Some eating disorders are hard to miss. Others live in plain sight for months or years before someone realizes what they’re seeing. By the time concerns are taken seriously, the illness may have progressed significantly, sometimes with life-threatening consequences. Early signs of eating disorders or disordered eating often go unnoticed, not because no one cares, but because they don’t match the stereotypes.
Let’s explore subtle eating disorder symptoms that are often overlooked in people of all ages, but especially in younger adolescents and even children. These red flags are not just quirks or phases. They may be early indicators of something serious, and recognizing them can help families, providers, and loved ones take meaningful action.
What are the Common Signs and Symptoms of Eating Disorders?
Many people are aware of the more widely recognized signs of an eating disorder, though that doesn’t mean they’re easy to spot in someone close to you—or even in yourself. Dramatic weight loss, persistent food restriction, frequent purging, and patterns of binge eating are often listed as red flags. Other signs can include noticeable changes in mood, irritability around meals, secrecy, or avoiding social situations involving food.
These behaviors can be frightening to witness, and they are important to take seriously. But they are not the only signs of an eating disorder. In many cases, they don’t appear until the illness has progressed. For some people, these patterns never look exactly like the checklists found online.
Awareness of these more commonly cited signs is a starting point. But early intervention often requires paying attention to what might seem subtle or even ordinary at first glance.
A Growing Preoccupation With Food
Some warning signs aren’t about refusing food, but rather becoming consumed by it. During the Minnesota Starvation Study of 1944, researchers found that prolonged restriction led participants to become intensely focused on food; dreaming, reading, and talking about food frequently, obsessing over meals, and thinking about eating constantly. This wasn’t a character flaw, but a predictable response to deprivation.
In real life, this growing preoccupation might look like:
- Excessive interest in cooking shows or recipes
- Baking for others but rarely eating yourself
- Planning meals or collecting menus
- Pushing others to eat high-calorie foods while eating little
Often, these behaviors appear long before someone recognizes there’s a problem.
The Other Realities of Purging
Purging isn’t always obvious. While frequent trips to the bathroom after meals can be a red flag, many signs are subtler and easier to miss. Some people purge through methods like excessive exercise, or the use of laxatives or diuretics. Others hide symptoms behind routines that seem harmless on the surface.
Less commonly recognized indicators can include:
- Dental erosion or increased cavities
- Swelling in the cheeks or jaw area
- Persistent sore throats or hoarseness
- Heavy use of mouthwash, gum, or mints
- Bloodshot or watery eyes, or tiny burst blood vessels around the eyes
These behaviors are harmful even when they’re hidden. Purging doesn’t always happen in the context of large binge episodes. When it occurs on its own, without a pattern of binge eating, it is often referred to as purging disorder, a serious condition in its own right.
Patterns of Disordered Eating You Might Be Missing
There is another layer that often gets missed. Some patterns are so normalized or socially rewarded that they rarely raise concern. Others are brushed off as quirks or personal preference. But these, too, can be early indicators of disordered eating, and they deserve attention.
Dieting and Weight Loss
Dieting is one of the most common precursors to eating disorders, yet it rarely gets flagged as dangerous. Contrary to popular beliefs, rapid or significant weight loss is not a sign of health. In teens especially, it is almost always a red flag. Adolescence is a time of substantial growth, and weight loss—especially when combined with changes in mood, energy, or eating habits—should prompt further examination.
This is not limited to teenagers. Many people can trace the start of their eating disorder back to a seemingly ordinary decision to cut calories or eliminate certain foods, and older adults, including elders, are also affected. Sometimes, generational habits or past experiences with food insecurity are used to explain away restrictive patterns that are, in fact, harmful.
Extreme Healthy Eating
Rigid food rules, hyperfocus on ingredients, and fear of processed foods can be signs of orthorexia, which is a term used to describe an obsession with eating in a way that feels pure, clean, or healthy. It may begin with a sincere desire to feel better or care for one’s body. Over time, it can lead to a shrinking list of “safe” foods, fear around eating in social settings, and deep anxiety about meals that don’t meet specific criteria.
Orthorexia can cause severe mental distress, malnutrition, and may co-occur or progress into other eating disorders like anorexia, bulimia, or binge eating disorder.
Over Exercise
Exercise is often seen as universally positive. But when it becomes rigid or compulsive, driven by guilt or fear rather than enjoyment, it can be another early sign of disordered eating. Excessive exercise can also involve prioritizing exercise over injury, illness, or relationships, and experiencing distress when unable to exercise. This pattern is easy to overlook, especially in fitness environments like CrossFit, or among athletes of all ages.
Picky Eating
Picky eating is common in children, but persistent, severe avoidance of food groups can indicate Avoidant/Restrictive Food Intake Disorder (ARFID). ARFID is not about body image or weight, and isn’t about ‘being difficult.’ It involves fear, sensory aversion, or anxiety around eating, it often causes social withdrawal, and can result in serious health consequences such as nutritional deficiencies and impaired growth.
Recognizing Eating Disorders in the Midst of Mental Health Struggles
Of all the challenges families face during the current youth mental health crisis, eating disorders can be the easiest to miss. When a child is struggling with anxiety, depression, self-harm, or aggression, those issues naturally become the focus of care and concern. But disordered eating often co-occurs with other mental health conditions. It can develop alongside them, as a way to manage distress or gain a sense of control.
Parents may look back months later and say, “I just realized what I was looking at.” The patterns were there—changes in mood, avoidance of meals, preoccupation with food—but they were overshadowed by more obvious signs of distress.
This pattern isn’t limited to young people. Adults, too, often minimize or dismiss restrictive eating as just a side effect of stress, grief, or anxiety. But using restriction to cope with emotional pain is itself disordered eating. It deserves care and attention, even if it doesn’t fit every diagnostic checkbox.
Listening for the Quiet Signs of Disordered Eating
Eating disorder red flags are not always loud. In people with larger bodies, dieting, extreme exercise, and weight loss are often encouraged or praised. Oftentimes there is pressure to engage in these behaviors from loved ones, medical professionals, and even strangers. This makes disordered eating even easier to overlook, leading to delayed or missed diagnoses, secrecy, and shame. Other mental health struggles, new hobbies, dismissing habits as “quirks”, dedicated workout or training schedules, and subtle physical effects can also mask disordered eating.
Early intervention is one of the most effective ways to prevent serious medical complications and long-term mental health effects. But intervention requires recognition. If the only warning signs we acknowledge are visible restriction, dramatic weight loss, or stereotypical behaviors, we will continue to miss those who need help the most.
At ‘Ai Pono, we understand how nuanced eating disorders can be. Our team works with adolescents and adults across a wide range of symptoms, presentations, and lived experiences. Whether someone is struggling with orthorexia, purging disorder, ARFID, or anorexia that doesn’t appear in the “classic” way, we believe their pain is valid and their story deserves to be heard.If you or someone you care about is struggling with an eating disorder, know that help is available, and recovery is possible. Reach out to get started today.
