10 subtle signs that someone has an eating disorder

Help them before it gets too late.

Unrealistic beauty standards imposed upon the society is making victims out of young men and women. In their quest to achieve the perfect rail-thin bodies, they fall prey to a variety of eating disorders like anorexia, orthorexia and bulimia. These disorders could turn out to be fatal if not addressed at the right time. It's not easy for someone suffering from eating disorders to come clean or even talk about their problems. It's understandable that you are worried for your loved one who is going through this harrowing ordeal and you would want to help them in whichever capacity you can, even if they don't confess about their situation. But there are always ways to find out whether they need help. Some subtle physical signs may suggest that someone is possibly battling an eating disorder. Watch out for them and get them help as soon as possible.

Fine body hair: Lanugo or fine body hair develops when a person is severely deprived of fat reserves in the body. Fat layers protect the body from excess cold. So in the absence of fat, the human body develops a thin layer of fine body hair to ward off the cold. It is a classic sign of someone who is malnourished with an eating disorder.¹

Subtle signs on the hand: Russell's signs are marks formed on the hands of people suffering from bulimia. While forcibly throwing up, the person ends up injuring the knuckles of the hands, forming abrasions, lacerations and calluses on the hand. It is distinct sign of a person with an eating disorder.²

Hoarse voice: Changes in the person's voice could also point towards a possible eating disorder, namely bulimia. Recurrent vomiting can cause the harsh stomach acids to reach down the larynx, similar to gastro-oesophageal reflux. This injures the larynx and alters the voice, imparting a distinct hoarse quality to it.³

Dry, pale skin: Anorexic people have abnormally dry skin, stemming from the lack of fat in the diet and dehydration. The skin becomes visibly dry and is accompanied by flaking. Here are ways in which an unhealthy diet affects the skin.¹

Orange skin: Often in anorexia, patients have a fixation with carrots, which they deem healthy for their weight loss benefits. Not surprisingly, they often base their entire meals around these vegetables and as a result of this, their skin takes on an orangish hue from all the excessive carotenoids in their food.¹

Eroded teeth: Bulimic people forcibly induce vomiting to expel whatever they have eaten before. This results in dental erosion which is caused by the stomach acids coming in contact with the enamel of the teeth. Here are other things that could be bad for the teeth enamel.⁴

Brittle nails: One of the most distinct signs of an eating disorder is malformed or brittle nails. Malnutrition associated with anorexia and bulimia alters the structure of the nails, making them look flat and pale. Koilonychia a condition where the nail becomes concave or spoon like is also a sign of an eating disorder.⁵

Layering clothes: In anorexia especially, sufferers tend to have a very low tolerance towards cold. The problem stems from the person having very low fat stores in the body to fend off cold. Such people may object to switching on air conditioners and fans in the room and may always sit bundled under layers of sweaters and jackets.⁶

Over-exercising: Eating disorders are often accompanied by excessive fixation with exercising. The person starts panicking if they miss out on a single session at the gym. A large portion of anorexics and bulimics combine dieting with a rigorous exercise regimen to maintain their weight.⁷

Puffy cheeks: Nutritional deficiencies and bizarre eating rituals characterised by constant vomiting causes the salivary glands of the patients to get enlarged. This gives an impression of swollen chipmunk-like cheeks. The sad part is that the enlargement persists even when the patient returns to normal weight.⁸

References:

1. Strumia, R. (2009). Skin signs in anorexia nervosa. Dermato-Endocrinology, 1(5), 268 270.

2.Daluiski, A., Rahbar, B., & Meals, R. A. (1997). Russell's Sign: Subtle Hand Changes in Patients With Bulimia Nervosa. Clinical orthopaedics and related research, 343, 107-109.

3.Ryt maa, I., J rvinen, V., Kanerva, R., & P. Heinonen, O. (1998). Bulimia and tooth erosion. Acta Odontologica Scandinavica, 56(1), 36-40.

4.Ryt maa, I., J rvinen, V., Kanerva, R., & P. Heinonen, O. (1998). Bulimia and tooth erosion. Acta Odontologica Scandinavica, 56(1), 36-40.

5.Handler, M. Z., & Tosti, A. (2013). Eating Disorders and the Nails. In Eating Disorders and the Skin (pp. 79-82). Springer Berlin Heidelberg.

6.Smith, D. K., Ovesen, L., Chu, R., Sackel, S., & Howard, L. (1983). Hypothermia in a patient with anorexia nervosa. Metabolism, 32(12), 1151-1154.

7.Davis, C., Katzman, D. K., Kaptein, S., Kirsh, C., Brewer, H., Kalmbach, K., ... & Kaplan, A. S. (1997). The prevalence of high-level exercise in the eating disorders: etiological implications. Comprehensive psychiatry, 38(6), 321-326.

8.Walsh, B. T., Croft, C. B., & Katz, J. L. (1982). Anorexia nervosa and salivary gland enlargement. The International Journal of Psychiatry in Medicine, 11(3), 255-261.

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