and using the bathroom immediately after eating also can be signs that someone is bulimic.

Binge eating

Binge eating is when people eat a large amount of food in a short period of time. When they are binging, they feel a complete lack of control so they eat until they are uncomfortably full. For families, binge eating is difficult to diagnose because it only happens in short bursts and it may only happen a few times. If the binge eating is mild, the episode may only happen once a week, and the family may not even know because they may not even be there when it happens. Binge eating may continue for a long time before the family takes notice.

Eating disorders are long-term illnesses, and treating them in a short time period will not be possible, Shah said. He explained that if you think someone you know has an eating disorder, you should encourage them to seek help, and he cautioned against being judgmental or making the person feel guilty.

“One of the most important ways you can help is to offer your support and to act as a listening ear if they want to talk about what they are going through,” Shah said. “Treating an eating disorder is not easy, and it is especially important to have the support of friends and family.”