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Is this an eating disorder? Warning signs that are important to know

פרופ' יעל לצר, הפקולטה למדעי הרווחה והבריאות, אוניברסיטת חיפה, מנהלת המחקר, המרכז להפרעות אכילה, רמב"ם, הקריה הרפואית לבריאות האדם
16 June 2025

Adolescence is characterized by changes, social and psychological influences and occasionally unusual eating habits, such as eating late at night, worrying parents. Occasionally, these behaviors do not necessarily indicate a serious problem but at the same time, there are signs that should be noted. 

Tendency towards excessive eating during adolescence

 Adolescent girls tend to eat more, particularly before and after the menstrual cycle. This type of eating is normal and critical during periods of growth and sexual development. During this time, caloric intake must be large to supplement development and achieve genetic potential. If we do not intervene in this natural process, the period of excessive eating generally disappears without causing unusual weight gain beyond normal weight for the age, height and innate body structure. Critical response by the parents or environment on eating episodes may undermine self-confidence, decrease body image, result in unwanted diets, obesity, eating-related pathology and, in certain cases, even development of a full-blown eating disorder.  

Behavioral changes related to eating 

There are several signs regarding the development of an eating disorder, such as avoidance of food, eating extremely limited amounts of food, excessive occupation with food, use of weight loss medications, and fear of obesity despite low weight. Other signs include changes in eating habits, such as skipping meals or avoiding certain food groups. 

Physiological changes

 Weight loss, sleep disturbances, hair loss, weakness, dizziness, fainting, abdominal pain, constipation, swelling, diarrhea, digestive issues, irregular or absent menstrual cycle. 

Psychological events  

Extreme fear of obesity, a sense of guilt after eating, poor self-esteem and confidence, feelings of stress and anxiety, particularly around mealtimes or when eating in company, feelings of lack of control around food and with regards to eating, fear of obesity and the pursuit of thinness. 

The differences between diet and development of an eating disorder

 Many adolescent femals want to diet to adapt themselves to the latest model of beauty. Dieting that becomes an obsession and is accompanied by unusual behavior such as obsessive sports or excessive eating may indicate a risk of development of an eating disorder.  

The importance of early diagnosis 
Early identification of the warning signs is critical, since treatment in the early stages can prevent deterioration. If you suspect that your child is suffering from an eating disorder, consult professionals who specialize in the field. 

The article is written in female form since most individuals with eating disorders are adolescent females, but the information is applicable to adolescent males and females as well as adult men and women of any age. 

Many parents of adolescent females (and males) are concerned when they notice behavioral changes that are related to eating. For the most part, the concern focuses on the development of eating disorders or obesity. 

Adolescence is characterized by a search for new experiences and endeavors, and this is also reflected in eating habits. Every parent of a teenager often encounters cases of excessive eating, in an unorganized manner and at unusual times - for example, eating pasta at 2 a.m. or making pancakes an hour after dinner is over. If you are parents of an adolescent, it may assure you to know that the behavior is generally normative for adolescence and this type of behavior is not necessarily indicative of an eating disorder. Having said that, there are signs that you should note that may raise red flags about the development of eating disorders. If you have even the slightest concern, you should seek professional advice. 

Tendency towards excessive eating during adolescence 

At the start of adolescence, approximately one-and-a-half to two years before starting menstruation and until approximately two years after, there is a tendency towards excessive eating. Excessive eating can appear excessive to anyone who knows an adolescent, but it is part of the process of growth and sexual development. During this time, caloric intake must be large to supplement development. This period of excessive eating generally disappears without causing unusual weight gain beyond normal weight for the age, height and innate body structure. Various interventions, such as encouraging diets or hurtful remarks, do more damage than create benefits. 

Changes that may indicate an eating disorder

During adolescence, behavioral changes occur in many areas. Concurrently, several changes may raise suspicion of the development of an eating disorder, and it is important that you notice them: 

  • Avoidance of food that was eaten without problems in the past. 
  • Eating only low-calorie products. 
  • Obsessive reading of nutritional labels, calorie tables, cookbooks and viewing diet programs. 
  • Weighing food. 
  • Preference for eating alone. 
  • Avoiding eating near others. 
  • Denial of hunger. 
  • Eating extremely slowly, playing with food and limited eating
  • Taking appetite suppressants, such as weight loss medication. 
  • Drinking large amounts of water, diet beverages, hot tea, coffee and excessive use of artificial sweeteners. 
  • Changes in eating habits, such as becoming vegetarian or vegan, or avoiding certain food groups, such as gluten, sugar, white flour, beef, chicken.
  • Skipping meals.
  • Fear of weight gain, despite being low weight. 
  • Excessive occupation with weight and body shape (calorie counts, physical examinations). 
  • Disappearance of unusual quantities of food from the house. 
  • Odd eating habits, such as cutting food into small pieces, to cope with hunger, control eating, and blur the fact that the quantity of food is extremely small. 
  • Spreading food over the plate, concealing food under the plate and under the table, in cups, etc. 
  • Purging after eating: desire to get rid of the food that was eaten, purging’ the body from what is perceived as harmful to it, and to maintain low body weight, if the adolescent feels that she has eaten too much or has eaten high calorie foods. Purging is done using several methods: 
    • Induced vomiting. 
    • Excessive physical activity 
    • Use of laxatives, diuretics or fasting. 
  • Disappearing when eating or immediately afterwards to the bathroom, in order to vomit. 
  • Self-esteem and moods that are affected by the quantity of food and by weight; sense of guilt and stress after eating, eating rituals, rigidity at mealtimes, visible unrest when changes occur at mealtimes or at special events where food is served, increased gum chewing, sugarless candy. 
  • Signs of leftover food and candy wrappings in the bedroom.  

  • Obsessive, exaggerated and excessive exercise, both at home and in the gym, focus on stomach crunches, jumps, going up and down steps, excessive swimming, excessive power walking, etc. The adolescent will perform these activities even when she is not in good physical shape, accompanied by feelings of guilt or anxiety when she is not exercising. 
  • Wearing large, loose clothing to hide the body and blur the exaggerated thinness. 
  • Adhering to a rigid schedule. 
  • Self-flagellation of hated areas of the body, particularly the stomach and calves. 
  • Measuring body organs. 
  • Social isolation and withdrawal. 
  • Mood swings, irritability. 
  • Use of alcohol. 

  • Fear of weight gain and pursuit of thinness. 
  • Excessive focus on body weight and spending most of the day thinking about food, shape and body, and controlling them.  
  • Excessive concern and warped perception of body weight and shape. For example, I thought that I was much larger than I actually am.  
  • Poor self-esteem and self-confidence. 
  • Perfectionism and setting particularly high personal standards. 
  • Feelings of stress, pressure and anxiety, particularly around mealtime or when eating with company.  
  • Sense of shame and guilt after eating episodes or after binge eating and purging. 
  • Sense of lack of control around food and with regards to eating. 

  • Weight loss or gain. 
  • Weakness, dizziness, fainting. 
  • Abdominal pain, constipation, swelling, diarrhea, digestive issues. 
  • Hair loss 
  • Irregular or absent menstrual cycle. 
  • Fatigue, sleep disorders. 
  • Sensitivity to cold or low body temperature. 
  • Lanugo - growth of soft, fine hair throughout the body. 
  • Low pulse and blood pressure. 
  • Poor blood flow. 
  • Impact on hormone levels. 
  • Swelling (edema) of feet, hands or face. 
  • Dry, poor skin. 
  • Sleep difficulties, fatigue. 
  • Swelling in the area of hands and feet.  
  • Damage to teeth and tooth enamel due to vomiting. 
  • Swollen salivary glands attributed to vomiting. 
  • Repeated complaints of sore throat due to induced vomiting.  
  • Warts on the back of the hand, resulting from using fingers to induce vomiting. 
  • Electrolyte imbalance, low potassium level due to vomiting and use of laxatives as well as diuretics. 
  • Fluctuating blood sugar levels that may lead to mood swings and fainting.  

Fad dieting or risk of eating disorder

How can one distinguish between fad diets, as a passing adolescent trend, and a diet that can result in the development of an eating disorder? Occasionally, the desire to ‘diet’ can be part of the environmental influence in which the ideal is “thin = beautiful”. Many adolescents attempt various diets to lose weight, because they believe that if they are skinny, they will be more physically attractive, based on the ideals of Western society, as well as being more socially popular. A young girl may occasionally be overweight or obese and wishes to eat in a controlled manner ino rder to lose weight with the help of a professional dietician. In these cases, it is important that the initiative comes from the adolescent, and it is important that she be at the end of sexual maturity (average age of 16). 

In contrast, there are many cases in which the adolescent’s weight is completely normal, and yet she is obsessively occupied with her weight and tries various diets. At this point, it is important to stop and try to differentiate between "a diet as a passing fad" and a diet that may put an adolescent at risk of developing an eating disorder.  
There are several warning sights that may indicate that the diet is becoming dangerous: 

 

 

Diet as a passing trend during adolescence  

Diet with a risk of developing an eating disorder 

Completion of the diet 

The adolescent expresses a wish to lose weight, establishes a target weight (not underweight) and stops the diet when she achieves the target weight.  

Achieving the target weight does not stop the adolescent. She continues with the diet, each time lowering the target weight she set for herself. 

Body image and self-confidence 

Body image and self-confidence improve once the desired target is achieved, and the adolescent feels better with herself and socially.  

Severe self-criticism of the body, poor self-confidence, isolation and distancing from friends, obsessive occupation with diets. 

Menstruation 

The diet does not affect menstruation. 

Irregular or absent menstrual cycle.  

General behavior 

Regular, normative behavior of an adolescent female.  

Unusual and obsessive behavior regarding eating, sports, etc.  

Eating habits 

Relatively stable eating habits, maintenance of a balance  

Changes in eating habits, such as becoming vegetarian or vegan, without an ideology that accompanies the process, or avoiding many foods. 

Social status  

With weight loss, self-esteem and body image of the adolescent improves.  

With weight loss, the adolescent chooses social isolation and avoids social relationships. 

Clothes 

With weight loss, the adolescent goes shopping for new clothes that accentuate the body.  

Despite the weight loss, the adolescent hides her body in large clothing because she is feeling ‘fat’.  

Unusual behaviors  

None 

Binge eating unreasonable quantities of food, or using various methods of purging, such as induced vomiting, use of laxatives, diuretics, obsessive sport. 

These signs indicate the start of the disorder and at this stage, they can be treated less intensively, including chances of avoiding deterioration. For this reason, early identification and diagnosis as well as treatment is critical. It is important to emphasize that an imbalanced diet without solid professional supervision may be harmful. Some behaviors from the set of behaviors we mentioned here that are not necessarily a warning sign of the development of an eating disorder, but if you have a suspicion, it is better to check and find out that you were wrong than to miss an important diagnosis, and therefore it is important to consult with qualified authorities.   

Important

Important

Different eating disorders have different characteristics. To become familiar with all existing eating disorders, read the article on Types of Eating Disorders.