When most people think of eating disorders, they picture someone who is extremely thin or engaging in extreme behaviors around food. But the reality is that eating disorders and disordered eating often look very different than the stereotypes we’ve been taught.

People in bodies of any size can struggle with eating disorders. Many people who are suffering deeply are told they’re “healthy,” “disciplined,” or “not sick enough” because of how they look. That’s one of the reasons so many people go unsupported for years.

When I assess whether someone may have an eating disorder - or whether they could benefit from support around food and body image - I’m not looking primarily at body size or numbers. I’m paying attention to their internal experience and their relationship with food, movement, and their body.

Here are some of the biggest signs I look for.

1. Guilt and Shame Around Food, Movement, or Your Body

One of the clearest signs that something may be wrong is when eating, resting, or existing in your body feels loaded with guilt, shame, or self-judgment.

This can sound like:

• Calling foods you like “gross,” “bad,” “junk,” or “unhealthy”
• Feeling like you need to “earn” food through exercise
• Calling yourself “lazy” for resting
• Feeling intense anxiety about weight gain
• Believing your current body size is unacceptable
• Feeling like your body must be controlled or prevented from changing

Many of these beliefs are normalized in our culture, which can make it hard to recognize them as harmful. But when your relationship with food or your body is rooted in fear, shame, punishment, or harsh self-criticism, that’s important to pay attention to.

2. Restriction or Avoidance Around Food

Another major sign is limiting food in some way - even if it doesn’t look “extreme.”

This might include:

• Avoiding certain foods or food groups
• Constantly trying to eat “clean” or “healthy”
• Eating less than you want to
• Ignoring hunger cues
• Trying to limit portion sizes 
• Feeling distressed when eating “off plan”

Importantly, you do not have to be “successful” at restriction for it to affect you psychologically or physically. Even attempted restriction can increase anxiety around food and create cycles of deprivation, bingeing, reactive eating, or feeling “out of control.” Often, the more rigid someone becomes around food, the more consumed they become by thoughts about eating.

Many people dismiss these patterns because they believe they’re just “being healthy.” But health-promoting behaviors generally increase flexibility, nourishment, and quality of life - not fear, obsession, guilt, or self-punishment.

3. Food, Exercise, or Body Thoughts Take Up Too Much Space in Your Life

Food and movement are biological functions. Preparing meals and caring for your body naturally takes some amount of time and energy, and that can vary based on things like finances, chronic illness, disability, neurodivergence, or access to support.

But ideally, eating and movement should not feel overly effortful or mentally exhausting.

If you spend large amounts of time:

• Overthinking food choices
• Worrying about calories or ingredients
• Planning how to compensate for eating
• Fixating on exercise
• Body checking (e.g., scrutinizing yourself in the mirror, weighing yourself compulsively, or measuring certain body parts)
• Comparing your body to others
• Ruminating about weight or shape

…that may indicate a deeper struggle.

Ideally, body size and shape would function more like other physical characteristics like shoe size, height, or eye color - it’s something you may have feelings about, but not something that should dominate your self-worth or consume your mental energy.

Everyone deserves a relationship with food, movement, and their body that feels easeful and flexible.

4. Your Relationship With Food or Your Body Is Limiting Your Life

Eating disorders and disordered eating often shrink people’s worlds.

Some examples:

• Avoiding social events because food will be there
• Skipping activities because of body image distress
• Feeling unable to rest because of exercise rules
• Struggling to focus at work because thoughts about food or your body are so overwhelming
• Feeling disconnected from loved ones because you’re mentally preoccupied
• Avoiding certain clothes, photos, dating, intimacy, or experiences because of shame about your body

One of the questions I often ask is: How much is this taking away from your life?

You deserve to participate fully in the things that matter to you without food and body image distress constantly interfering.

5. Suicidal Thoughts or Self-Harm Related to Body Image or Eating

This is something that should always be taken seriously.

If you are experiencing suicidal thoughts, self-harm urges, or intense hopelessness because of your body, eating, exercise, or feelings of shame around these things, you deserve support and compassionate care.

This is unfortunately very common among people struggling with eating disorders, disordered eating, and severe body image distress. It should never be minimized.

You do not have to wait until things get “bad enough” to seek help.

What Support Can Look Like

My approach to these concerns is compassionate, collaborative, and non-pathologizing.

I don’t lecture people about what they “should” or “shouldn’t” eat, or tell people what their recovery needs to look like. I’m interested in understanding your unique relationship with food, movement, and your body - including the emotional, cultural, relational, and survival-based reasons these patterns may have developed.

Our work may include:

• Exploring core beliefs about deservingness, rest, food, joy, and self-compassion
• Untangling harmful cultural and family messaging around body size, eating, and movement
• Identifying unmet needs that disordered eating may be helping you cope with and finding other ways to meet those needs safely and sustainably
• Providing accurate, evidence-based information about food, weight, and bodies
• Building flexibility and trust with yourself
• Collaborating with dietitians, primary care providers, and psychiatrists when appropriate
• Involving supportive loved ones when helpful

Healing is not about achieving “perfect” eating habits or loving your body every moment of every day. Often, it’s about reducing shame, increasing flexibility, reconnecting with yourself, and creating more room for your actual life.

If reading this brought up recognition, concern, or even just curiosity, that’s worth paying attention to. You do not need to meet a stereotypical image of an eating disorder to deserve support.