In 2020, National Eating Disorders Awareness Week runs from February 24th to March 1st. This year, learn about the indicators, signs and screening tools to identify and properly treat eating disorders.
According to the National Eating Disorder Association, this year’s theme is Hindsight is 20/20. The idea behind the theme is to reflect on positive steps taken by participants toward accepting themselves and others. Those positive steps can include actions that stem from setbacks or challenges.
One major positive step is recognizing the signs and indications of an eating disorder, so this is a good time to review those signs and indicators. Knowing what an eating disorder might look like is crucial to identifying whether you or someone you care about is suffering from disordered eating.
3 Screening Tools for Eating Disorders Awareness
There are several screening tools that might be used to identify an eating disorder. The SCOFF questionnaire, the ESP, and the Eating Attitudes Test are three commonly used ones. These are generally meant for use by non-specialists, like your primary care doctor. If one or more of these tests indicate a problem, you may be referred to an eating disorder specialist for treatment.
The SCOFF test consists of 5 questions:
- Do you make yourself Sick because you feel uncomfortably full?
- Do you worry that you’ve lost Control over how much you eat?
- Have you recently lost more than One stone (14 lbs) in 3 months?
- Do you believe that you’re Fat even though others say you’re too thin?
- Would you say that Food dominates your life?
The first letters of Sick, Control, One, Fat, and Food make up the acronym SCOFF. Each question answered with a “yes” is worth one point, and a score of greater than two indicates that the person may be suffering from anorexia or bulimia.
The ESP (Eating Disorder Screening Tool for Primary Care) also consists of five questions:
- Are you satisfied with your eating patterns?
- Do you ever eat in secret?
- Does your weight affect the way that you feel about yourself?
- Have any members of your family suffered from an eating disorder?
- Do you suffer from an eating disorder now or have you in the past.
A “no” answer to the first question and “yes” answers to the remaining four questions are considered abnormal answers.
Finally, the EAT-26 (Eating Attitudes Test) is a set of screening questions whose answers are considered in context with behavioral questions about weight loss and eating symptoms and the person’s BMI. It’s one of the more common screening tools for eating disorders.
It’s important to remember that screening tools are just one way to determine whether a person should be examined by an eating disorder specialist, but they aren’t perfect and don’t necessarily catch every eating disorder. For example, people who suffer from binge eating disorder can score fairly low on the EAT-26, but they still suffer from a serious condition. Screening tools are helpful, but they shouldn’t be solely relied on for a diagnosis.
Physical Signs of an Eating Disorder
Identifying the physical signs of an eating disorder can be tricky. There are many reasons that a person might be under or overweight, including their natural build and body chemistry and medical problems unrelated to how the person eats. In some cases, physical changes that are related to an eating disorder are invisible or imperceptible to others, even if the person with the eating disorder is seriously ill.
It’s important not to jump to conclusions or to ignore the possibility that a person who seems to be a more or less average size might still be suffering from an eating disorder. Be aware of the physical signs of eating disorders, but be sure to put those signs into context with other indicators, like behavioral symptoms, health history, and other factors. Physical signs of an eating disorder include:
- Rapid weight gain or loss
- Frequent changes in weight
- Lack of energy
- Poor sleep
- Fainting or dizziness
- Feeling cold, even in warm rooms or hot weather
- Loss of menstruation in girls and women
- Loss of libido in men
- Tooth damage and bad breath
- Swelling around cheeks or jaw
- Calluses on knuckles
Behavioral Symptoms Associated With Eating Disorders
In many ways, eating disorders come down to control. Some people with eating disorders tightly control everything about when, where, and how much food they take in. Others seem to lose control when it comes to food. In either case, this results in certain behaviors related to controlling diet or concealing the way they eat.
Behavioral symptoms may in some cases be more noticeable than physical symptoms if you know what to look for. And behavioral symptoms in combination with physical symptoms can make it more apparent that someone may be suffering from an eating disorder. Take a look at some of the behavioral symptoms associated with eating disorders.
- Avoiding meals with other people
- Excessive dieting behaviors like calorie counting, avoiding food groups, or fasting
- Ritualistic habits around preparing or serving food:
- Measuring everything, cutting food into very small pieces, or chewing for a long period of time before swallowing
- Changes in clothing style
- Exercising excessively
- Hoarding or hiding food
- Frequent trips to the bathroom during or after meals
- Sudden changes in food preferences
- Lying about food intake, or behaving secretively where food is concerned
- Frequent vomiting or use of laxatives, appetite suppressants, or diuretics
- Extreme sensitivity to any comment about body shape, exercises habits, weight, or eating habits
Psychological Indicators of Eating Disorders
Psychological symptoms of eating disorders can be tough for family or friends to pick up on, although you may notice them in conversation or comments made by a loved one. People who think they may be suffering from an eating disorder may also be able to recognize psychological symptoms in themselves. Some psychological indicators of eating disorders include:
- Anxiety or irritability during meals or around mealtime
- Rigid thinking about which foods are good or bad
- Using food as a form of comfort or punishment
- Feeling preoccupied with thoughts of food, weight, eating, and body shape
- Feeling out of control around food
- Having a distorted image of what their own body looks like
Awareness of the signs and symptoms of eating disorders is vital. Knowing the indicators and spreading eating disorders awareness and symptoms can inspire someone to seek help on their own, or give friends or family the push they need to seek help for someone with an eating disorder.