Physical signs of an eating disorder

How it presents

An eating disorder is often first seen on the body rather than heard in the history, and the physical signs fall into a small set worth holding.

• Frequent changes in weight, loss or gains
• Signs of damage due to vomiting: swelling around the cheeks or jaw, calluses on knuckles, damage to teeth, and bad breath
• Feeling bloated, constipated, or developing intolerances to food
• Loss of or disturbance of menstrual periods in girls and women
• Fainting or dizziness
• Feeling tired and not sleeping well

Causes and risk

Relative energy deficiency in sport (RED-S), formerly known as the female athlete triad, is a relatively common condition in female athletes. It is characterized by amenorrhea, disordered eating and osteoporosis, and it is more common in sports that promote lean body mass. Female athletes should be screened for the disorder during their preparticipation evaluations.

The rule that follows from a triad is that the components go with one another: individuals who present with one or more components of RED-S should be evaluated for the other components. So a low body weight found on its own is a reason to ask about periods and about bone density, not a finding to be recorded and left.