Eating disorders don’t always look the way you think they do. They’re not always dramatic or visible, like emaciated teenage girls or someone purging in the bathroom.
In fact, some of the most serious eating disorders are hiding in plain sight, disguised as “healthy eating,” “discipline,” or “just trying to be good.”
Over the years, I’ve worked with many clients who came to me wanting to heal their relationship with food through intuitive eating, only to discover that what was actually blocking their progress was an underlying eating disorder.
And what breaks my heart is that they were blaming themselves because they “weren’t doing intuitive eating right” or “lacked willpower.” But in reality, an eating disorder was quietly running the show.
Today, we’re going to talk about how to recognize an eating disorder and what I say to a client when I suspect that’s what’s happening.
First: What Is an Eating Disorder, Really?
According to the National Institute of Mental Health (NIMH), “eating disorders are serious illnesses marked by severe disturbances in eating behaviors,” including related thoughts and emotions.
They carry real medical and psychological risks, including increased mortality (not “phases” or “being health conscious,” like diet culture says).
You cannot tell whether someone has an eating disorder by looking at them. Eating disorders affect people of all body sizes, ages, genders, races, and socioeconomic backgrounds.
In other words, the stereotype? Not even close to the reality.
The Most Common Types of Eating Disorders
Many people only think of anorexia or bulimia. But there are several different types, and most people don’t fit neatly into just one category.
Here are some of the most common:
- Anorexia Nervosa is commonly classified by the restriction of food intake, intense fear of weight gain, and distorted body image.
- Bulimia Nervosa symptoms materialize as binge eating episodes followed by compensatory behaviors like purging, excessive exercise, fasting.
- Binge Eating Disorder (BED) manifests in repeated episodes of eating past comfort, feeling out of control, or eating quickly or secretly and experiencing intense shame afterward.
- ARFID (Avoidant/Restrictive Food Intake Disorder) is characterized by a limited intake or variety of foods not driven by weight concerns.
- While not yet an official DSM diagnosis, orthorexia is an obsession with “clean” or “pure” eating and has a moral rigidity around food choices.
Many people live in the blurry space between diagnosable eating disorders and disordered eating. And that gray area can make it harder to recognize what’s really going on.
Subtle Signs That Often Fly Under the Radar
Eating disorders are sneaky. I often describe them as goggles that distort hunger, fullness, body signals, thoughts about food, and self-trust.
But the problem is they don’t always show up as dramatic binging or obvious starvation. Sometimes they’re disguised to look like “wellness.”
Here are subtle indicators that might be worth paying attention to:
- “Healthy” restriction (clean eating, low-carb, intermittent fasting)
- Eating the same “safe” foods on repeat
- Difficulty eating spontaneously
- Avoiding foods due to fear of fullness or loss of control
- Stopping at “not quite enough” instead of satisfied
- Planning restriction tomorrow to compensate for today
- Frequent body checking
- Needing reassurance about your body before eating
- Feeling calmer when the scale trends down (regardless of health)
- Believing body acceptance is only possible after weight loss
- Grazing at night with urgency or restlessness
- Shame around eating-even when no one else would judge it
If you’re reading this thinking, “Oh my gosh, this sounds like me…” take a deep breath.
Awareness is not a verdict. It’s an invitation.
Why Eating Disorders Get Missed in the Intuitive Eating Space
Sometimes people start intuitive eating and feel frustrated that they “can’t make it work.”
They say (or think) things like, “I can’t trust my hunger,” and “I still feel out of control.”
In some cases, the issue isn’t that intuitive eating doesn’t work. It’s that hunger and fullness cues may not be reliable yet.
And because the eating disorder voice may still be loud and rigid thinking may still be running the system, it might feel like dieting is the right fix.
But remember, dieting worsens eating disorders. Always.
Why? Because it increases rigidity, fuels binge–restrict cycles, strengthens the eating disorder voice, and alters brain chemistry in ways that reinforce the cycle.
The reality? The very thing you were told would “fix” your food issues may actually be keeping you stuck.
What I Say to a Client When I Suspect an Eating Disorder
If I’m working with someone and begin to notice intense cognitive distortions, overwhelming shame, the inability to apply intuitive eating principles, extreme rigidity, or weight obsession, here’s what I do.
- Gently bring it up. I usually say something like “I wonder if what’s happening here might actually be an eating disorder. Let me share why I’m thinking that…”
- Educate. I explain that eating disorders are serious, severity is not determined by weight, and that “I’m not sick enough” is often an eating disorder thought.
- Clarify next steps. From there, I recommend an evaluation with an eating disorder–specialized therapist or medical workup to assess physical impact.
My goal is to make you feel supported, educated, and cared for through every stage of your journey.
How Recovery Changes the Approach (And What Stays the Same)
Here’s something many people misunderstand: Having an eating disorder does not mean intuitive eating is off the table forever.
But it may change how we apply it.
Often, recovery requires more structure at first – think structured meals, consistent timing, gentle accountability – to give you the support you deserve.
But rejecting diet mentality, practicing food neutrality, cultivating respect for your body? That all stays the same.
The philosophy of intuitive eating still applies. We just adapt the strategy to the nervous system and brain chemistry involved.
One of the Most Powerful Shifts: Externalizing the Eating Disorder
One of the most transformative moments in recovery is separating the eating disorder from your identity.
The eating disorder is not you.
It’s a part, a coping mechanism, a misguided protector. Its intentions often revolve around control, safety, protection from pain, but its methods are harmful.
We work to distinguish between the eating disorder’s voice and your true self. Recovery becomes about strengthening your true self’s voice so you can stop automatically obeying the ED.
If You’re Wondering About Yourself…
If this stirred something in you, here are helpful starting points:
- The National Eating Disorders Association (NEDA) offers education and support resources.
- The Academy for Eating Disorders provides medical guidance information.
- The EAT-26 is a widely used screening questionnaire.
These are screening tools, not diagnoses, but they can be a first step.
The best next step is speaking with a therapist who specializes in eating disorders for a proper evaluation.
And please hear me when I say this: There is no shame in having an eating disorder. It can happen to anyone. Smart, successful, kind, high-achieving people struggle with this.
Recovery is possible.
For Dietitians, Therapists & Health Professionals
If you work with clients struggling with food or body image, these conversations matter deeply. What we say in vulnerable moments can either reinforce shame or open the door to healing.
That’s exactly why I created my free guide, “10 Well-Intended Comments That Miss the Mark With Struggling Clients.” (If you want a copy, DM me on Instagram. I’m happy to share it.)
Because even the most compassionate professionals can accidentally say something that reinforces the eating disorder voice.
This topic can feel heavy, so be gentle with yourself.
If today brought clarity, that’s a gift. If it brought discomfort, that’s okay too.
Remember, you are not broken, dramatic, or weak. You deserve the right level of support.And in case nobody has told you today: You are worthy just as you are.
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Looking for more support on your journey to food freedom and body acceptance?
– Check out my course, Non-Diet Academy
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