Many people have complicated feelings about food and their bodies. Diet messages, social media, comments from others and life stress can all shape how you see yourself. Some days it may be a passing worry. For some people, though, thoughts about eating, weight or appearance start to take up more and more space, affecting health, mood, relationships and daily life.
Eating concerns can affect people of any age, gender, body size or background. You do not need to be underweight, or to fit a stereotype, for your concerns to be real and worth talking about. This article covers some signs that may be worth paying attention to and how to take a first step.
Disordered eating and eating disorders
"Disordered eating" is a broad term for patterns such as frequent dieting, skipping meals, rigid food rules, binge eating or compensating for eating through exercise or purging. Eating disorders are specific diagnoses, such as anorexia nervosa, bulimia nervosa and binge eating disorder, along with others.
You do not need to know which category fits you. The more useful question is whether your relationship with food and your body is causing distress or getting in the way of your life. Only a qualified professional can assess what is going on.
Signs that may be worth noticing
Some patterns that people describe include:
- Thinking about food, weight or shape much of the day
- Strict rules about what, when or how much you can eat, and distress when rules are broken
- Skipping meals or eating very little, especially around others
- Episodes of eating that feel out of control, often followed by guilt or shame
- Making up for eating by vomiting, using laxatives, fasting or exercising intensely
- Exercising even when sick or injured, or feeling panicked about missing a workout
- Avoiding social events that involve food
- Frequently checking your body, such as weighing, measuring or mirror checking, or avoiding mirrors altogether
- Self-worth that rises and falls with weight or appearance
- Physical changes, such as dizziness, fatigue, feeling cold, changes in periods, stomach problems or noticeable weight changes
Having one of these does not mean you have an eating disorder. But if several sound familiar, or if they have been going on for a while, talking with a professional is a reasonable step.
Body image distress
Body image is how you think and feel about your body. Body image concerns can exist with or without disordered eating. For some people, worry about a perceived flaw in appearance becomes so intense that it leads to hours of checking, comparing, hiding or seeking reassurance.
If thoughts about your appearance are causing significant distress, leading you to avoid people or places, or taking up large parts of your day, it may help to talk with a clinician.
How eating concerns connect with other mental health conditions
Eating concerns often show up alongside other experiences, such as anxiety, depression, obsessive-compulsive symptoms, trauma or substance use. Sometimes changes in eating are a sign of another condition. Sometimes eating concerns make other symptoms worse. This is one reason an evaluation that looks at the whole person can be helpful.
Some medications, including certain psychiatric medications, can affect appetite and weight. If you have concerns about this, talk with your prescriber. Do not stop or change a medication on your own.
Why reaching out matters
Eating disorders are serious health conditions that can affect the heart, bones, digestion and other parts of the body, as well as mental health. Many people wait a long time before asking for help, sometimes because they feel ashamed, sometimes because they do not believe they are "sick enough." There is no threshold you need to reach to deserve support.
Care for eating concerns often involves a team, which may include a medical provider, a mental health clinician and a dietitian, depending on what is needed. A clinician can help you understand what level of care fits your situation.
Starting the conversation
Telling someone can feel very hard. A few ideas:
- Start small. "I've been struggling with food lately, and I'm not sure what to do" is enough to begin.
- Choose someone safe. That might be a trusted friend, family member, primary care provider, school counselor or therapist.
- Write it down if saying it out loud feels too difficult.
- Bring notes to an appointment about what you have noticed, how long it has been happening and how it affects your day.
If you are worried about someone else
If you are concerned about a friend or family member, choose a private, calm moment. Share specific things you have noticed, with care rather than criticism. Avoid comments about weight or appearance, even positive ones, and avoid labeling foods as good or bad. Encourage them to see a professional and offer to help find one. They may deny a problem at first; keep the door open.
When it is urgent
Some situations need immediate medical attention. Call 911 or go to the nearest emergency room if someone faints, has chest pain, a racing or irregular heartbeat, confusion, severe weakness, or vomits blood.
If you or someone you know is having thoughts of suicide or self-harm, call or text 988 to reach the 988 Suicide & Crisis Lifeline. If there is immediate danger, call 911.
Taking a first step in Ohio
At SOS Wellness, our team provides psychiatric evaluation, therapy and medication management for adults, children and teens, including care for anxiety, depression, OCD and trauma that can occur alongside eating and body image concerns. A conversation with our team can help you understand whether our services fit your needs. Appointments are available at our Middletown and Norwood offices and by telehealth for people located in Ohio.
If food or body image worries are weighing on you or someone you care about, you are welcome to contact us or request an appointment. You can start with whatever you feel ready to share.
This article provides general educational information and does not replace an individual clinical assessment. Contact your healthcare provider about your own care.