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Is This an Eating Disorder? Important Warning Signs to Recognize

Prof. Yael Letzer, Faculty of Welfare and Health Sciences, University of Haifa, Research Management, Eating Disorders Center, Rambam, Medical Center for Human Health
29 September 2025

Adolescence is accompanied by significant changes in the body, mind, and behavior.   Parents occasionally notice unusual eating behaviors, such as eating late at night or preferring to eat alone.   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 the 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 associated with 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, 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 females want to diet to adapt themselves to the latest model of beauty. Dieting 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 the 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.

Red flags and changes that may signal 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: 

Changing Eating Habits

  • Changes in eating habits: eating very little, skipping meals, or avoiding certain food groups that were previously eaten.
  • Switching to vegetarianism or veganism for reasons not related to personal beliefs or ideology.
  • Avoiding eating around others and preferring to eat alone.
  • Denying hunger.
  • Eating very slowly or playing with food.
  • Weighing food.
  • Eating only low-calorie products.
  • Increased focus on baking cakes without tasting them.

Compulsive Eating Patterns

  • Ritualistic behaviors before, during, and after eating.
  • Unusual eating habits: cutting food into very small pieces to cope with hunger, control eating, and hide the fact that the quantity is very small; spreading food around the plate; hiding food under the plate, under the table, or in pockets, etc.
  • Excessive preoccupation with food: obsessively reading nutrition labels, calorie charts, and cookbooks, or watching diet programs.
  • Drinking large amounts of water, diet beverages, hot tea, or coffee, and excessive use of artificial sweeteners.
  • Excessive chewing of gum or sucking on sugar-free candies.
  • Disappearance of unusual amounts of food from the home.

Bingeing and Purging Patterns

  • Episodes of uncontrolled binge eating followed by self-induced vomiting.
  • Purging after eating: wanting to get rid of food eaten, “cleanse” the body of what is seen as harmful, or maintain a low body weight if the teen feels they’ve eaten too much or high-calorie foods. Purging may involve:
    • Self-induced vomiting.
    • Excessive exercise.
    • Use of laxatives, diuretics, or fasting.
  • Disappearing during or immediately after meals to go to the bathroom to vomit.

Emotional Signs Around Eating

  • Feeling irritable or anxious at events where food is served, such as family meals or holidays.
  • Expressing feelings of guilt about eating.
  • Statements such as “I ate too much,” “I’m fat,” or “I’m ugly.”
  • Self-esteem and mood strongly affected by how much food is eaten or by weight.
  • Feeling out of control around food or when eating.
  • Rigid meal times and visible distress when eating times or food-related events change.
  • Finding food scraps or candy wrappers in the teen’s room.

Changes Related to Body Image and Self-Criticism

  • Excessive focus on weight and body shape (counting calories, checking body measurements).
  • Distorted perception and excessive concern about weight and body shape—for example, thinking “I’m much bigger than I really am.”
  • Fear of gaining weight, even when underweight.
  • Frequent weighing.
  • Measuring body parts.
  • Self-hitting or punishing disliked body areas, especially the stomach and thighs.
  • Wearing large, loose clothing to hide the body and mask extreme thinness.
  • Using appetite suppressants, such as diet pills.

Changes Related to Physical Activity

  • Compulsive, excessive exercise at home or in gyms, focusing on sit-ups, jumping, stair climbing, swimming, carrying heavy loads while walking, etc.
  • Exercising even when physically unwell, often accompanied by guilt or anxiety if unable to work out.
  • Standing while watching TV as part of compulsive exercise.

Changes in Mood and Social Relationships

  • Low mood for most of the day.
  • Rigid daily routines.
  • Social withdrawal and isolation.

  • Low self-esteem and poor self-confidence.
  • Excessive focus on body weight, spending most of the day thinking about food, body shape, and controlling them.
  • Perfectionism and setting extremely high personal standards.
  • Self-harm.
  • Mood swings, sometimes reaching depressive levels.
  • Irritability, impatience, and low tolerance.
  • Impulsive behaviors, such as kleptomania, or substance misuse, such as alcohol abuse.

General Physical Changes

  • Weight loss or weight gain.
  • Weakness, dizziness, or fainting.
  • Fatigue or sleep disturbances.
  • Yellowish skin tone.
  • Dry, dull skin.
  • Hair loss.
  • Lanugo – fine, soft hair growing over the body.
  • Increased sensitivity to cold, frostbite, or low body temperature.
  • Stomach pain, constipation, bloating, diarrhea, or digestive problems.
  • Tingling in the fingers.
  • Fluctuations in blood sugar, which can affect mood and cause fainting.
  • Frequent headaches.
  • Poor blood circulation.
  • Low heart rate and blood pressure.
  • Swelling (edema) in the feet, hands, or face.
  • Swelling in the hands and feet.

Hormonal Changes

  • Irregular periods or missed periods.
  • Impact on hormone levels.

Symptoms Related to Vomiting or Purging

  • Tooth damage and enamel erosion due to vomiting.
  • Swollen salivary glands from repeated vomiting.
  • Calluses on the back of the hands from using fingers to induce vomiting.
  • Electrolyte imbalances, including low potassium, due to vomiting and use of laxatives or diuretics.
  • Repeated sore throats from self-induced vomiting.

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 in order 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 signs that may indicate a diet is becoming dangerous:

  Diet as a Passing Trend in Adolescence Diet with Risk of Developing an Eating Disorder
Completion of the Diet The adolescent wants to lose weight, sets a target weight (not underweight), and stops the diet once the target is reached. Reaching the target weight is not enough. She continues dieting, each time lowering the target weight she sets for herself.
Body Image and Self-Confidence Body image and self-confidence improve once the target weight is reached, and the adolescent feels better about herself both personally and socially. Severe self-criticism of the body, low self-confidence, social withdrawal, and obsessive focus on dieting.
Menstruation The diet does not affect menstruation. Irregular or absent menstrual cycles.
General Behavior Normal, age-appropriate behavior for an adolescent girl. Unusual or obsessive behaviors related to food, exercise, or other routines.
Eating Habits Relatively stable eating habits with balanced nutrition. Changes in eating habits, such as becoming vegetarian or vegan without ideological reasons, or avoiding many foods.
Social Status With weight loss, social status, self-esteem, and body image improve. Despite weight loss, the adolescent chooses social isolation and avoids social connections.
Clothing With weight loss, the adolescent buys new clothes that highlight her body. Despite weight loss, she wears loose clothing to hide her body because she feels “fat.”
Unusual Behaviors None Binge eating excessive amounts of food, or using purging methods such as induced vomiting, laxatives, diuretics, or obsessive exercise.

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 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.  Early detection of severe dieting behaviors, along with all the physical, behavioral, and psychological signs, can help you, the parents, seek early diagnosis and treatment, thereby preventing the development or worsening of the disorder.   If you have any concerns, it is recommended to consult with professionals who specialize in eating disorders in the fields of mental health or medicine.  

Attention to the adolescent girl’s behavior

Everyone has different eating patterns, a different eating pace, favorite flavors, table manners, etc.   This is true at every stage of life and varies from one age period to another.   When it comes to adolescent girls, it is important to rely on your deep knowledge of your daughter's natural characteristics and the traits that make her unique.   Only in this way will you be able to notice if any unusual changes have occurred in her in any area: in her eating patterns, mood, social situation, development, and daily functioning.   It is important to notice whether she is irritable and impatient, and how her overall mood is.   Does she have poor self-esteem? Does she have low self-esteem?   Is there a gap between her achievements, appearance, and qualities and how she perceives herself?   And additionally: Has her eating behavior changed, and is she hiding things?   Does she avoid eating with you, the parents, or perhaps does she have unusual rituals around eating?   Has she lost a significant amount of weight? All of these can be warning signs, and it is important to address them with sensitivity and care. 

Important

Important

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