how to spot an eating disorder? weak, Marie Claire

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A story on the front cover Marie Claire magazine caught my eye: 5 ways to spot an eating disorder. Despite the strange verbage in that statement ("spot" an eating disorder? Sounds like a treasure hunt, and not a particularly fun one), I was very curious to see what they named. The magazine's resident dermatologist and psychiatrist, Dr. Amy Weschler, names the following as symptoms and behaviors to keep an eye on: a fine layer of body hair (also known as lanugo), yellow teeth, low self-esteem, lack of periods, and change in appearance.

I experienced all of the above during my years struggling with eating disorders, and know most women who have an ED experience at least one. So why do I have a problem with this article?

Because lanugo and a lack of menstruation are hallmarks of extreme and long-term anorexia, which while deadly and terrifying to watch, is very rare and far less common than bulimia, binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS, the catchall term for individuals who are clearly sick with an eating disorder but don't meet the strict diagnostic criteria of anorexia, bulimia, or BED). The last three disorders are far less glamorous than anorexia and get less excitement and airplay in magazines, but they are just as unhealthy and have the potential to destroy lives and happiness to the same extent as starvation, and to not give the other diseases equal time in such an article is fucking unrealistic and a disservice to readers.

The yellow teeth is noted in regard to bulimia. But such a sympton is incredibly easy to fix (there are dozens of products on the market for teeth whitening), and many bulimics don't necessarily purge by vomiting (laxatives and exercise are also common means, and wouldn't be as easy to "spot" as yellowed teeth). Scared a friend is puking their food? If they chew a lot of gum, have chipmunk cheeks (from overstressed salivary glands), drink a lot of water with their food, and make excuses to visit the bathroom following meals, you might have something to worry about and discuss with them.

I do give them props for mentioning a lack of self-esteem, which can be a risk factor for many issues (drug/alcohol abuse, falling into unhealthy romantic relationships, etc.), not just eating disorders. And a change in appearance is tricky: many people with eating disorders fight to hide their changing shape when they realize it's become obvious that they've gained/lost significant weight, but it can be one indicator that something might be wrong.

Bottom line: If it worries you, it's worth a conversation. And on Wednesday, I'll give you some tips about how to do just that.