It starts quietly. Maybe someone skips a meal and calls it “not being hungry.” Maybe they spend twenty minutes in the bathroom after dinner — and nobody asks why. Maybe they’ve lost weight, and everyone around them keeps saying “you look amazing” without noticing the fear behind the smile.

Eating disorders don’t announce themselves. They don’t arrive with warning labels or dramatic scenes like the ones you see in the movies. They build slowly — wrapped in discipline, wrapped in control, and wrapped in a silence that nobody thinks to question. And by the time someone close to you (or you yourself) realizes something is wrong, the disorder has already put down deep roots. As a psychologist in Chania with specialized certification in Mindful Eating and CBT for eating disorders, I’ve worked with people who lived with anorexia or bulimia for years before anyone — including themselves — recognized it. Not because they weren’t smart. Not because they weren’t self-aware. But because eating disorders are masters of disguise. They hide behind “healthy habits,” behind compliments about weight loss, behind a culture that often rewards restriction and punishes appetite.

This article isn’t a clinical checklist. It’s a conversation — the kind I wish more people would have before things reach a breaking point. I’m going to walk you through 10 warning signs that most people miss, and some of them might surprise you. If you’re reading this because you’re worried about yourself or someone you love — you’re already doing something brave. Keep reading. And know that whatever you discover in these pages, there is a path forward.

What Eating Disorders Really Look Like

Let’s clear something up. Eating disorders aren’t about food. Not really. They’re about control, emotions, pain, identity — and a relationship with the self that has gone off course. Food is just the battlefield. The real war is internal.

Most people picture eating disorders as extreme thinness or dramatic episodes of purging. And yes, those can be part of the picture. But here’s what I’ve learned after years of clinical practice: some of the most severe eating disorders I’ve encountered were invisible to the outside world. The person looked “normal.” They went to work, socialized, smiled at family gatherings. And nobody suspected that every single meal was a source of terror.

Anorexia nervosa involves severe restriction of food intake, an intense fear of gaining weight, and a distorted perception of one’s own body. Bulimia nervosa involves episodes of consuming large amounts of food followed by compensatory behaviors — vomiting, excessive exercise, fasting, or misuse of laxatives. But these clinical definitions, while accurate, don’t capture the human experience of living inside these conditions. One of my clients once described it this way: “It’s like two people live in my head. One wants to eat. The other won’t let me.” That image has stayed with me for years — because it captures something no textbook can. The constant internal conflict. The exhaustion of it. The loneliness of fighting a battle nobody else sees.

Eating disorders aren’t a choice, a phase, or a “diet gone wrong.” They’re serious mental health conditions — and they respond to treatment. The American Psychiatric Association recognizes eating disorders as among the most fatal psychiatric disorders, while emphasizing that early identification and treatment are important for lasting recovery.[8] And it’s something I’ve witnessed in my own practice here in Chania: with the right support, recovery is absolutely possible. But the first step is recognition. You can’t address what you can’t see. So let’s talk about what to look for.

The 10 Signs Your Body and Mind Are Sending

These aren’t always obvious. That’s exactly the point. Eating disorders are experts at hiding in plain sight — and some of these signs might look like “normal” behavior, especially in a culture that celebrates thinness and self-control. But when several of them appear together, they form a pattern that deserves attention.

Changes in Eating Habits and Body Obsession

The first sign isn’t always about eating less. Sometimes it’s about eating differently. Suddenly cutting out entire food groups. Insisting on eating alone. Spending an unusual amount of time reading nutrition labels or counting calories with an intensity that feels almost religious. Creating rigid food rules — “I don’t eat after 6pm,” “I can’t mix carbs with fats,” “I only eat clean.”

Here in Crete, where food is a central part of life and social connection, these changes can be especially visible — and especially painful. Refusing a plate of food that someone’s grandmother made with love isn’t just a dietary choice. It’s a fracture in connection. And when it happens repeatedly, it’s worth asking: is this about health, or about something deeper?

The second sign is obsession with body image. Not the normal dissatisfaction that honestly most people experience to some degree, but a consuming preoccupation. Checking the mirror constantly. Weighing themselves multiple times a day. Changing outfits five times before leaving the house. Asking “do I look fat?” in a way that no answer can satisfy. When someone’s entire mood depends on what the scale says that morning — that’s a red flag worth paying attention to.

Third: noticeable weight changes. I want to be careful here — weight fluctuation alone doesn’t indicate an eating disorder. But sudden, significant weight loss (especially when the person insists “I’m fine”) or weight that swings unpredictably up and down can signal something serious underneath. This is particularly true when the weight change doesn’t match what the person claims to be eating.

Emotional and Behavioral Warning Signs

The fourth sign is withdrawal from social situations — especially those involving food. Avoiding dinner with friends. Making excuses to skip family meals. Eating before arriving at a gathering so they “won’t have to eat in front of people.” In Chania, where so much of social life happens around a table — think coffee by the harbor, long Sunday lunches, holiday gatherings — this withdrawal can feel especially isolating. And it almost always gets worse with time.

Fifth: excessive exercise that doesn’t feel joyful. There’s a real difference between someone who loves running and someone who runs because they “have to burn off” what they ate. Compulsive exercise — exercising through injury, through illness, through exhaustion, feeling panicked if a workout is missed — is one of the most overlooked signs of an eating disorder. It’s often praised as “dedication” or “discipline” when it’s actually desperation.

Sixth: mood changes that seem disproportionate. Irritability around mealtimes. Sudden tearfulness. Anxiety that spikes whenever food is mentioned. Emotional numbness at other times. Eating disorders directly affect brain chemistry — malnutrition changes the way your brain processes emotions. So if someone’s personality seems to shift alongside changes in their eating patterns, don’t dismiss that connection. It matters.

The seventh sign is secrecy. Hiding food. Eating in secret. Disposing of food so it looks like it was eaten. Going to the bathroom immediately after every meal. Secrecy is one of the hallmarks of both anorexia and bulimia — because shame drives the disorder underground, where it grows undisturbed. And the longer the secrecy continues, the harder it becomes to break through.

Physical Signs That Something Is Wrong

Eighth: physical symptoms that don’t have an obvious medical explanation. Constant fatigue. Hair loss or thinning. Feeling cold all the time, even in summer. Dental problems — this one is especially common in bulimia, because stomach acid damages tooth enamel over time. Dizziness. Fainting. Persistent digestive issues. These are your body’s distress signals, and they’re worth listening to.

Ninth: perfectionism and rigidity that extends far beyond food. If someone is extremely rigid about eating AND about other areas of life — work, appearance, schedules, cleanliness, performance — the pattern matters. Eating disorders rarely exist in isolation. They’re usually part of a bigger picture that involves a deep need for control. Ever noticed how the person who can’t eat without calculating every calorie is often the same person who can’t relax about anything else either? That connection isn’t accidental.

And the tenth sign? Denial. Fierce, absolute denial that anything is wrong. “I’m just being healthy.” “Everyone diets.” “You’re overreacting.” This is perhaps the most painful sign for loved ones — because you can see what’s happening, but the person can’t. Or won’t. And that gap between what you observe and what they admit can feel impossible to bridge. If you recognized three or more of these signs in yourself or someone you care about — please, don’t wait. Early intervention is one of the strongest predictors of recovery.

You don’t have to figure this out alone. If something in this article feels familiar, consider taking the first step. Book a free 20-minute introductory session with me — no pressure, no commitment. Just a safe conversation about what you’re experiencing and what might help. Contact me here →

Why These Warning Signs Go Unnoticed

There’s a painful irony at the heart of eating disorders: the people closest to someone often don’t see what’s happening until the disorder is well-established. This isn’t because they don’t care. It’s because eating disorders are designed to be invisible — and our culture makes them even harder to spot.

We live in a world that celebrates thinness, “clean eating,” and extreme discipline around food. So when someone starts restricting their intake or exercising compulsively, the first response is often admiration. “You look incredible!” “I wish I had your willpower!” These compliments — well-intentioned as they are — pour fuel on the fire. They reinforce the disorder’s voice. And they make the person even less likely to seek help, because seeking help would mean admitting something is wrong with the thing everyone praises.

In my experience (and this is something I feel strongly about), the cultural pressure around body image is especially complicated in Mediterranean cultures. Here in Greece, there’s a contradiction that many of my clients describe: on one hand, food is love — your grandmother will be offended if you don’t finish everything on your plate. On the other hand, there’s enormous pressure to maintain a specific body type, especially in summer. Sound familiar? This push-and-pull creates a perfect environment for disordered eating. I’ve seen this pattern again and again — in my office in Chania, in online sessions with Greeks living abroad, in conversations that start with “I don’t know when it began, but I can’t stop.”

Shame is another reason these signs stay hidden. People with eating disorders often become incredibly skilled at concealing. They develop elaborate systems — lying about what they’ve eaten, wearing loose clothing, timing their bathroom visits so nobody notices. They’re not doing this to deceive the people who love them. They’re doing it because the shame feels unbearable. And shame always thrives in silence.

There’s also a dangerous belief that eating disorders only affect teenage girls. That’s simply not accurate. Adults in their 30s, 40s, and 50s develop eating disorders. Men develop eating disorders. Eating disorders affect up to 5% of the population, and while they’re more common among girls and women, they affect people of all genders, body sizes, ages, and socio-economic backgrounds.[8] According to Savina Anastasaki, MSc Clinical Psychologist and certified specialist in Mindful Eating and CBT for eating disorders based in Chania, “One of the biggest barriers to getting help is the misconception that eating disorders have a specific ‘look.’ They don’t — and that misconception costs people years of unnecessary suffering.”

The truth is: if something feels wrong around food — if eating has become a source of anxiety, control, or punishment — that’s reason enough to talk to a psychologist. You don’t need to meet every diagnostic criterion to deserve support.

The Real Cost of Ignoring the Signs

I won’t sugarcoat this part. Eating disorders — when left without treatment — can cause lasting damage. This isn’t written to frighten you. It’s written to motivate you to act, because the earlier someone receives help, the better the outcome tends to be.

Physically, the consequences are serious. Anorexia nervosa often has its onset during adolescence or early adulthood and is associated with premature death due to medical complications or suicide.[1] Bulimia can cause severe dental erosion, esophageal tears, dangerous electrolyte imbalances, and kidney problems. Individuals with bulimia nervosa are at a significantly increased risk for substance use, suicidality, and health complications.[1] This isn’t an exaggeration — eating disorders have the highest mortality rate of any psychiatric disorder.[3]

But the cost isn’t only physical. Emotionally, untreated eating disorders erode a person’s sense of self. Their identity becomes consumed by the condition. Relationships suffer — because it’s hard to be present with the people you love when you’re in constant warfare with your own body. Career and daily performance decline. The world gets smaller. And the longer this continues, the harder the recovery becomes. Not impossible — I’ve seen people recover after years — but harder.

I’ve worked with people who spent five, ten, even fifteen years living with an eating disorder before seeking professional help. And while they did recover (which is the important part), every single one of them said the same thing: “I wish I’d come sooner.” That sentence comes up so often in my practice that it’s almost a refrain. And it motivates me to write articles like this one. Because if these words reach even one person earlier, it was worth every minute.

Here’s what I want you to understand: the right time to seek help isn’t when things become unbearable. It’s before that. It’s now. You don’t need to wait until you’re in crisis. If food has become a source of fear, guilt, or obsession — that’s enough. You deserve support. Period. As a BACP-registered psychotherapist with specialized training in both CBT and Mindful Eating approaches for eating disorder therapy, I’ve seen how early intervention completely changes the path of recovery. The patterns are easier to identify and restructure. And hope — real, grounded hope — arrives much faster.

How Therapy Can Change Everything

So what does recovery actually look like? Not the Instagram version. The real one.

It starts with something simple — and terrifying. It starts with talking. With sitting across from someone (in a therapy office, or through a screen in an online counseling session) and saying out loud what you’ve been hiding. That first conversation is often the hardest thing my clients have ever done. And it’s also the most important. There’s nothing you can say that I haven’t heard before. And nothing — absolutely nothing — that would make me think less of you.

In individual therapy for eating disorders, I use an integrative approach. That means I don’t rely on a single method. Instead, I draw from the tools that work best for each specific person. Cognitive-behavioral therapy (CBT) forms the backbone of most treatment plans, because it directly addresses the distorted thoughts about food, weight, and body image that keep the disorder alive. Bulimia nervosa is best treated with CBT[3], as recommended by the APA’s updated practice guidelines. But CBT alone isn’t always the whole answer. That’s why I also incorporate elements of Mindfulness-Based Cognitive Therapy (MBCT) — which helps clients reconnect with their bodies in a way that isn’t punishing. With my diploma in MBCT and my certification in Mindful Eating, I’ve developed an approach that treats both the thoughts and the physical relationship with food simultaneously.

Someone I worked with recently described their experience this way: “For the first time, I ate something without mentally calculating how many calories I’d need to burn afterward. It was just a meal.” That moment — that quiet, ordinary moment — is what recovery can look like. Not a dramatic revelation. Just peace where there used to be war.

What therapy does, at its core, is interrupt the cycle. The cycle of restrict–binge–purge–shame–restrict. Or the cycle of restrict–deny–isolate–restrict. These patterns feel unbreakable from the inside. I know that. But from the outside — with the right support and the right evidence-based tools — they’re not. They’re learned behaviors. And what’s been learned can be unlearned. Honestly? I think CBT combined with mindfulness is one of the most underestimated combinations we have for eating disorders. And I say that after years of watching it transform people’s relationships with food.

I also want to address something that comes up in almost every first session: the fear that therapy will “make me gain weight” or “take away my control.” I understand that fear completely. It makes perfect sense within the logic of the eating disorder. But here’s what I can tell you from my clinical experience: therapy doesn’t take away control. It gives you real control — the kind that doesn’t depend on a number on the scale. The kind that lets you live your life fully, not just survive it.

For Greeks living abroad — in Germany, the UK, Australia, Canada, or anywhere else — online psychotherapy sessions offer a way to work with a psychologist online who speaks your language and truly understands the cultural context. Because food, family, body image, and the pressure to appear “fine” — these things carry different weight in Greek culture. And having a psychologist who understands that difference isn’t optional. It’s essential. I work with Greeks abroad regularly, and one of my clients once told me: “I tried explaining to my therapist here why my mother’s comments about my weight hurt so much. She didn’t get it. She said I was overreacting.” That’s not something you’d have to explain to me. I get it. Because I’ve lived in the same culture.

Recovery from an eating disorder isn’t about becoming a “normal” eater. It’s about becoming free. Free from the fear. Free from the shame. Free to sit down at a table with people you love — and actually enjoy the meal.

If you’re ready to take that first step — or even if you’re not sure yet — I’m here. Sometimes the bravest thing you can do is just have an honest conversation. Schedule your free 20-minute session and let’s talk about what you’re going through. No pressure. No judgment. Just a safe space for you to be honest. Learn more about eating disorder therapy →

When to Ask for Help

You don’t need to check every box on a diagnostic manual to deserve support. One of the biggest myths about eating disorders is the idea that you need to be “sick enough” before you ask for help. You don’t. And waiting for things to get worse before seeking support is one of the most common — and most costly — mistakes I see.

Here are some signs that it’s time to talk to a psychologist: you think about food, weight, or your body more than feels normal. Meals cause anxiety instead of nourishment. You’ve developed rules around eating that feel impossible to break. You’ve noticed physical symptoms — fatigue, hair loss, digestive problems, feeling cold when others feel warm. Your relationships are suffering because of how you relate to food. You feel trapped in a cycle you can’t stop. Even one of these is enough to pick up the phone.

And if someone close to you has expressed concern about your eating — even if you disagree — consider that they might be seeing something you can’t. Eating disorders distort perception. That’s part of the condition itself.

Seeking help isn’t weakness. It isn’t giving in. It’s one of the strongest things you can do — choosing yourself over the disorder. My office in Chania (and my online sessions, for those who aren’t nearby) is a space where you can say everything. No filter. No judgment. Whatever you’re carrying — you don’t have to carry it alone. The first step is always the hardest. But it’s the one that changes everything. Learn more about how therapy works →

Frequently Asked Questions

What is the difference between anorexia and bulimia?

Anorexia nervosa primarily involves severe restriction of food intake, intense fear of weight gain, and distorted body perception. Bulimia nervosa involves cycles of eating large amounts of food followed by compensatory behaviors like vomiting, excessive exercise, or fasting. Both are serious mental health conditions, and both respond well to professional treatment. Cognitive-behavioral therapy (CBT) is one of the most effective approaches for both.

Can someone have an eating disorder without looking underweight?

Absolutely — and this is one of the most common misconceptions. There is no eating disorder “look” — most people affected are not underweight.[3] You can be at a “normal” weight or a higher weight and still have a severe eating disorder. The external appearance doesn’t reflect the internal struggle, which is why professional evaluation from a psychologist matters.

How effective is online therapy for eating disorders?

Online therapy has proven highly effective for eating disorders, especially when using evidence-based approaches like CBT and MBCT. I work with clients across Greece and with Greeks abroad through online sessions, and the therapeutic connection is just as strong as in-person work. The most important factor isn’t the medium — it’s the quality of the relationship between therapist and client, and the expertise of the psychologist.

How long does treatment for an eating disorder usually take?

There’s no single timeline that fits everyone. Some people experience significant improvement within a few months of starting therapy. Others need longer-term support — especially if the eating disorder has been present for many years. What I can tell you is that early intervention typically leads to faster recovery. The sooner you start with a psychologist, the better the outcome.

Can eating disorders come back after treatment?

Recovery is real and lasting for many people. But it’s honest to say that eating disorders can have a relapsing pattern — especially during times of high stress. That’s why therapy doesn’t just address symptoms in the moment. It builds long-term skills and strategies that help you maintain your recovery even during difficult periods. As a psychologist in Chania, I also offer follow-up sessions for former clients who want ongoing support.

How can I help someone I love who might have an eating disorder?

Express your concern with love, not accusation. Avoid commenting on their weight or appearance — even positive comments can reinforce the disorder. Don’t monitor their eating or turn mealtimes into a battleground. Instead, you might say: “I’ve noticed you seem stressed around food lately. I’m worried about you. I’m here whenever you want to talk.” And encourage them to speak with a psychologist — even a single conversation can make a difference.

Does Savina Anastasaki offer specialized treatment for eating disorders?

Yes. As a certified specialist in Mindful Eating and CBT for eating disorders, with additional training in Mindfulness-Based Cognitive Therapy (MBCT) and NLP, I offer evidence-based treatment tailored to each individual. Sessions are available in person at my office in Chania, Crete, and online for clients across Greece and abroad. Book a free 20-minute introductory session to discuss your specific needs.

If you’ve read this far, I want you to know something that I tell every person who sits across from me for the first time. Whether you’re worried about yourself or about someone you love — the fact that you’re here, reading these words, means you already sense that something matters. Trust that instinct. Don’t dismiss it.

Eating disorders grow in the space between “something feels wrong” and “but it’s probably nothing.” This article was written to close that space — to give you the words for what you might be seeing but can’t yet name. I’ve sat across from many people in my office in Chania who started exactly where you are right now — uncertain, scared, not sure if what they’re experiencing is “bad enough” to deserve help. Every single one of them discovered that it was. And that the help was closer than they imagined.

You deserve to have a peaceful relationship with food. You deserve to look in the mirror without fear. You deserve to eat a meal and simply enjoy it — with the people you love, without the guilt, without the counting, without the war. And you can. Based on the clinical experience of Savina Anastasaki, MSc Clinical Psychologist and specialist in CBT and Mindful Eating based in Chania, I can tell you: I’ve seen this happen hundreds of times. And I’d be honored to help you make it happen too. If you’re ready, contact me for a free 20-minute conversation. No pressure. Just a first step. And sometimes, that’s all it takes.

About the Author

Savina Anastasaki is an MSc Clinical Psychologist, Integrative and Systemic Psychotherapist, and certified specialist in Mindful Eating and CBT for Eating Disorders. She holds a diploma in Mindfulness-Based Cognitive Therapy (MBCT) for physical disorders, is a certified NLP Master-Practitioner (INLPTA), and is trained in Timeline Therapy for phobias and anxiety. A registered member of the British Association for Counseling and Psychotherapy (BACP — No: HAC2302) and the European Federation of Interactive Counseling and Psychotherapy, Savina brings both clinical depth and genuine warmth to her work with clients facing disordered eating. With specialized training from the Kapodistrian University of Athens in anxiety disorders and depression — conditions that frequently co-occur with eating disorders — she offers a truly integrative approach. Based in Chania, Crete, she provides both in-person and online sessions for clients across Greece and Greeks living abroad. Learn more about Savina → | Book your free 20-minute session →

References

[World Health Organization]. (2024). Mental Disorders — Fact Sheet. WHO. Link

[American Psychiatric Association]. (2023). Practice Guideline for the Treatment of Patients with Eating Disorders, 4th Edition. APA. Link

[Crone, C. et al.]. (2023). The APA Practice Guideline for the Treatment of Patients With Eating Disorders. American Journal of Psychiatry, 180(2), 167–171. PubMed

[American Psychiatric Association]. (2026). What Are Eating Disorders? Psychiatry.org. Link

[National Institute of Mental Health]. (2025). Eating Disorders. NIMH. Link

[Mayo Clinic]. (2025). Eating Disorders — Symptoms and Causes. Mayo Clinic. Link