Eating Disorder Symptoms: Recognizing the Signs & Treatment Options

October 7, 2025

Authored by: Eilaf Meenai, MD

Edited by: Emma Loker, BSc, PgDip

Eating disorders are psychological conditions, each with its own mix of physical changes and behavioral patterns. The identification of these symptoms is important for two reasons.

First, some warning signs indicate you may be in immediate danger and need urgent medical attention. Second, recognizing the cluster of symptoms you’re experiencing is what guides professionals toward the right treatment plan.

If you’re currently in the grips of an eating disorder or are worried that you might have some early eating disorder symptoms, professional support is strongly advised. These conditions pose significant risks to both mental and physical well-being, and can worsen without effective treatment.

This page can also help you recognize the symptoms of eating disorders and seek the right form of support by discussing:

How to recognize the symptoms of the different types of eating disorders
How a diagnosis for eating disorders is made based on these symptoms
When to seek urgent help for eating disorder symptoms
Treatment options for eating disorders
Where to find professional support

Recognizing the Symptoms of Eating Disorders

Eating disorders are commonly divided into four main groups:¹

Anorexia nervosa
Bulimia nervosa
Binge-eating disorder
A category for other specified feeding or eating disorders

Each group comes with its own set of defining symptoms; however, there can be quite an overlap. The following sections cover the symptoms of each type of eating disorder in turn.

Anorexia Nervosa Symptoms

Anorexia nervosa has specific diagnostic markers that distinguish it from everyday dieting gone too far. According to the DSM-5, a cluster of three core symptoms defines anorexia.

These core symptoms are:²

Restriction of energy intake leading to significantly low body weight
Intense fear of gaining weight or becoming fat, even when underweight
A disturbance in body image and self-evaluation, or denial of the seriousness of low body weight

Aside from these core symptoms, there are further behavioral and physical symptoms of anorexia nervosa.

Behavioral Symptoms of Anorexia:

When someone is struggling with anorexia, they might:

Strict dieting or skipping meals altogether
Cutting food into very small pieces
Obsessively counting calories
Wearing baggy or layered clothes to hide body shape
Exercising excessively
Frequently checking body parts in the mirror
Refusing to eat certain food groups
Showing anxiety around eating
Withdrawing from social activities

Physical Symptoms of Anorexia:

Physically, the body often starts showing the following symptoms of anorexia:

Slow heart rate
Very low blood pressure
Feeling cold all the time
Fine hair growth on the body (lanugo)
Fainting
Irregular or absent periods (known as “amenorrhea”) in women

Bulimia Nervosa Symptoms

Bulimia nervosa comes with symptoms of binge eating and repeated behaviors to prevent weight gain. Self-worth is also significantly tied to body shape. For a diagnosis, both symptoms must be happening at least once a week for three months.³

Unlike anorexia, people with bulimia appear to maintain a “normal” body weight, which makes it easy for the disorder to fly under the radar.

The following are the signs and symptoms of bulimia nervosa:

Eating large amounts of food in a short time with loss of control (binges)
Repeated vomiting, laxative use, fasting, or over-exercising to avoid weight gain
Swelling of the cheeks or jaw
Erosion of tooth enamel and increased dental cavities from stomach acid
Sore throat
Scars on the back of the hand/knuckles (“Russell’s sign”) from self-induced vomiting⁴
Dehydration
Electrolyte imbalances (which can cause muscle weakness or irregular heartbeat)
Stomach pain, bloating, and constipation
Fluctuations in weight
Fatigue and general weakness

Binge Eating Disorder Symptoms

Binge eating disorder does not include regular purging behaviors or gym marathons to counteract the bingeing episodes, as seen in bulimia.

Instead, the disorder is defined by recurrent, rapid episodes of consuming unusually large amounts of food to the point of discomfort. It is also associated with a distressing sense of loss of control.

Symptoms of binge eating disorder are as follows:⁵

Eating a larger amount of food than most people would eat under similar circumstances. This is typically done in a distinct period, such as within two hours
Consuming food much more rapidly than would be considered typical
Binging until feeling uncomfortably full
Eating alone because of embarrassment about how much they are eating
Feeling disgusted and very guilty after a binge
Marked distress regarding binge eating
Binge eating episodes occurring, on average, at least once a week for three months
Stomach discomfort and bloating after binge episodes

Symptoms to Catch Other Common Disordered Eating Patterns

A large percentage of people struggling with food fall into what’s called “other specified feeding or eating disorders” (OSFED).⁶These include:

Atypical anorexia
Subthreshold bulimia nervosa
Subthreshold binge eating disorder
Subthreshold purging disorder
Night eating syndrome

The symptoms of atypical anorexia are similar to those of anorexia nervosa: severe restriction, intense fear of weight gain, and body image distortion. But people with atypical anorexia often maintain a “normal” weight. However, the physical symptoms that can follow insufficient calorie intake are typically the same.

Purging disorder causes people to regularly induce vomiting or misuse laxatives to influence weight. But these behaviors are not accompanied by the binge eating episodes that define bulimia nervosa.

Similarly, the symptoms of night eating syndrome, where people consume a significant portion of daily calories late at night, include:

Morning anorexia (not being hungry at breakfast)
Eating more than 25% of daily intake after dinner, also known as evening hyperphagia
Poor sleep
Mood disturbances

In general, the thread across all disordered eating patterns is rigidity with eating, followed by distress.

How Is a Diagnosis for Eating Disorders Made Using Your Symptoms?

When healthcare providers suspect that someone has an eating disorder, they pay attention to the person’s symptoms and how these symptoms affect their life.

The first step to diagnosis is having a conversation. For instance, your provider will likely ask you about your eating habits and how often you skip meals, binge, or purge. They may also ask what goes through your head about food and your body.

Your physical signs will also be assessed. These include your heart rate, blood pressure, lab results, and an examination of your teeth or throat if vomiting is one of your symptoms.

Part of the process is also ruling other things out. Weight and appetite changes can happen with many medical problems, such as thyroid issues, diabetes, or depression. Therefore, your provider would want to be sure that your symptoms are not caused by something else.

There are also standardized assessment tools, such as the Eating Disorder Examination (EDE) or Eating Attitudes Test (EAT-26). These can help capture the severity and frequency of symptoms associated with eating disorders.⁷

When to Seek Urgent Help for Eating Disorder Symptoms?

Eating disorders can cause dangerous complications that may become life-threatening. Certain symptoms are red flags for serious medical risk, and they mean you should not wait to book a routine appointment. Rather, they indicate you need urgent medical care.

If any of the following apply to you (or someone you care for), it’s important to call 911 or go straight to the emergency department:

Severe dehydration that causes dizziness, confusion, or inability to keep fluids down
Irregular heartbeat
Very low body temperature
Sudden unexplained seizures
Fingers or toes turning blue from poor circulation
Difficulty breathing
Vomit or stool that contains blood
Suicidal thoughts
Intense depression that makes daily functioning nearly impossible
Panic attacks that do not settle down on their own
Feeling completely out of control with eating behaviors

These symptoms warrant hospitalization to stabilize your body before you can continue with therapy. Inpatient treatment provides 24/7 monitoring, medical support, structured nutrition, and intensive psychological therapy to bring you out of immediate danger.

Treatment for Eating Disorder Symptoms

Psychotherapy remains the gold standard treatment for eating disorders. This is because it addresses the behaviors tied to eating disorders but also teaches someone to tackle the thoughts and triggers that fuel them.

While researchers have explored medications for different eating disorders, very few are FDA-approved. Plus, even approved medications tend to work best when paired with therapy rather than on their own.

The following are some evidence-based treatment options for eating disorders:

Cognitive Behavioral Therapy

Cognitive behavioral therapy, particularly the enhanced version known as CBT-E, is the most widely studied and effective approach for bulimia nervosa and binge eating disorder. It is also often used for anorexia nervosa in adults.⁸

CBT-E works by breaking the cycle of strict food rules, distorted body image, and compensatory behaviors like purging or over-exercise. During CBT sessions, your therapist will monitor your meals and make you practice flexible eating. You’ll also learn to restructure your negative thoughts about food and self-worth.

Additionally, research shows that CBT can reduce binge and purge episodes and improve psychological symptoms more effectively than general supportive therapy.⁹

Family-Based Treatment

Family-based treatment, also called the “Maudsley method,” is considered the gold standard treatment for adolescents with anorexia nervosa.¹⁰

In this psychological intervention, parents take an active role in restoring their child’s weight and normalizing their eating patterns before responsibility is gradually returned to the adolescent.

The treatment is delivered in three phases:

Parents are empowered to take control of meals
Control is gradually handed back to the adolescent
The focus of therapy shifts to healthy adolescent development and family functioning

In young people, family-based treatment often has higher recovery and remission rates than individual therapy.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) can be useful when binge eating or purging is triggered by overwhelming emotions.

It teaches practical skills to regulate emotions and tolerate distress without resorting to food-related behaviors. During therapy, you build healthier coping strategies rather than falling back into unhealthy eating patterns at every inconvenience.

Plus, DBT is often recommended for people who struggle with both disordered eating and self-harm or severe mood swings.

Interpersonal Psychotherapy

Interpersonal psychotherapy (IPT) addresses the role of relationships and social functioning in maintaining disordered eating.

IPT works because eating disorders do not happen in isolation. In many circumstances, they emerge as a response to disputes, transitions, grief, and interpersonal deficits. Therefore, this therapy aims to fix issues that cause unregulated eating in the first place.

According to research, IPT is slower to bring change than CBT when studied for eating disorders, but its long-term outcomes are similar.¹¹

Medical Support

Medicines alone cannot cure an eating disorder. So, they are best thought of as one part of a broader treatment plan alongside psychological therapy. Further, medication is most effective when it targets specific symptoms that occur with eating disorders, rather than the disorder itself.

For example, fluoxetine is an antidepressant used in bulimia nervosa and binge eating disorder to target mood-related symptoms.¹²Similarly, lisdexamfetamine has been shown to reduce binge frequency through regulation of impulsive eating behaviors.¹³

Other medical treatments prescribed for specific symptoms may include:

Fluid correction for electrolyte imbalances from vomiting or laxative misuse
Calcium, vitamin D, or bisphosphonates for osteoporosis due to long-term malnutrition
Iron, B12, or folate supplements if anemia has developed
Hormone replacement therapy when menstrual cycles do not return after weight restoration

Therapy for Eating Disorders at Mission Connection

Recovery from eating disorders needs the right team, the right tools, and the right level of support.

We at Mission Connection understand that one-size-fits-all therapy doesn’t work for those experiencing symptoms of eating disorders. Some days you may need one-on-one time with a therapist. On other days, group sessions or psychiatric support can help carry you forward.

Our programs weave these therapeutic elements together and combine evidence-based options like CBT, DBT, mindfulness, and solution-focused approaches with flexible scheduling that actually works with your life.

Call us today or get in touch online to learn more about how we can help with your or a loved one’s eating disorder symptoms.

References

National Institute of Mental Health. (2024, December). Eating disorders. U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/topics/eating-disorders
Moore, C. A., & Bokor, B. R. (2021). Anorexia nervosa. PubMed. https://pubmed.ncbi.nlm.nih.gov/29083743/
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Daluiski, A., Rahbar, B., & Meals, R. A. (1997). Russell’s sign: Subtle hand changes in patients with bulimia nervosa. Clinical Orthopaedics and Related Research, 343, 107–109. https://pubmed.ncbi.nlm.nih.gov/9345215/
Iqbal, A., & Rehman, A. (2020). Binge eating disorder. PubMed. https://pubmed.ncbi.nlm.nih.gov/31869164/
Riesco, N., Agüera, Z., Granero, R., Jiménez-Murcia, S., Menchón, J. M., & Fernández-Aranda, F. (2018). Other specified feeding or eating disorders (OSFED): Clinical heterogeneity and cognitive-behavioral therapy outcome. European Psychiatry, 54, 109–116. https://doi.org/10.1016/j.eurpsy.2018.08.001
Papini, N. M., Jung, M., Cook, A., et al. (2022). Psychometric properties of the 26-item Eating Attitudes Test (EAT-26): An application of Rasch analysis. Journal of Eating Disorders, 10(1). https://doi.org/10.1186/s40337-022-00580-3
Agras, W. S. (2019). Cognitive behavior therapy for the eating disorders. Psychiatric Clinics of North America, 42(2), 169–179. https://doi.org/10.1016/j.psc.2019.01.001
DeBar, L. L., Wilson, G. T., Yarborough, B. J., et al. (2013). Cognitive behavioral treatment for recurrent binge eating in adolescent girls: A pilot trial. Cognitive and Behavioral Practice, 20(2), 147–161. https://doi.org/10.1016/j.cbpra.2012.04.001
Le Grange, D. (2005). The Maudsley family-based treatment for adolescent anorexia nervosa. World Psychiatry, 4(3), 142. https://pmc.ncbi.nlm.nih.gov/articles/PMC1414759/
Murphy, R., Straebler, S., Basden, S., Cooper, Z., & Fairburn, C. G. (2012). Interpersonal psychotherapy for eating disorders. Clinical Psychology & Psychotherapy, 19(2), 150–158. https://doi.org/10.1002/cpp.1780
McElroy, S., Guerdjikova, A. I., Mori, N., & O’Melia, A. (2012). Pharmacological management of binge eating disorder: Current and emerging treatment options. Therapeutics and Clinical Risk Management, 8, 219. https://doi.org/10.2147/tcrm.s25574
Armanious, A. J., Asare, A., Mitchison, D., & James, M. H. (2024). Patient perceptions of lisdexamfetamine as a treatment for binge eating disorder: An exploratory qualitative and quantitative analysis. Psychiatry Research Communications, 4(4), 100195. https://doi.org/10.1016/j.psycom.2024.100195