Mental Health

Hiding in Plain Sight: Lesser-Known Eating Disorders

Diet culture is all around us.

Celebrities market products that promise to “slim” and “shape” us, food items are advertised as void of sugars and fats, and flawless filtered faces stare back at us from our screens. Because of diet culture, a lot of disordered eating is masked as okay, or even impressive. Approximately 30 million Americans will have an eating disorder in their lives, and that statistic is on the rise

Eating disorders thrive in secret. But some lesser-known eating disorders may be even more difficult to recognize and diagnose, we sat down with Terri Griffith, PsyD, a psychologist at Sheppard Pratt’s Center for Eating Disorders.

What are lesser-known eating disorders?

As with any eating disorder, people with lesser-known eating disorders can have a variety of  body shapes and sizes and may not experience significant weight loss at all. A couple of the most common lesser-known eating disorders are ARFID, OSFED, and Orthorexia. 

  • ARFID, or avoidant restrictive food intake disorder, is not driven by negative body image. Instead, those with ARFID often have fear surrounding food that has led them to adopt ritualistic eating patterns or avoid certain foods textures and types. ARFID can sometimes be triggered by a choking incident, individuals who are picky eaters as children, an aversion to certain textures of foods, etc
  • OSFED, or other specified feeding and eating disorder, is used to describe a pattern of disordered eating that does not quite fit the traditional criteria for a specific eating disorder. Those with OSFED may have a preoccupation with weight, rituals around eating, secretive behaviors surrounding food, extreme weight loss or gain, obsessive exercise, increased dental problems, and more.  
  • Orthorexia is categorized by an obsession with eating “clean,” “healthy,” and organic foods free from preservatives, additives, and seasonings. Those with Orthorexia are often at a below average weight because they are not receiving enough nutrients from their food. 

Do these disorders have medical consequences?

Psychological and physiological complications from lesser-known eating disorders can be just as severe as those caused by common eating disorders, including but not limited to: 

  • Nutritional deficits 
  • Weight loss
  • Difficulty regulating body temperature
  • Nerve and circulation problems
  • Tooth decay
  • Esophageal problems
  • Heart problems and more

Who is most at risk for developing an eating disorder?

Contrary to popular belief, all eating disorders – including lesser-known eating disorders –transcend gender, race, sexual preference, and socioeconomic status. While we often hear about young white women with an eating disorder, members of the military, racial minorities, members of the LGBTQ+ community are at a higher risk for developing an eating disorder. Eating disorders can also affect men just like they affect women.

How do you know if you should be concerned about a loved one? 

Many of the symptoms of an eating disorder are not socially acceptable, Dr. Griffith says. Therefore, those suffering tend to decline invitations to social gatherings where food plays a central role. “When someone won’t eat around other people, they could potentially be hiding something,” she says. You may also notice that your loved one is: 

  • Keeping secrets or isolating
  • Preoccupied with weight, food, or calories
  • Canceling plans
  • Skipping meals
  • Neglecting their hygiene
  • Losing interest in work or hobbies
  • Extreme mood swings or otherwise acting strangely

There are many other possible signs and symptoms of an eating disorder, and someone struggling with one generally won’t display all of them at once. And, while these signs could indicate an eating disorder, they could also indicate depression or another serious mental health condition. The first step is to start a conversation with your loved one, and let them know you want to help.

If you or a loved one is struggling with an eating disorder or disordered eating, there is hope! Walk in to one of our Psychiatric Urgent Care locations or connect with a Sheppard Pratt Care Navigator by calling 410-938-5000.

Meet the Expert

  • Terri Griffith, PsyD

    Psychologist, The Retreat by Sheppard Pratt; Clinical Coordinator, The Center for Eating Disorders at Sheppard Pratt
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