Public understanding of eating disorders is often shaped by narrow narratives that focus on appearance instead of experience. But in reality, eating disorders are more complex, more diverse, and more insidious than those stereotypes allow. They don’t always announce themselves. Sometimes, they develop behind good grades, clean eating, anxiety, or limited access to food.
Lesser-known traits and experiences that may be tied to disordered eating, especially in the early stages. These aren’t diagnostic criteria or checklists. They’re windows into how eating disorders can take root, persist, or remain hidden in plain sight. Understanding them can help us recognize what’s often overlooked and shift how we approach therapy for eating disorders. By noticing what doesn’t typically get flagged—the routines, reactions, and rationalizations that seem benign—we can create space for earlier intervention, more individualized care, and a deeper awareness of the many forms disordered eating can take.
1. Discipline Isn’t Always Healthy: The Mask of Compulsive Exercise
In a culture that equates discipline with virtue, compulsive exercise is often celebrated rather than questioned. This isn’t limited to athletes. From CrossFit culture to social media fitness influencers to “no excuses” workout slogans, we’re constantly shown that more is better, and that pushing through pain is a moral good. When overexercising is framed as admirable, warning signs are easy to miss.
But for individuals with eating disorders, exercise isn’t always about strength or endorphins. It can become a rigid, punishing behavior driven by anxiety, obsession, or the perceived need to “undo” food intake. In some diagnoses, like bulimia nervosa, excessive exercise may be a form of purging. In others, like anorexia nervosa, movement is often tracked alongside calories with painstaking intensity. The fixation isn’t always visible, but its role can be deeply entrenched.
2. Diets, Wellness, and the Normalization of Restriction
Not everyone with an eating disorder avoids food entirely. Some follow diets. Some eat only “healthy.” Some cut out whole categories of food in the name of wellness.
Extreme or rigid approaches to eating can fly under the radar precisely because they’re so common. A person might be praised for weight loss, for ordering the salad, for “taking care of their health.” But what looks like motivation or willpower may actually be rooted in fear, shame, or a deeper pattern of disordered eating. When restriction is a reflection of the broader impact of diet culture, and cloaked in the language of wellness—clean eating, detoxing, or cutting out “inflammatory” foods—it becomes harder to spot.
In some cases, the patterns align with orthorexia: an obsessive focus on purity or health that begins to interfere with daily life. In others, it may be more about low-calorie eating, “safe” foods, or strict weight loss rules that reflect anorexia or another eating disorder. And for people in larger bodies, restriction is often medically prescribed, making it even more difficult to identify when a diet crosses the line into disordered territory. The reality is that many eating disorders don’t look like what people expect, especially when the behaviors they’re built on are applauded.
3. The High Achiever Paradox: When Malnourishment Hides in Plain Sight
When someone excels in school, work, or creative pursuits, few people pause to ask whether they’re eating enough to function. And yet, many individuals with eating disorders, particularly anorexia nervosa, continue to perform at an astonishingly high level, even while significantly malnourished. This is one of the most confounding and dangerous aspects of the illness: the ability to over-function while the body and brain are running on empty.
Certain temperament traits commonly associated with eating disorders can play a role in this paradox. Perfectionism, rigidity, and an intense drive for achievement often appear in individuals with anorexia nervosa. Impulsivity may show up more frequently with bulimia nervosa or binge eating disorder. These traits are not diagnostic criteria, nor are they always present. But they can shape how disordered eating is expressed and, importantly, how long it goes undetected.
Because these patterns are often praised in other contexts, they can shield the eating disorder from view. A student who wakes up at 4 a.m. to finish homework before sports practice may be labeled responsible. A young adult who controls every aspect of their schedule and diet might be seen as “disciplined” or “driven.” But behind the productivity and precision, disordered eating may be quietly stealing physical and emotional resources. By the time someone begins to show more obvious signs—fatigue, irritability, withdrawal—the damage may already be significant.
4. Depression, Anxiety, and PTSD: What You See May Not Be the Whole Story
Eating disorders rarely exist in isolation. Depression, anxiety, and PTSD are among the most common co-occurring conditions, and in many cases, they’re the symptoms most visible to others. Loved ones, providers, and even the individual themselves may recognize and seek help for panic attacks, insomnia, or trauma-related distress, while disordered eating patterns remain private, rationalized, or entirely hidden from view.
Part of this concealment comes from the secrecy and shame that so often surround eating disorders. But secrecy isn’t always rooted in shame. Some eating disorders can be egosyntonic, meaning the behaviors align with the person’s self-image or values. Restriction, rituals, and even binge-purge cycles may feel purposeful, not problematic. The eating disorder is protected, not disclosed. Someone might openly discuss their anxiety in therapy while skipping over the part where they punish themselves with food. A trauma survivor may be in active treatment for PTSD while adhering to rigid food rules that feel too personal—or too necessary—to mention. In some cases, the eating disorder remains invisible not because it is less severe, but because the individual has not yet recognized its role in their suffering.
Recognizing the link between disordered eating and other mental health symptoms can offer new clarity. Sometimes, what looks like anxiety or trauma alone is part of a more complex story. . . one that includes a struggle with food that hasn’t yet been named.
5. Food Insecurity and Its Aftermath
Not all disordered eating is rooted in body image. For many people, particularly those impacted by poverty, chronic illness, or caregiving demands, their relationship with food has been shaped by survival, not choice.
Skipping meals to feed a child. Stretching one meal across several days. Feeling shame about eating in front of others. These patterns often begin as pragmatic responses to scarcity, but over time, they can take on psychological weight. Studies show a strong association between food insecurity and eating disorder behaviors in both adults and adolescents. Individuals who have experienced food scarcity are significantly more likely to engage in restrictive eating, binge eating, and compensatory behaviors such as vomiting, fasting, or laxative use. What starts as survival can calcify into rituals of anxiety, rigidity, or restriction.
It’s important to distinguish between food insecurity and an eating disorder, but it’s equally important to recognize where they intersect. Structural barriers to care, cultural stigma, and the normalization of food scarcity in certain communities can make it harder to identify an eating disorder when it’s masked by hardship. Survival strategies can linger long after conditions change, and given the long-term effects of disordered eating, they deserve the same care and attention as any other mental health concern.
6. Not Just “Picky Eating”: When ARFID Is the Real Story
Some forms of disordered eating don’t look like restriction, purging, or body dissatisfaction. They look like an extreme aversion to certain textures. A limited list of “safe” foods that hasn’t changed in years. Panic at the idea of eating outside the home. Meals skipped not out of defiance or control, but because the sensory overload is too much to bear.
For many people—especially children—these patterns are written off as developmental quirks or something they’ll eventually grow out of. But when the impact is significant enough to affect health, growth, or daily life, what’s often called “picky eating” may actually fall under the diagnosis of ARFID: Avoidant/Restrictive Food Intake Disorder.
ARFID isn’t a new experience, but it’s a relatively new framework that brings together sensory sensitivity, fear-based avoidance (like choking or vomiting), and low appetite or disinterest in food under one clinical umbrella. That framework matters. It can offer a way to name something that’s long been misunderstood, dismissed, or treated as a behavioral issue rather than a mental health one.
Recognizing ARFID doesn’t just validate the struggle. It can open the door to more appropriate support, more compassionate care, and more effective treatment, especially for those who’ve felt for years like nothing quite described their experience.
Changing the Lens on Eating Disorder Symptoms
Eating disorders are often described as invisible, but it’s not always because the signs are hidden. Sometimes, they’re simply misunderstood, dismissed, or reframed as something else entirely: discipline, anxiety, sensitivity, survival. When we expand our lens beyond the body and toward the behaviors, patterns, and contexts that surround food, a clearer picture begins to emerge. One that challenges the binary of “sick enough,” and invites earlier recognition, earlier intervention, and greater compassion for the complexity of each person’s experience.
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