Anorexia and bulimia have destroyed thousands of lives and placed the victims in a mental prison that is endured 24 hours a day, every day. The clinical definitions of these disorders are as follows:

Anorexia Nervosa

A. Refusal to maintain body weight at or above a minimally normal weight for age and height.

B. Intense fear of gaining weight or becoming fat, even though underweight.

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C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape of self-evaluation, or denial of the seriousness of the current low body weight.

D. Amenorrhea in postmenarchal women, that is, the absence of at least three consecutive menstrual cycles.

Bulimia Nervosa

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

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1. Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances, and

2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.

C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months.

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D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of anorexia nervosa.

(Taken from the Diagnostic and Statistical Manual, Fourth Edition.)

While these definitions give objective definitions that the medical, psychological, and insurance communities can agree on, eating disorders exist on a continuum of disordered eating practices. Someone could be suffering in the beginning stages of one of these disorders and not clearly fall into these definitions. The earlier eating disorders are discovered and treated, the better the outcome and the fewer the heartbreaks. Below are listed other signs and symptoms of these disorders that could be early warning signals of a developing problem:

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Anorexia

1. Undue attention to counting fat grams or calories.

2. Refusal to eat a certain category of food (ex. meat, fat, sugar) that arises for no known reason.

3. Obsessive attention to weight.

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4. Lack of desire to participate in social functions involving food (isolation).

5. Relentless pursuit of activity and exercise.

6. Deceptive actions around eating (ex. hiding food, lying about food eaten).

7. Food rituals, such as cutting food into tiny portions, re­heating food multiple times, insistence upon eating at an exact time or refusal to eat after a certain time.

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8. Constant comments about being fat, feeling fat .. despite excessive thinness.

9. Increase in depressive personality traits.

10. Development of obsessive behaviors in other areas; such as cleanliness, study habits, organization, etc.

11. Comments placing foods into “good’ and “bad” categories and then pursuing “perfection” in food selection.

12. Perfectionist goals and attitudes in other areas of life.

13. Wearing of loose clothes to hide weight loss.

14. Increased interest in information about food, nutrition, weight, etc. Consuming the same foods day after day in order to maintain a “safe” and “controlled” intake.

15. Skipping of meals, sometimes eating very little, or fasting for days.

16. Pale skin or other changes in the condition of skin. Loss of hair on the scalp, while growth of downy like hair increases on arms, back or stomach.

17. Complaints of being excessively cold.

18. Signs of increased muscle weakness and general lethargy.

Bulimia

Since bulimia often begins with restrictive practices, many of the early warning signs and symptoms will be similar to those for anorexia. In addition the following indicators may be apparent:

1. Frequent trips to the bathroom following meals.

2. Evidence of purging in and around the bathroom.

3. Indications that laxative, diuretics, or enemas are being used.

4. Signs of secretive eating or bingeing.

5. Dramatic fluctuations between restriction and overeating accompanied by weight fluctuations of 10 pounds or more.

6. Evidence of self-induced vomiting, i.e. blood shot eyes, “chipmunk cheeks”, or knuckle scarring.

7. Presence of other impulse control behaviors such as stealing, shoplifting, or substance abuse.

The development of any one of these behaviors, attitudes, or symptoms does not indicate that one is in a full blown eating disorder. However, it may be an indication that the person is at risk. The greater the number of these early indicators that are apparent, the greater the risk.