You’re most likely familiar with the common signs of an eating disorder — things like rapid weight loss and secretive eating habits. However, there are many symptoms of restrictive eating that are often overlooked or even dismissed by family and friends. 

In a YouTube video for The Kahm Clinic, nutritionist Elaina Efird, RDN, CD, CEDRD, CSSD shares 10 discreet signs of restrictive eating disorders.

1. A preoccupation with food portions, weight, and calories.

You may notice a loved one suddenly interested in food labels, questioning how many grams of fat are in something or how many servings are in a box. This behavior often stems from someone thinking they’re eating too much fat or too many carbohydrates in a meal or snack.

2. A refusal to eat certain foods that progresses into entire food groups.

This behavior often disguises itself as “eating healthy” or “cutting back” on an unhealthy habit. It tends to snowball into entire food groups though. It’s also usually driven by a fear of calories in higher calorie foods like sugar or carbohydrates.

3. Bloating, constipation, or abdominal pain. 

This symptom is often associated with overeating or food intolerance, but it can actually be caused by under-eating. 

4. Denying feeling hunger.

Do you notice a loved one often denies being hungry at the start of a meal? They may only eat a couple of bites or nothing at all. This behavior can be concerning if it happens frequently, as it’s a form of avoidance.

5. Developing food rituals.

“This sign can manifest in a lot of different ways,” explains Elaina. “Someone may eat foods in a certain order, cut things into very small pieces, take tiny bites, or push food around on their plate.” They may also question what’s in a meal and how you prepared it; these answers help them determine what to eat or how much to eat. Excessive chewing is another food ritual associated with eating disorders. 

6. Cooking meals for others but not eating it themselves.

On the same note, they may eat the food but only if they’ve prepared it themselves. There’s a need to be in full control of the kitchen (i.e. deciding how much oil or butter to use). 

7. Unusual food combinations.

Someone may start using low-calorie condiments that don’t make sense for a meal, like adding mustard or vinegar. Or maybe they stop using dressing for their salads. 

8. Maintaining rigidity.

They may have a particular routine they follow for meals, like breakfast, lunch, and dinner at a set time each day with one snack in between. Here, the strictness around meals often creeps into their exercise habits as well. 

9. Loss of a period.

While this sign doesn’t often go overlooked, it is frequently dismissed, especially in adolescents who started their period within the last year or so. It is normal for it to be irregular at first, but it can also disappear as a result of decreased caloric intake.

10. Thin skin on hands or face.

For instance, underneath their eyes or at their temples may look concave due to loss of fat. It may even make their hands and face look older than they actually are.

Remember: Not every symptom or behavior means someone has a restrictive eating disorder. 

However, taking note of these discreet signs may be the difference between your loved one adopting even more restrictive habits instead of getting the help they need. “If you’re noticing any of these symptoms in yourself, your friends, or your family, pay attention,” explains Elaina. “I think these signs often get masked by what our society deems is normal when it comes to food. Oftentimes, though, it’s actually an eating disorder.”

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