Recognizing Eating Disorders

two women walking together

An expert explains common misconceptions and typical symptoms


Robert Wood Johnson University Hospital (RWJUH) Somerset is one of only two hospitals in New Jersey that offer both inpatient and outpatient care for patients with eating disorders. Psychiatrist Shilin R. Pandya, DO, MBS, Medical Director of the Eating Disorders Program, explains who’s at risk for eating disorders and how to recognize the signs.

Which eating disorders are most common?

We often treat anorexia nervosa and bulimia nervosa. But we are seeing more cases of what’s known as avoidant restrictive food intake disorder, which is characterized by picky eating and often affects people with autism spectrum disorder. We also see cases of diabulimia, in which people with diabetes change their insulin dosage to promote weight loss.

Is there a misconception that eating disorders only affect teenaged girls?

Absolutely. Eating disorders don’t spare any gender, generation, culture, religion or socioeconomic class. That said, more patients are female. An estimated 20 million females and 10 million males in the U.S. will develop an eating disorder at some point in their lives. And while symptoms often show up first in the teen years, they can manifest in middle age as well. In older patients, we often see a history of disordered eating that dates back to the teen years but wasn’t addressed. A stressful or depressive episode in midlife can trigger symptoms. We don’t see a lot of elderly patients with eating disorders because these diseases have a high mortality rate.

Do men experience eating disorders?

Yes, but eating disorders in men are under-recognized and stigmatized. Men don’t talk about these issues very much, but they suffer just like women do.

What are the signs of an eating disorder?

Symptoms include rapid weight loss or gain; obsessing about food, nutrition and calories; skipping meals; sores on the backs of the hands or knuckles (from inducing vomiting)  and abuse of medications like laxatives, diet pills and diuretics. Other signs: thinking you’re fat when your weight is normal.. avoiding eating in public; hiding food in a napkin.. constantly checking your body in a mirror.. being overly concerned about your skirt or pants size, and
checking your weight frequently, Many of us do these things fr om time to time, but when these behaviors interfere with your daily functioning and affect your health, it’s important to seek treatment. There’s a serious problem if a person is severely restricting his or her food intake, vomiting after meals, exercising excessively or bingeing and purging.

What types of specialists treat patients with eating disorders?

Our multidisciplinary team includes psychiatrists; therapists; a nutritionist; occupational therapists, who help patients learn to balance daily activities; psychiatric nurses with training in eating disorders.. primary care physicians.. and specialists, such as cardiologists, gastroenterologists and endocrinologists.

If you or a loved one has signs of an eating disorder, what should you do?

Seek help right away, whether it’s from a primary care physician, psychiatrist or psychotherapist. Recovery is possible with proper treatment and support.

Learn more about eating disorders and treatment at RWJ University Hospital Somerset.