While only a doctor or other treatment professional can diagnose an eating disorder, you can ask yourself some questions to determine if your relationship with food and your body is problematic. Below are some warning signs. A commonly used early detection questionnaire is the SCOFF questionnaire, which asks the following:

1. Do you make yourself Sick because you feel uncomfortably full?
2. Do you worry that you have lost Control over how much you eat?
3. Have you recently lost more than One stone (14 pounds) in weight in a three-month period?
4. Do you believe yourself to be Fat when others say you are too thin?
5. Would you say Food dominates your life?

If you answered “yes” to two or more questions, there is a good possibility you may have an eating disorder. Early intervention is critical in the treatment of eating disorders, so if you think you may have an eating disorder, seek help as soon as possible.

In a society that is obsessed with thinness and fitness, it is sometimes difficult to tell what is “normal” dieting and what indicates an eating disorder. It’s important to know what to look for in yourself or a loved one to indicate that a diet may have gone too far and they may be suffering from an eating disorder. Seeing the following signs in a family member, friend or co-worker could mean they are suffering from an eating disorder and need help.

Talking to a loved one you think may have an eating disorder is not an easy task. However, there are some things you can do to make the conversation easier and, more importantly, more likely for your loved one to listen to and accept your concerns.

Plan a time – This is an important conversation and you want to be sure that you have your friend/family member’s full attention and that you can give them your full attention. Minimize distractions by meeting in a private place and finding a time that works for both of you. Be sure to allow plenty of time to state all your concerns, as well as listen to any response your family member or friend has.

Stick to facts – Don’t make accusations, which could cause them to shut down and end the conversation immediately. Use “I” statements to tell them what you have observed in their behaviors and habits lately that is causing you concern. “I noticed you have been going to the bathroom after every meal and I’m worried you may be purging.” This is going to be better received than “Oh, so I guess you’re puking in the bathroom after all your meals now?”

Avoid placing shame or blame – It will not help to tell your loved one that they are being “irresponsible” or “wasting food” or that their illness is creating a burden for the family. People with eating disorders often already feel ashamed of their behaviors and avoid seeking help for that very reason. Placing blame or making shaming comments will only serve to compound the shame your loved one already feels and drive them further into the eating disorder.

Show support without minimizing the issue – Make sure your loved one knows you are there to help them through this. At the same time, don’t say things like, “We will just get you eating again and it will all be fine.” Your loved one has an eating disorder for a variety of complex reasons and while nutritional stability is vital to recovery, it is not the only thing that matters. Offer to help your loved one find an appropriate dietitian or therapist or to attend appointments or support groups with them. Assure them that you will be there with them through the entire process.

Seek professional help – This is true not only for your loved one but for you as well. In treating their eating disorder, your loved one will likely need at least a dietitian, therapist, and primary medical provider. An eating disorder is not a “phase” and will not go away on its own. The sooner your loved one seeks help from qualified professionals, the better their chances for a full recovery. Additionally, you may benefit from a support group or individual therapy, especially if you are a primary caregiver or support person (e.g., parent or spouse, among others). Therapy can help you deal with your own feelings about the situation and allow you a chance to get the support you need.

Warning signs for Anorexia Nervosa:
Excessive weight loss in a short period of time
Constant focus on weight reduction, calorie counting, and food rituals
Making excuses for not eating
Avoiding meal times
Skipping meals
Persistent fear of gaining weight
Disturbance in body image (e.g., believing oneself to be “fat” despite being underweight)
Irregular or absent periods in females
Layering clothing/wearing more layers or clothes than necessary (to hide body and/or stay warm)
Cold intolerance

Warning signs for Bulimia Nervosa:
Excessive weight loss or gain in a short period of time
Frequent trips to the bathroom after eating
Damage to teeth and gums
Evidence of self-induced vomiting, excessive exercise, or use of diet pills, laxatives, or diuretics
Calluses on hands (“Russell’s sign,” caused by self-induced vomiting)
Focus on shape and/or weight in self-evaluation
Swollen salivary glands

Warning signs for Binge Eating Disorder:
Excessive weight gain
Eating more rapidly than normal
Secrecy surrounding eating habits
Unexplained disappearance of large amounts of food
History of dieting and/or failed diet attempts