How to Recognise Warning Signs of a Restrictive Eating Disorder

Restrictive eating disorders such as Anorexia Nervosa can affect anyone across the lifespan, regardless of gender, background or body weight. They can often begin innocently as a genuine desire for improved health, fitness or “wellness” or dietary restriction can hide under the guise of pursuing vegetarianism, veganism, a detox or to build muscle versus a desire to lose weight. Over time, these restrictive eating patterns +/- exercise routines can become rigid, consuming, and harmful to both mind and body.

At Dietwise, our Credentialed Eating Disorder Clinicians understand the complex physical, emotional, psychological, and behavioural challenges that accompany restrictive eating disorders. Early recognition of the signs and prompt professional support by an eating disorder informed dietitian, can make a significant difference in trajectory of the ED and recovery outcomes. Below, we explore how to recognise some of the signs of a restrictive eating disorder noting that it is possible for a person with Anorexia Nervosa to display a combination of these symptoms, or no obvious symptoms.

Physical Warning Signs of a Restrictive Eating Disorder

Restrictive eating disorders can have serious physical consequences on the body, even when a person doesn’t appear underweight. In fact, the health risk for people in a higher body weight can be more significant, as visible weight loss is applauded and encouraged to achieve a socially constructed thin ideal of beauty which drives the ED. It is important to understand the physical warning signs to be on the lookout as they can result in serious medical instability and require hospital admission in many cases.

Be vigilant and on the lookout for:

Noticeable weight loss, persistent low weight or in young people, failure to gain expected weight
Feeling cold all the time, especially in the extremities such as hands and feet
Fatigue, low energy or weakness
Tingling in the arms and legs, swelling in legs, muscle cramps
Stress fractures, bone pain, abnormal bone density scan results indicating such as osteopenia or osteoporosis
Dizziness, light-headedness or fainting, especially on standing
Chest pain
Slowed heart rate (bradycardia) or fast heart rate (tachycardia)
Low blood pressure
Frequent complaints of abdominal pain, nausea, bloating, or constipation, feeling full quickly, acid reflux
For females assigned at birth, irregular, missed, or lighter-than-usual menstrual periods
Symptoms of low blood sugar (hypoglycaemia) — such as shakiness, sweating, , headaches, blurred vision
Abnormal blood results such as low iron, elevated liver enzymes, low potassium, sodium, magnesium and phosphate
Brain fog, difficulty concentrating, making decisions or thinking clearly
Hair thinning, brittle nails, dry skin, yellow skin (carotenemia from eating large amounts of carrots) or fine hair on the face and body (lanugo)
Cuts and calluses across the top of finger joints (a result of inducing vomiting)
Dental problems, swollen chipmunk cheeks (enlarged salivary glands form self-induced vomiting)
Frequent illness or poor wound healing
Trouble sleeping or insomnia

These signs often but not always, reflect the body’s struggle to function without adequate calories and nourishment. Even subtle physical changes should be taken seriously — the body gives important clues long before outward appearance reflects the severity of the illness. It is important to note that if some of these symptoms are present, it is important to have an appointment with your GP to also exclude other potential underlying causes that also may co-exist alongside an ED.

Behavioural Warning Signs of a Restrictive Eating Disorder

Behavioural changes are often the most visible signs of a restrictive eating disorder. These behaviours can emerge subtly and slowly over time or have a sudden onset. A key hint that an eating disorder may be developing is that previously flexible eating patterns become rigid and rule driven, and these new behaviours represent a change from previous behaviours. It is important to note that people with neurodivergence such as Autism or ADHD may present with rigidity and inflexibility regarding food and eating that is related to sensory preferences, nervous system regulation and felt safety. Our Dietitians are neurodiversity affirming and are skilled to screen for an ED on the background of diagnosed or suspected neurodivergence.

Common behavioural signs to be on the lookout for include:

Preoccupation with weight, food and calories including reading food labels and weighing and measuring food, watching mukbang videos, reading cookbooks, collating elaborate Pinterest boards of recipes
Skipping or delaying meals which can include fasting periods during the day and eating the family meal at dinner
Avoiding eating by saying “I forgot”, “has already eaten”, “is not hungry”, “will eat later”, “feels sick”
Eating noticeably smaller serves or wanting to have control over serving own food
Avoiding certain food groups such as carbs, liquid calories such as milk or juice, avoiding fats such as nuts, avocado, mayonnaise or spreads, picking out cheese from dishes
Noticeable anxiety or irritability before, during and after mealtimes
Frequent trips to the toilet or showering immediately or shortly after eating
Wanting to eat alone, not participating in family meals or a sudden need to know what’s for dinner
Secretive eating including hiding, discarding, or lying about eating food
Wanting to supervise and control food prepared by others or insisting on preparing own food
Lack of flexibility with eating different brands of the same food or sticking to rigid mealtimes
Increased fluid intake which can include large amounts of coffee, energy drinks, or diet soft drinks or drinking too little
Patterns of obsessive rituals around food such as wanting to use specific cutlery or crockery, eating food in a certain order, only eating 4 strawberries
Odd eating behaviours such as cutting, dissecting, crumbling or breaking food into tiny pieces, eating very slowly or very fast or excessive use of condiments
Cooking elaborate meals or new interest in baking for others but not eating it
Making frequent comments about feeling “fat” or perceived body flaws and heightened sensitivity to comments about weight, eating, shape or exercise
Wearing layers or loose clothing to hide body shape or weight loss
Frequent weighing or body checking behaviours, such as constantly touching or measuring body parts such as thighs, waist or arms, pinching stomach, taking selfies, comparing body size to others, or spending long periods examining one’s reflection
Compulsive, excessive or rigid exercise routines and feeling a strong sense of agitation, guilt or anxiety if unable to exercise
Exercising despite injury, illness, fatigue, time of day, or extreme weather, or prioritising exercise over rest, recovery, or social commitments
Using exercise to “compensate” for calories eaten

These behaviours are not about vanity or discipline — they can be symptoms of a serious mental illness. Recognising these subtle, gradual changes is an important step toward early intervention and recovery.

Psychological and Emotional Warning Signs of a Restrictive Eating Disorder

Restrictive eating disorders are often fuelled by distorted thinking and obsessive focus on food, body image, and control. You may notice:

Extreme body dissatisfaction which can include distorted body image — seeing oneself as larger or “unhealthy”
Intense fear of gaining weight or becoming “fat”
Preoccupation with food, eating, weight and shape
Black-and-white thinking about food such as “good” vs. “bad” foods
Irritability, anger, anxiety and mood swings particularly around food
Feeling zoned out or emotionally numb
Emotional dysregulation, where emotions feel intense, unpredictable, or difficult to manage resulting in meltdowns or emotional outbursts
Increased feelings of overwhelm and anxiety, difficulty making decisions
Low mood or persistent sadness
Intense feelings of guilt, shame or self-loathing after eating
Low self-esteem and poor body image
A strong need for control, increasing perfectionism or detail focused
Suicidal ideation or self-harm
Substance misuse

These psychological and emotional experiences can be overwhelming and isolating. It’s important to remember that they are not a choice — they are symptoms of an illness that deserves care, understanding, and professional support.

Social Warning Signs of a Restrictive Eating Disorder

Eating disorders often lead to withdrawal from friends, family, and social activities. Some common signs to look out for from a social perspective include:

Avoiding social activities involving food such as eating out
Making excuses not to eat with others and wanting to eat alone
Withdrawing from friendships or isolating from family
Losing interest in hobbies or activities previously enjoyed
Heightened anxiety around shared meals with family and friends

Social withdrawal is not a lack of interest in others — it’s often driven by fear, shame, or anxiety about eating in front of people when an ED has hijacked the brain. These patterns can deepen feelings of loneliness and disconnection, reinforcing the illness further which is why an ED is often called a life thief.

Why Early Detection and Support Matters

Restrictive eating disorders can have serious health consequences, but early intervention can significantly improve recovery outcomes. Recovery isn’t simply about eating more — it involves addressing the underlying factors that maintain the eating disorder, hence why best practice care involves the skills and collaboration of a multidisciplinary team.

The longer restrictive patterns continue, the harder they can be to reverse as they ED becomes more entrenched. That’s why seeking help as soon as possible — even if symptoms seem mild — is so important. You don’t have to “look sick” or meet a specific weight criteria to deserve support and treatment.

At Dietwise, we recognise that recovery is not a straight line and looks different for everyone. Our dietitians work alongside clients at every stage— from screening for an ED, to renourishing the brain to building a peaceful and attuned relationship with food, eating and body that honours neurodiversity if relevant.

How Dietwise Dietitians Can Help You

We foster a brave and hopeful space where our clients feel safe, supported, and empowered. We believe that recovery is possible and that it’s never too early or too late to begin the path to recovery. Our team of Credentialed Eating Disorder Clinicians provide specialised, evidence-based support for individuals experiencing restrictive eating disorders.

We offer:

Comprehensive nutritional assessment and screening
Collaboration with GPs, Psychologists, Psychiatrists, Paediatricians, Physiotherapist/Exercise Physiologists and Recovery Coaches to ensure holistic care
Nutrition rehabilitation and meal support therapy
Therapeutic support that is trauma-informed and neurodiversity affirming
Family-inclusive care for children and adolescents

At Dietwise, our approach is grounded in compassion and respect. We focus on empowering each person to rediscover trust in their body, rebuild confidence, and reconnect with life beyond the eating disorder. We provide compassionate, evidence-based care for people of all ages and backgrounds, supporting recovery with expertise, empathy, and respect.

If You’re Concerned About Yourself or Someone You Care About

If you or someone you love is struggling with eating concerns and you recognise any of the signs described above, please remember — you don’t have to face this alone. Help and recovery are possible with the right support. Reaching out is a courageous first step. You don’t need to have everything “figured out” or know for certain that you have an eating disorder. Simply starting a conversation can open the door to healing. We are ready to get started on your recovery journey, either in person or via Telehealth or a combination of both.

At Dietwise, our Care Coordinator can guide you through the next steps and connect you with the most appropriate Dietitian to suit your needs. Call our Care Coordinator on (08) 9388 2423 or email reception@dietwise.net.auWe’re here to listen, support, and help you begin the journey toward recovery — with compassion, respect, and expertise. All our other dietitians are also available for in-person or telehealth consultations with appointments available weekdays from 9am to 6pm and Sonya, Caylah and Eryn available on Saturday mornings from 8am to 1pm.

You deserve support. You deserve nourishment. You deserve recovery.

Written by:

Sonya Douglas

Principal Accredited Practising Dietitian & Credentialed Eating Disorder Clinician