Eating Disorder Red Flags You Might Be Missing in Session
Eating disorders are often invisible. Clients don’t need to look a certain way, or even bring up food directly, for disordered eating to be part of their story. Many therapists understandably miss these signs, especially since graduate training often provides little education on eating disorders.
Why Eating Disorders Can Be Overlooked
Stereotypes: Many imagine eating disorders only affect thin, young women. In reality, they impact people of every size, gender, and background.
Shame & Secrecy: Clients may avoid disclosing their behaviors out of fear of judgment.
Cultural Norms: Dieting, food rules, and body dissatisfaction are so normalized that they can blend into “everyday” talk.
Red Flags to Watch For
Frequent negative body talk (“I hate how I look in everything”)
Rigid food rules (“I can’t eat after 7 p.m.”)
Guilt or shame around eating (“I was so bad this weekend”)
Exercise fixation (“I have to work off everything I eat”)
Physical symptoms like dizziness, fatigue, or GI issues with no clear medical cause
How to Respond Without Harm
If you notice these signs, approach with curiosity rather than assumptions. A few weight-neutral questions can open the door:
“How does food impact your day-to-day life?”
“When you think about your body, what feelings come up?”
Avoid comments that reinforce diet culture (e.g., praising weight loss). If an eating disorder seems likely, consider collaborating with or referring to a specialist.
Building Your Skills as a Therapist
If you feel uncertain about navigating these conversations, you’re not alone. Consultation and training can help you:
Understand eating disorder presentations
Build confidence in responding without harm
Integrate HAES and Intuitive Eating principles into your work
If you’d like support, I offer consultation for therapists who want to feel more equipped in this area.
Download my freebie: 12 Go-To Phrases for Talking about Food and Bodies in Therapy.