• weight loss or unusual weight changes

• periods being irregular or stopping

• missing meals, eating very little and avoiding ‘fattening’ foods

• avoiding eating in public, secret eating

• large amounts of food disappearing from the cupboards

• the person believing they are fat when in fact they are underweight

• exercising excessively, often in secret

• becoming preoccupied with food, cooking for other people, calorie counting and setting target weights

• going to the bathroom or toilet immediately after meals

• using laxatives and vomiting to control weight or sometimes using other medications/herbal remedies to lose weight.

• feeling excessively cold

• headaches and dizziness

• changes in hair and skin

• tiredness and difficulty with normal activities

• damage to health, including stunting of growth and damage to bones and internal organs

• loss of periods and risk of infertility

• anxiety and depression

• poor concentration, missing school, college or work

• lack of confidence, withdrawal from friends

• dependency or overinvolvement with parents, instead of developing independence.

• Worry or stress may lead to comfort eating. This may cause worries about getting fat.

• Dieting and missing meals leads to craving for food, loss of control and overeating.

• Anorexia or bulimia can develop as a complication of more extreme dieting, perhaps triggered by an upsetting event, such as family break-down, death or separation in the family, bullying at school or abuse.

• Sometimes, anorexia and bulimia may be a way of trying to feel in control if life feels stressful.