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Psychological and Emotional Symptoms of Anorexia: Obsessions about food Strong fear of gaining weight Negative body image/dysphoria or distortion Social isolation/withdrawal Irritability Flat affect Numb mood Low self-esteem Behavioral Symptoms of Anorexia: Dieting or fasting in extreme ways Eating only a few specific foods, typically those lower in calories or perceived as healthy Refusing to eat or making excuses to avoid eating Ordering or preparing food, but not eating it Leaving during or right after eating to go to the restroom Lying about how much they ate Chewing and then spitting out the food Excessive and/or compulsive exercising Vomiting and/or abusing laxatives in efforts to avoid weight gain Wearing baggy clothing to hide low weight (if the individual can recognize their thinness) Physical Symptoms of Anorexia: Weight changes Dizziness, feeling faint Low blood pressure Fatigue Feeling cold Dehydration Irregular heart rate Yellowish or dry skin Thinning or brittle hair Bulimia Nervosa Bulimia signs and symptoms may be behavioral, physical, or emotional and psychological: Behavioral Signs: Frequent episodes of binge eating (eating large amounts of food in a short time) Purging behaviors (self-induced vomiting, or misuse of laxatives, diuretics, or enemas) Excessive exercise or fasting after eating Secrecy around eating or disappearing after meals (often to vomit) Ritualistic eating habits (e.g., cutting food into tiny pieces, eating in private) Frequently looking in the mirror for perceived flaws Preoccupation with weight, food, and dieting Physical Signs: Fluctuating weight (can be normal, underweight, or overweight) Swollen cheeks or jaw area (from salivary gland enlargement) Sore throat or chronic sore throat Dental erosion or cavities (due to stomach acid from vomiting) Calluses or scars on knuckles (from inducing vomiting, known as Russells sign) Acid reflux or gastrointestinal problems Dehydration Electrolyte imbalances (can lead to irregular heartbeat or even heart failure) Fatigue or dizziness Emotional and Psychological Signs: Low self-esteem and distorted body image Mood swings, irritability, or depression Feelings of guilt or shame after eating Anxiety, especially around meal times or weight gain Loss of control during binge episodes Binge Eating Disorder People who binge eat often do so in secrecy, hiding their activities because they feel shame or guilt about what they are doing