Previously I have discussed relapse.  Now I would like to put together a short list of concerning symptoms to be aware of. These symptoms, should they occur, must prompt a closer inspection and possible reevaluation by your eating disorder team.

1.    Obviously, weight loss.  Any weight loss of more than 5 pounds is very, very concerning.  Do not wait until five pounds has become ten. Add calories (food) to arrest the weight loss promptly.  If you meet with resistance, consider this a sign you need help now.

2.    Increasingly limited food choices, especially fat limitation and its proxy: medically unconfirmed “lactose intolerance”

3.    Ever-diminishing amounts of food eaten

4.    Social isolation, insisting on eating alone or being “so busy with homework” that they cease doing things with friends

5.    Refusing meals on the grounds “I ate already”. If you encounter this, inquire exactly what was eaten, when and where

6.    Body checking (constantly holding one’s wrist with the opposite hand or feeling stomach or waist)

7.    Compulsive weighing

8.    Constant comments about other people’s weight

9.    Unexplained up-tick in exercise or physical activity, but no increase in food

10.    Any signs of bingeing or purging mandate a return to treatment.  It is not normal to throw up food “sometimes”.  No amount of purging is acceptable and bingeing will drive a person to acts of desperation.

11.    Finding medication, which you thought they were taking consistently, in the sofa, on the floor, in the garbage, etc.

I’ll bet some experienced parents out there in cyberspace could add to this list!