Whether you have starved at clinical or subclinical levels (less than 1000, or 1000-2000 calories a day respectively); whether you are still in the healthy BMI range or below it; and whether you have starved for just a few months or much, much longer, you are on the restriction eating disorder spectrum when you meet the following criteria:
The Telltale Dozen:
1. Family and friends have shifted from congratulating you on your weight loss and/or your healthier choices to making either careful or even blunt comments that you look too thin, sick, or generally don’t seem to eat enough.
2. You are cold when others are not. You’ve started wearing sweaters when others are in short-sleeves. Sometimes you feel light-headed and dizzy. Other times you feel foggy-headed – like you are listening to others through cotton wool.
3. You are tired and find your mind wanders. You struggle to focus in class or at work. You cannot remember things that others remember easily.
4. You are prone to crying spells and/or explosive bouts of anger (more so than what might be usual). You alternate between wanting to be alone, snapping at family and then finding you are clingy and needy, seeking reassurance from loved ones.
5. Not only do you find it hard to concentrate, but also you find you are absolutely consumed with thoughts of food. When you will eat. What you will eat. What you won’t eat.
6. Facing social circumstances that involve food creates panic: family celebrations, lunches with friends at school, holiday times…in the days leading up to such events you feel extremely anxious and spend a lot of time trying to figure out how to avoid it altogether.
7. The number of rules you assign to when and how will eat keeps getting longer. You have become ritualistic to the point where any deviance causes massive anxiety (the wrong plate, the fork in the wrong place…).
8. You have longer and longer lists of forbidden foods that you will not touch.
9. If you indulge in any food that you consider unacceptable, you are wracked with guilt, self-hatred, loathing and usually ‘punish’ yourself for the transgression (exercising to exhaustion, skipping yet another meal)
10. As a woman, your regular menstrual cycle is irregular or has disappeared completely. Whether you are a woman or man you notice your skin appears dull and dry. Your hair and nails are brittle and perhaps your hair loss seems more pronounced than usual (clumps in the bathtub drain or on your brush).
11. You find yourself promising yourself and others more and more that “tomorrow” will be different. But it isn’t.
12. You lie to loved ones about what you ate that day, or about how much you actually exercised and make excuses for why you cannot eat now. If they are friends or acquaintances, you often fabricate food allergies, intolerances or other reasons why you cannot have the particular item being offered.