Eating Disorders Aren’t Always Visible: Recognising the Hidden Signs

When people think of eating disorders, they often picture dramatic physical changes or extreme behaviours. But the reality is far more complex—and far more hidden. As a therapist, I’ve sat with many individuals who appear “fine” on the outside while privately battling deep distress around food, body image, and control. Eating disorders don’t always look the way we expect them to. They can affect anyone, regardless of size, gender, age, or background.

Recognising the subtle signs—and creating a space where someone feels safe enough to talk about them—is often the first step towards healing. Here’s what I’ve learnt about the hidden nature of eating disorders, and how in-person therapy can gently help people open up and find their way forward. 

The Myth of the “Look”

One of the most damaging misconceptions about eating disorders is that they’re always visible. In truth, many people with disordered eating maintain what’s considered a “normal” weight. Some may even be praised for their appearance or discipline, while secretly struggling with overwhelming anxiety, guilt, or shame around food.

This invisibility can delay support. Loved ones may not notice anything wrong, or they may feel unsure how to raise concerns when there’s no obvious “proof” of illness. That’s why awareness matters—so we can move beyond appearances and begin to tune into the quieter signs. 

Subtle Clues That Someone May Be Struggling

Eating disorders often manifest through patterns that are easy to overlook or dismiss at first. You might notice someone:

• Becoming increasingly rigid around food choices
• Avoiding meals in social settings
• Frequently commenting on their body, weight, or “being good” or “bad” with food
• Engaging in secretive behaviours around eating
• Displaying sudden mood changes or withdrawing from activities they used to enjoy
• Exercising excessively or becoming distressed when unable to work out

Sometimes, it’s not about food at all. It’s about control, perfectionism, or managing emotional pain in a way that’s become deeply entangled with eating habits. 

The Role of Shame and Silence

One reason eating disorders often go unnoticed is the shame that surrounds them. Many people feel embarrassed or believe they don’t “deserve” help because they don’t look a certain way or don’t feel “ill enough”. Others fear being judged or misunderstood.

In face-to-face therapy, we can gently dismantle that shame. The physical presence of someone who listens without judgement—who sees you as more than your behaviours or symptoms—can be incredibly healing. It creates a space where you don’t have to explain everything with words, where silence is welcome, and where your story can unfold at your own pace. 

Why In-Person Therapy Can Be Especially Supportive

Eating disorders are deeply tied to both body and emotion. In face-to-face sessions, we can work more effectively with the embodied aspects of healing: noticing how tension shows up in the body, practising grounding techniques together, and building awareness of how emotions and physical sensations connect.

Being in the same room also allows for real-time attunement. If your voice catches, your eyes dart away, or your body curls in on itself—I notice. And I can meet you there with curiosity and compassion, helping you feel seen in ways that go beyond words. 

Reclaiming Control, Gently

For many, eating disorders are a way of feeling in control when life feels overwhelming. Therapy isn’t about taking that control away—it’s about understanding what lies beneath it. Together, we explore the fears, beliefs, and experiences that may have shaped your relationship with food and body. Over time, we begin to build a new kind of trust—one that allows for flexibility, self-compassion, and choice. 

You Don’t Have to “Prove” You’re Struggling

If you’ve ever thought, “I’m not thin enough to have an eating disorder,” or “It’s not bad enough to need help,” please know this: your pain is valid. You don’t have to wait until things get worse to reach out. The earlier you seek support, the more space there is for healing.

In Summary

Eating disorders are complex, often hidden struggles that thrive in silence. But with the right support, healing is absolutely possible. Face-to-face therapy offers a safe, compassionate space to begin that journey—a space where you can be heard, held, and gradually helped to reconnect with your body, your needs, and your sense of self.

If you or someone you care about might be struggling with an eating disorder—even if it’s not visible—please don’t hesitate to seek support. You don’t have to go through this alone.