Anorexia nervosa, bulimia nervosa, and binge-eating disorders manifest themselves in infinite combinations of signs and symptoms. That's because the way these eating disorders is defined takes into account whether or not someone who displays the behaviors associated with those conditions really has control over their own actions.
For instance, someone can have a fear of weighing too much or lack an appreciation of the seriousness of the consequences of not weighing enough. Even if this person gets enough calories and achieves a normal weight, they may still be diagnosed with anorexia. On the other hand, someone may develop an extreme aversion to eating while taking chemotherapy. This person may be said to be anorectic, but is not likely to be diagnosed with anorexia.
People who have bulimia aren't considered to have the disease unless they can't control eating and purging. And it's possible to binge on food without "binge eating". Binge eaters not only eat to excess, they also lack control over the speed and amount they eat. A physician may see "threshold behaviors" or diagnose an "eating disorder not otherwise specified," but not take actions that get someone who as a real eating problem the treatment they need. And it turns out, researchers have found, that the catch-all category "eating disorder not otherwise specified" can be just as deadly or more deadly than the better known anorexia and bulimia.
Sticking to a strict diet, regardless of weight
Perfectionism is in general a personality characteristic of many people who develop eating disorders. The need to follow a "perfect" diet may indicate a condition known as orthorexia nervosa, which involves slavish devotion to supposed health rules, or it may be part of a pattern that points to secret behaviors that damage health.
Storing large amounts of food
People who have lived through famines and food shortages often insist on keeping significant amounts of food on hand. This behavior is not a sign of an eating disorder. It may even be a prudent precaution. But stashing shelves full of Hostess Ding Dongs or hoarding Häagen-Dasz ice cream in the freezer in anticipation of eating mass quantities all at once indicates a problem, possibly bulimia or a binge eating disorder.
Exercising all the time, despite repeated injuries
College student Kathy (not her real name) loved to work out. She went to the gym before her first college class every morning. She tried to sneak in a workout at lunch. She spent a couple of hours in the gym after her last class in the afternoon. No weekend was complete without a long bike ride, a climb in nearby mountains, or signing up for a marathon, biathlon, or triathlon. By age 25, Kathy jad zero social life, missed so much time from work she felt she was on a career ladder to a very low ceiling, and was in constant pain from three herniated discs. Kathy reported feeling tired all the time whether she tried to exercise or not. Finally her life began to turn around when a perceptive doctor suggested she might have exercise bulimia.
Using stimulants to suppress weight gain
Millions of people use green tea with caffeine to stimulate fat burning. Hundreds of thousands of people use Adderall (a prescription drug that combines four kinds of methamphetamines) to suppress their appetites. And hundreds of thousands of people do the same thing with cocaine. If you need to see a pharmacist or a dealer to get a pill to keep you from eating too much, you also need to see a doctor to make sure your "drug habit" doesn't get out of hand.
Eating in secret
If you don't want other people to know how much you eat, or even the fact that you re eating, you have a problem with food guilt. Feeling bad about how much you eat can lead you to deal with the unpleasant emotion of guilt by eating even more and feeling even more guilty. It's essential to pull out of this downward spiral. Professional counseling may help.
Withdrawal from friends and family at events that involve food
Some people are afraid of losing control at the buffet table or at a family meal. Some people are so ashamed of their eating habits that they don't want to eat when other people are around. This behavior is an indication of emotional disturbance that may be part of an eating disorder.
Preoccupation with specific aspects of appearance
Sometimes it isn't upset about the waistline that drives an eating disorder. Men who become bald prematurely, women who develop PCOS, and teenagers with acne can all suffer disturbances of body image that they medicate with food or that cause them to deny themselves food. It's not always about weight.