How to Recognize Eating Disorders in Your Patients Over the Holidays

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The busy season is here. Between holiday shopping, baking, and traveling, many patients are also making time for medical appointments to maximize insurance benefits before the year ends.

During these routine check-ups and clinic visits, providers like you have a unique role in recognizing eating disorder symptoms. These appointments are a valuable opportunity to not only notice signs of trouble but also to provide support during what is often the most challenging time of year for those with these complex illnesses.  

Warning Signs of Eating Disorders 

Because denial and shame are common in people experiencing eating disorders, it is rare for those affected to disclose the thoughts, feelings, and behaviors they may be experiencing during their illnesses. Providers, therefore, should stay gentle and alert, remaining mindful of the possibility of illness in all patients. Eating disorders do not have one “look,” but some typical signs can indicate the presence of one.

While your patient may not explicitly name their eating disorder, they may refer to other conditions associated with it. Watch and listen for signs or complaints of physical illness, including:

  • Menstrual irregularity/amenorrhea
  • Sore throat
  • Gastroesophageal reflux
  • Dizziness
  • Dry skin and nails
  • Hair loss
  • Stomach cramps or abdominal pain
  • Muscle weakness
  • Cold intolerance
  • Leg cramps

Because even “normal” physical results cannot rule out an eating disorder, consider the emotional and verbal signs as well: Does your patient talk about wanting to diet despite being a normal weight? Do they seem hesitant to step on the scale? Do they mention stress eating or excessive exercise?

Continue to screen for anorexia, bulimia, binge eating disorder, and other eating disorders by asking questions about your patient’s relationship with their body, food, and exercise.

How to Ask Your Patients About Food or Body Image Concerns

Discussions about food can be highly triggering for those with eating disorders, so it is wise to open these conversations with broad, non-leading questions. “Tell me about your diet and exercise,” for example, may invite comments that “Are you eating and exercising in a healthy way?” would not. People with eating disorders often have distorted beliefs about food, weight, and exercise, and providers can work to uncover these distortions with open-ended questions.

It is also essential to maintain a weight-neutral approach when asking patients to step on the scale. Even well-meaning remarks (“I wish the scale was this kind to me!”) can be damaging to those experiencing or at risk of developing an eating disorder. Such comments can inadvertently reinforce dangerous behaviors, especially when they come from such a credible source.

If you do suspect an eating disorder in your patient, follow up with questions to specifically screen for these illnesses. Consider guiding them through our online quiz to get started. A study published in the Journal of General Internal Medicine recommends similar screening questions:

  1. Are you satisfied with your eating patterns?
  2. Do you ever eat in secret?
  3. Does your weight affect the way you feel about yourself?
  4. Have any members of your family suffered with an eating disorder?
  5. Do you currently suffer with or have you ever suffered in the past with an eating disorder?

Asked in an open, non-judgmental manner, these questions fit as part of a standard medical assessment and can quickly alert you to a potential eating disorder. Refer any patients with concerning signs to specialty care, where the symptoms can be identified, evaluated, and properly treated. The sooner a patient receives care, the better the outcome.

Learn how The Emily Program can assist in getting patients like yours the care they need. If you are concerned that your patient is struggling with an eating disorder, please visit our Get Started page or call 1-888-364-5977 today.

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