The Telltale Dozen
Telltale dozen
How can you tell if you have an eating disorder? Because it is a neurobiological condition and therefore rarely includes external, visible symptoms, it is the mindset you are forced to adopt toward food that is most telling.
Those dealing with this condition are two-thirds more likely to be of average or above-average weight than the emaciated icon that is commonly used to represent the condition in popular culture. [1] The fact that emaciation is not a definitive marker is yet another reason to pay particular attention to analyzing mindset, behaviours, and subjective reduction in quality of life. While answering yes to four or more of these questions is a tell that you are likely dealing with an eating disorder, answering yes to #5 on its own (in the absence of actually living with serious food insecurity or famine) is a serious warning sign.
Family and friends have shifted from congratulating you on your weight loss and/or your healthier choices to making either careful or even blunt comments that you look unwell or generally don’t seem to eat enough. When workouts, runs, exercise and/or clean eating are dominant behaviours, then family and close friends start to make comments about how they feel you are unable to keep your commitments and priorities (meaning you put your food/weight/‘healthy lifestyle’ management ahead of your relationships).
You are cold when others are not. You’ve started wearing sweaters (jumpers, pullovers) when others are in short sleeves. Sometimes you feel light-headed or dizzy. Other times you feel foggy-headed—like you are listening to others through cotton wool.
You are tired and find your mind wanders. You struggle to focus in class or at work. You cannot remember things that others remember easily.
You are prone to crying spells and/or explosive bouts of anger (more so than what might be usual). You alternate between wanting to be alone, snapping at family, and finding you are clingy and needy, seeking reassurance from loved ones.
Not only do you find it hard to concentrate, but also you find you are absolutely consumed with thoughts of food: when you will eat; what you will eat; what you won’t eat.
Facing social circumstances that involve food creates panic: family celebrations, lunches with friends at school, holiday gatherings…in the days leading up to such events you feel extremely anxious and spend a lot of time trying to figure out how to avoid it altogether or how to squeeze in additional pre-emptive behaviours (exercise, more restriction of food..) to be able to attend.
The number of rules you assign to when and how you will eat keeps getting longer. You have become ritualistic to the point where any deviance causes massive anxiety (the wrong plate, the fork in the wrong place…).
You have longer and longer lists of forbidden foods that you will not touch.
If you indulge in any food that you consider unacceptable, you are wracked with shame, self-hatred, and loathing and usually “punish” yourself for the transgression (exercising to exhaustion, skipping yet another meal).
As a woman, your regular menstrual cycle is irregular or has disappeared completely. * Whether you are a woman or man you notice your skin appears dull and dry. Your hair and nails are brittle and perhaps your hair loss seems more pronounced than usual (clumps in the bathtub drains or on your brush).
You find yourself promising yourself and others more and more that tomorrow will be different. But it isn’t.
You lie to loved ones about what you ate that day or how much you actually exercised and make excuses for why you cannot eat now. If they are friends, you often fabricate food allergies, intolerances, or other reasons why you cannot have the food being offered.
*An absent menstrual cycle is a marker of ill health but its presence is not a marker of health. It is a one-way marker only.
Whitelaw, Melissa, Heather Gilbertson, Katherine J. Lee, Mick B. Creati, and Susan M. Sawyer. "A new phenotype of anorexia nervosa: The changing shape of eating disorders." Journal of Eating Disorders 1, no. 1 (2013): 1-1.
